Chest
Clinical InvestigationsRapidly Reversible Alterations of Pulmonary Epithelial Permeability Induced by Smoking
Section snippets
Materials and Methods
The scanning technique has been described in detail previously.2 While seated in front of an Anger camera, subjects inhaled an aerosol of 99mTc-DTPA diluted in 2 ml of isotonic saline solution. The aerosol was generated into a 30-L balloon 2 minutes prior to inhalation. This technique allows settling of large droplets and prevents large airway labeling. The median aerodynamic diameter of the inhaled particles is 1.8 μm (count median diameter, 0.84 m, geometric SD, 1.65). The subjects inhaled
Results
Ages, spirometric test results, and smoking histories are indicated in Table 1. The ages of the six men and four women varied from 19 to 60 years (mean 44.6 ± 15.3 SD). The cumulative smoking histories ranged from three to 57 pack-years (mean 20.7 ± 19.0), and the subjects were currently smoking between ½ to 2 packs/day (mean 1.0 ± .5). Carboxyhemoglobin levels were elevated in nine of ten subjects while smoking (Table 2). Subject 1 had a normal carboxyhemoglobin level, but stated that he had
Discussion
It is clear from both our observations and those of Jones et al,6 and Minty et al7 that smoking causes a rapidly reversible increase in clearance of hydrophilic radionuclides from the lung. There are several reasons for believing that this change is related to an increase in permeability of the airways and alveoli.
The clearance of the lower molecular weight radionuclide, 99mTcO4−, is more rapid than that of 99mTc-DTPA in both normal and abnormal lungs.2, 3 Similarly, the clearance of solutes
Acknowledgment
We would like to thank John Carmody, Paul Macias, Ken Shoaf and Jim Fain for their invaluable technical assistance, and Anna Marie M. Gastar for her excellent secretarial help in preparing this manuscript.
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Supported in part by NIH grant HL18606 and by grant RR05551 awarded by Biomedical Research Support Grant Program, Division of Research Resources, NIH.
Manuscript received June 11; revision accepted August 13.