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Tobacco Smoke Exposure and Altered Nasal Responses to Live Attenuated Influenza Virus
Noah, T., H. Zhou, J. Monaco, K. Horvath, M. Herbst, AND I. JASPERS. Tobacco Smoke Exposure and Altered Nasal Responses to Live Attenuated Influenza Virus. ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, 119(1):78-83, (2011).
These data suggest mechanisms for increased susceptibility to influenza infection among persons exposed to tobacco smoke.
Background: Epidemiologic evidence links tobacco smoke and increased risk for influenza in humans, but the specific host defense pathways involved are unclear. Objective. Develop a model to examine influenza-induced innate immune responses in humans and test the hypothesis that cigarette smoke exposure alters nasal inflammatory and antiviral responses to live attenuated influenza virus (LAIV). Methods. This was an observational cohort study comparing nasal mucosal responses to LAIV among young adult active smokers, nonsmokers exposed to secondhand smoke (SHS), and unexposed controls. Virus RNA and inflammatory factors were measured in nasal lavage fluids (NLF) serially after LAIV inoculation. For key endpoints, peak and total (area under curve) responses were compared among groups. Results. NLF IL-6 responses to LAIV (peak and total) were suppressed in smokers. Virus RNA in NLF cells was significantly increased in smokers, as were IP-I0/virus ratios. Responses in SHS exposed subjects were generally intermediate between controls and smokers. There were significant associations between urine cotinine and NLF IL-6 responses (negative correlation) or virus RNA in NLF cells (positive correlation) for all groups combined. Conclusions. Nasal inoculation with LAIV results in measurable inflammatory and antiviral responses in human volunteers, thus providing a model for investigating environmental effects on influenza infections in humans. Exposure to cigarette smoke is associated with suppression of specific nasal inflammatory and antiviral responses, as well as increased virus quantity, after nasal inoculation with LAIV. These data suggest mechanisms for increased susceptibility to influenza infection among persons exposed to tobacco smoke.