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Secondhand
Smoke exposure is associated with worsening
of lung function for persons with Cystic
Fibrosis
Newswise — Exposure to
secondhand smoke is associated with adverse
effects on lung function among persons with
cystic fibrosis, with this effect being
worse for persons with certain gene
variations, according to a study in the
January 30 issue of JAMA.
Cystic fibrosis (CF) is
a fatal disorder that affects more than
30,000 individuals in the United States,
with the major cause of illness and death
being progressive obstructive lung disease.
“Despite public health
warnings, including a recent U.S. surgeon
general’s report stating that there is no
risk-free level of secondhand smoke
exposure, substantial numbers of individuals
with CF are exposed to secondhand smoke.
Unfortunately, published studies have been
inconsistent in associating poorer clinical
outcomes in patients with CF with secondhand
smoke exposure,” the authors write.
J. Michael Collaco,
M.D., of Johns Hopkins University School of
Medicine, Baltimore, and colleagues
conducted a study examining several issues
including whether secondhand smoke exposure
is associated with worse lung disease and
other outcomes in individuals with CF, and
if the gene-environment interactions between
the CF-causing gene (CFTR) or the
transforming growth factor β1 (TGFβ1) gene
influence the effect of secondhand smoke
exposure on lung function.
The researchers
analyzed data from the U.S. Cystic Fibrosis
Twin and Sibling Study, with missing data
supplemented by the Cystic Fibrosis
Foundation Data Registry. Of the 812
participants with data concerning secondhand
smoke exposure in the home, 188 (23.2
percent) were exposed. Of the 780
participants with data showing their
mother’s smoked during pregnancy, 129 (16.5
percent) were exposed.
The researchers found
that secondhand smoke exposure was
associated with decreased lung function for
all measures of lung function studied.
Also, socioeconomic
status did not worsen the relationship
between secondhand smoke exposure and
reduced lung function.
They also found that
certain mutations in the CFTR gene
determines the magnitude of the effect of
secondhand smoke exposure on lung function
in patients with CF.
“… CF may be a good
model for uncovering gene-environment
interactions that are detrimental to lung
function. This study also raises the specter
that healthy children bearing certain
genetic variants may be at much higher risk
for worse outcomes as a result of secondhand
smoke exposure. Demonstration that
genetically defined subsets of patients with
CF exposed to secondhand smoke in the home
have a substantial lifetime reduction in
lung function provides potent justification
for eradication of cigarette smoke exposure
for all individuals with this life-limiting
disorder,” the authors conclude.
