CIGARETTE-SMOKING AND LUNG DESTRUCTION - ACCUMULATION OF NEUTROPHILS IN THE LUNGS OF CIGARETTE SMOKERS

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Abstract
Lung destruction in persons with emphysema associated with cigarette smoking may be mediated by elastase released by neutrophils that have migrated to the alveolar structures in response to cigarette smoke. To directly evaluate this hypothesis, cell suspensions, isolated from bronchoalveolar lavage fluid and from open lung biopsies of nonsmokers and cigarette smokers with normal lung parenchyma, and from open lung biopsies of nonsmokers and cigarette smokers who have sarcoidosis were evaluated for the presence of neutrophils. A significantly increased number of neutrophils was present in the cell suspensions isolated from bronchoalveolar lavage fluid and from open lung biopsies of both normal and sarcoid cigarette smokers compared with that in the nonsmokers (P < 0.01, each comparison). Evaluation of the alveolar macrophages present in lavage fluid suggested a mechanism by which neutrophils may be attracted to the lungs of cigarette smokers; alveolar macrophages of cigarette smokers release a chemotactic factor for neutrophils; alveolar macrophages of nonsmokers do not. Alveolar macrophages of nonsmokers, after exposure to cigarette smoke, in vitro, are stimulated to release this chemotactic factor. An increased number of neutrophils are present in the lungs of cigarette smokers compared with that in nonsmokers. Cigarette smoke may attract neutrophils to the lung by stimulating alveolar macrophages to release a potent chemotactic factor for neutrophils.

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