Investigation finds that cigarette smoking does not affect everyone in same way
MUHC leads international review published in The New England Journal of Medicine
Cigarette smoking induced COPD, or chronic obstructive pulmonary
disease, is a disease that results in severe breathing difficulty.
According to World Health Organization (WHO) it is the fourth
leading killer worldwide. However the mechanisms responsible for
some smokers developing COPD and others evading the disease have
not been well understood.
from the Ï㽶ÊÓƵ Health Centre, in
collaboration with Italian and Spanish scientists, reports in The
New England Journal of Medicine that an autoimmune mechanism,
compounded by genetic predisposition in COPD, would explain the
progression of the disease in some smokers and the evasion in
others. COPD has a family connection and next of kin of patients
with COPD have a much higher chance of developing the disease, a
characteristic of autoimmune diseases.
Although smoking is the primary risk factor for COPD in the western
world, open fire pollutant cooking and heating fuels in the home is
an important risk factor for the development of COPD in women in
developing nations. "Smoke can play an important role in autoimmune
diseases such as COPD, and other diseases like rheumatoid
arthritis, because it accentuates genetic predispositions to the
disease," warns Dr. Cosio.
Yet contrary to previous scientific beliefs, COPD does not progress
in the same way in all smokers. The authors describe three steps in
the potential progression to COPD in smokers: "COPD does not go
from stage one, two and three in all people," Dr. Cosio says.
"Depending on their personal balance between immune response and
immune control some people would stop at stage one, others at stage
two, and some will progress to stage three, full autoimmunity and
lung destruction."
"Hopefully investigators will now see the disease in a totally
different way," Dr Cosio stresses. "Our hope is that our research
will open the door for a different investigation on COPD, where
scientists learn more about the immunological processes and how
these processes could be controlled and modulated to eventually
provide the right treatment."
Dr Manuel Cosio is Professor of respiratory medicine at the McGill
University Health Centre (MUHC) and an investigator in "Respiratory
health" at the Meakins Christie laboratories of the Research
institute of the MUHC.
Funding
This study was supported by the Lloyd-Carr Harris Foundation, the
Italian Ministry of University and Research and CIBERES (Centro de
investigación biomédica en red sobre enfermedades
respiratorias).
Partners
This article was authored by Dr.Manuel G. Cosio of the McGill
University Health Centre (Canada), Dr.Marina Saetta of the
University of Padua, (Italy) and Dr.Alvar Agusti of the Hospital
Universitario Son Dureta, (Spain).
The Research Institute of the Ï㽶ÊÓƵ Health
Centre (RI MUHC) is a world-renowned biomedical and
health-care hospital research centre. Located in Montreal, Quebec,
the institute is the research arm of the MUHC, the university
health center affiliated with the Faculty of Medicine at McGill
University. The institute supports over 600 researchers, nearly
1200 graduate and post-doctoral students and operates more than 300
laboratories devoted to a broad spectrum of fundamental and
clinical research. The Research Institute operates at the forefront
of knowledge, innovation and technology and is inextricably linked
to the clinical programs of the MUHC, ensuring that patients
benefit directly from the latest research-based knowledge.
The Research Institute of the MUHC is supported in part by the
Fonds de la recherche en santé du Québec.
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