pulmonary diseases that are less common among smokers than nonsmokers
- related: Pulmonology
- tags: #literature #pulmonary
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- Pulmonology
- mesothelioma
- HP hypersensitivity pneumonitis is divided into fibrotic and nonfibrotic types
- Although the vast majority of lung diseases are exacerbated by cigarette smoke exposure, results from several studies suggest that smoking may confer a benefit that reduces the risk of developing HP, as well as sarcoidosis (pulmonary diseases that are less common among smokers than nonsmokers). The mechanisms behind this benefit are not well understood, but investigators in many studies have reported a decreased prevalence of precipitating antibodies in smokers exposed to avian or mold antigens.
Tobacco smoke modulates inflammatory and immune mechanisms, amplifying some and suppressing others. Epidemiologic evidence indicates that smoking increases the risk, severity, and rate of exacerbations of rheumatoid arthritis, systemic lupus erythematosus, and Graves' disease (choice B is correct). However, some disorders are less common in smokers than in nonsmokers. A large case-control study of the etiology and sarcoidosis showed a negative association between a history of tobacco smoking and sarcoidosis, while exposure to insecticides, agricultural employment, and microbial aerosols were associated with an increased risk of developing the disease (choice C is incorrect). Other studies show that ulcerative colitis, hypersensitivity pneumonitis, chronic beryllium disease, and Parkinson disease are less common among current and former smokers than nonsmokers (choices C and D are incorrect). Biologic mechanisms for the apparent protective effects of cigarette smoking on the development of these disorders must be better clarified to convincingly exclude the possibility that alternative, noncausal explanations may account for these inverse associations.
Cigarette smoking does not increase risk for mesothelioma.1