Inhaled corticosteroids (ICS) and long-acting β-agonists (LABA) are frequently used in patients with chronic obstructive pulmonary disease (COPD). Combination treatment with ICS/LABA improves lung function and quality of life, and reduces exacerbation frequency compared to treatment with either ICS or LABA alone. Although it is presumed that continued cigarette smoking impairs acute responses to these medications in patients with COPD, there is little direct evidence to support this view. Studies of ICS use in asthma have shown less short-term improvement in lung function and reduced anti-inflammatory effects in active smokers compared to non-smokers [1, 2]. Although similar effects are plausible in COPD, they have not been definitively demonstrated. We hypothesised that former smokers with COPD would have greater short- and long-term changes in lung function, respiratory-related quality of life, and exacerbation risk, in response to ICS than continuing and intermittent smokers. Current smokers have a blunted FEV1 response and exacerbation reduction with inhaled corticosteroids http://ow.ly/PBIW30hcISK

中文翻译：

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吸烟和 COPD 患者吸入皮质类固醇的反应

吸入性皮质类固醇 (ICS) 和长效 β-激动剂 (LABA) 常用于慢性阻塞性肺疾病 (COPD) 患者。与单独使用 ICS 或 LABA 相比，ICS/LABA 联合治疗可改善肺功能和生活质量，并降低恶化频率。虽然推测持续吸烟会损害 COPD 患者对这些药物的急性反应，但几乎没有直接证据支持这一观点。ICS 用于哮喘的研究表明，与非吸烟者相比，吸烟者的肺功能短期改善较少，抗炎作用减弱 [1, 2]。虽然类似的效果在 COPD 中似乎是合理的，但尚未得到明确证实。我们假设，与持续和间歇性吸烟者相比，患有 COPD 的前吸烟者对 ICS 的反应在肺功能、呼吸相关生活质量和恶化风险方面的短期和长期变化更大。当前吸烟者对吸入皮质类固醇的 FEV1 反应迟钝和恶化减少 http://ow.ly/PBIW30hcISK