Peripheral blood leukocyte count and respiratory symptoms

Assessment of asthma and chronic obstructive pulmonary disorder in relation to reversibility, IgE, eosinophil, and neutrophil count in a University Teaching Hospital in South Delhi, India

Objectives:

The physiological and clinical similarities between asthma and chronic obstructive pulmonary disorder (COPD) make their differentiation difficult. In the present study, we compared reversibility to bronchodilator, immunoglobulin E (IgE), blood eosinophil and neutrophil levels among asthma and COPD patients to differentiate these diseases.

Materials and Methods:

The study was carried on 20 asthmatics and 29 patients of COPD that reported to the outpatient and inpatient department in University Teaching Hospital, Jamia Hamdard, New Delhi, India. The parameters evaluated included pulmonary function (FEV₁, FVC, and FEV₁/FVC), IgE levels, and eosinophil and neutrophil count.

Results:

It was observed that reversibility was significantly higher in asthmatic patients, while irreversibility predominates in COPD patients. There was no significant difference in pre- and post-FEV₁ and pre- and post-FVC and in their percentage predicted. However the percentage change in FEV₁ significantly varies in asthma and COPD patients. No significant changes in neutrophil and eosinophil levels were observed in these patients. The serum IgE levels were found significantly higher in asthmatic patients.

Conclusions:

We conclude that reversibility in FEV₁ levels or percentage change in FEV₁ and serum IgE levels are promising lab parameter to distinguish these two conditions. However, further research is required to fully understand the role of neutrophil and eosinophil in the onset and development of asthma and COPD.

Exposure level to cigarette tar or nicotine is associated with leukocyte DNA damage in male Japanese smokers

We investigated the number of cigarettes smoked daily, years of smoking, cigarette pack-years, levels of daily exposure to cigarette tar (LECT, mg/day) or nicotine (LECN, mg/day) in 53 male Japanese smokers using a questionnaire and measured each participant's baseline leukocyte DNA damage using the alkaline comet assay. The results showed that the baseline value of peripheral leukocyte DNA strand breaks was significantly associated with LECT (P < 0.05), LECN (P < 0.05), years of smoking or cigarette pack-years (P < 0.05) but not with the number of cigarettes smoked per day. Stepwise multiple regression analyses of factors including age, occupation, years of employment, alcohol drinking behaviour, physical activity, nutritional balance and cigarette smoking parameters showed that LECT was a positively significant predictor (Partial r = 0.0005, P < 0.05) of the comet tail moment. In consideration of the high correlation between LECT and LECN (Y(tar) = 12.53 X(nicotine) -7.23, r = 0.995, P < 0.0001), these results suggest that levels of exposure to cigarette tar or nicotine (mg/day) would be a sensitive parameter in appreciation of genotoxicity of cigarette smoking in these male Japanese smokers.

The effect of smoking, smoking cessation, and passive smoke exposure on common laboratory values in clinical settings: a review of the evidence

Evidence now supports that active and passive cigarette smoke exposure increase the risk for disease manifestations and adverse outcomes for patients in acute and critical care settings. By understanding the effect of active and passive smoke exposure on common laboratory tests, nurses in acute and critical care settings can plan essential components of care more accurately. This article addresses the effects of active and passive smoking and cessation on common parameters of hematology, hemostasis, immunology and inflammation, and chemistry laboratory tests.

Gas cooking, respiratory health and white blood cell counts in children

The use of gas stoves has been associated with respiratory symptoms of chronic airway inflammation and higher rates of respiratory infections. We used data from a 1992/93 survey of 2,198 East German school children (aged 5 to 14) to assess whether gas cooking increases respiratory symptoms and is associated with a chronic inflammatory process reflected by an increase in white blood cell (WBC) count in children who do not exhibit signs of an acute respiratory infection. We found increases for the respiratory symptoms 'cough without cold' [odds ratio (OR) = 1.68; 95% confidence interval (CI), 1.18-2.39], 'cough in the morning' (OR = 1.58; CI, 1.23-2.04) and 'cough during the day or at night' (OR = 1.42; CI, 1.13-1.78) in children living in homes with gas ranges, but lifetime prevalence of asthma, bronchitis, wheeze, and the prevalence of acute infections were not affected. Furthermore, we examined WBC levels in a subgroup of 1,134 children for whom blood samples were available and who did not suffer from an acute infection. We observed small increases in the risk of having WBC counts above the 75th or 90th percentile (8300 or 9800 cell counts per microliter) when children were exposed to gas cooking after adjustment for age, gender, and passive smoking (OR = 1.30; CI, 0.98-1.73, and OR = 1.38; CI, 0.91-2.10). The strongest effect estimates for chronic inflammation were found for those children likely to have been exposed at higher levels, that is when stoves had no fans, in smaller homes, and for children spending more time indoors.

Prospective study on the effect of smoking and nicotine substitution on leucocyte blood counts and relation between blood leucocytes and lung function

BACKGROUND

The influence of smoking and of nicotine substitution on the counts of total blood leucocytes and leucocyte subsets and the relations between the counts and lung function was investigated.

METHODS

The study was a combined cross sectional and prospective study of 298 smokers and 136 non-smokers. Forced expiratory volume in one second (FEV1) was measured in all participants at baseline and six months after quitting smoking in 160 ex-smokers (quitters) and 138 persons with smoking relapse. Blood samples were obtained from all participants at baseline and from 160 quitters and 30 continuing smokers two, six, 12, and 26 weeks after smoking cessation and from 92 quitters one year after the cessation of smoking.

RESULTS

Blood leucocyte counts and leucocyte subsets were all higher in smokers than in non-smokers. In cigarette smokers total leucocyte, neutrophil, and lymphocyte blood counts showed a dose dependent relationship with the daily cigarette consumption and pack years consumption. In smokers the neutrophil blood count was independently associated negatively with FEV1 residuals. After quitting smoking total leucocyte, neutrophil, and lymphocyte blood counts decreased during the first 26 weeks and after one year lymphocyte blood counts were higher than in non-smokers. In quitters substituted with nicotine chewing gum (2 mg) the accumulated number of pieces of chewing gum used in the 12 weeks had an inverse relationship with the decrease in the total lymphocyte blood count at 12 weeks after smoking cessation.

CONCLUSIONS

Leucocyte blood counts are raised in smokers and decrease after smoking cessation. Neutrophil blood counts had an inverse relationship with lung function and nicotine may increase lymphocyte blood counts in smokers.

Prediction of respiratory symptoms by peripheral blood neutrophils and eosinophils in the First National Nutrition Examination Survey (NHANES I)

To examine specific cellular markers of inflammation in peripheral blood (neutrophils and eosinophils) and their relationship to respiratory symptoms, we used data from the First National Health and Nutrition Examination Survey (NHANES I). Cross-sectional data were available on a random sample of 6,913 adults aged 30 to 74 years who had American Thoracic Society-National Heart, Lung, and Blood Institute questionnaire information on respiratory symptoms and illnesses, including asthma, chronic bronchitis, dyspnea (grade 3), chronic cough, and chronic phlegm. Information was available on age, race, smoking status, peripheral blood leukocyte count, and differential cell count. These data were analyzed using logistic regression controlling for age, race, sex, and cigarette smoking. Physician-diagnosed asthma was significantly associated only with the eosinophil count (p = 0.001). Physician-diagnosed bronchitis was significantly associated with the neutrophil count (p = 0.012) and marginally associated with the eosinophil count (p = 0.072). Chronic phlegm was also significantly associated with both the eosinophil count (p = 0.049) and the neutrophil count (p = 0.041). Grade 3 dyspnea (p = 0.049) was only significantly associated with the neutrophil count. These data suggest that both peripheral blood neutrophils and eosinophils are associated with a broad range of respiratory symptoms and that the eosinophil may play a role in nonasthmatic respiratory inflammation.