Smoking Flashcards
How much of the general population smokes?
About 20%
What are the biologically active components of cigarette smoke?
Nicotine, carbon monoxide, acetaldehyde, arsenic, aromatic hydrocarbons, radioactive components, and trace metals.
How much does smoking 1-4 cigarettes per day increase cardiovascular disease?
3x the normal risk of ischemic disease
How much does smoking 3-5 cigarettes per day increase cardiovascular disease?
2x the normal risk of myocardial infarction
What risk factors does smoking increase?
Heart disease, aneurysms, lung and esophageal cancer, increased joint injury, and decreased fertility and higher risk of birth defects.
What is the mechanism behind smoking increasing the risk of TB?
Smoking inhibits the cytokine response of the respiratory system and inhibits the containment of the mycobacterium.
What general pulmonary effects does smoking have?
Transient bronchoconstriction, prolonged infections, and chronic lung disease (80% of COPD caused by smoking)
By which specific mechanisms does smoking cause damage?
Ciliary impairment, mucus gland hyperplasia (excessive number of mucus glands), increase in goblet cells (also hyperplasia leading to excess mucus), airway thickening due to reduced apoptosis, and a reduced immune response.
What physical changes do we see in the lungs due to smoking?
Small airway remodeling, thickened walls due to cell proliferation and hyperplasia, cilia impairment, increased mucus production and mucus cell hyperplasia
What immunological changes do we see from smoking?
Reduced immune response but increased number of neutrophils, macrophages, lymphocytes
What cellular components contribute to airway remodelling?
The increase in fibrin production leads to peribronchial fibrosis and increased vascular endothelial growth factor (VEGF) partially leads to restriction
What are Clara cells and why are they important?
Clara cells are secretory cells that produce surfactant and other proteins that make up the epithelial lining fluid. They secrete cytochrome P450 which metabolizes toxins, so the loss of this means loss of detoxification ability. Reduced Clara cells also deteriorates the ability too regenerate bronchiolar epithelium and damaged Clara cells give rise to adenocarcinoma.
What changes can we see in the lower airways from smoking?
Proteolysis of supporting structures, apoptosis of alveoli, inhibition of normal repair mechanisms.
What part of the artery does nicotine damage the most?
The intima (all the layers between the lumen and the smooth muscle)
How does carbon monoxide damage blood vessels?
It causes vasoconstriction so repeated exposure can cause an increase in smooth muscle, narrowing the vessels.
