Effect of Cigarette Smoking on Clinical and Molecular End-points in COPD Patients

Cigarette smoking is a primary contributor to mortality risks and is associated with various diseases. Among these, COPD represents a significant contributor to global mortality and disability. The objective of this study is to investigate the effect of smoking on a selected battery of variables, with an emphasis on DNA damage. Methods: A total of 87 elderly patients diagnosed with COPD, divided into three groups based on their smoking history (current, former, never-smokers), were evaluated using a cross-sectional approach. Clinical features including mortality, and inflammatory/oxidative parameters (Lymphocytes/Monocytes, Neutrophils/Lymphocytes, Platelets/Lymphocytes ratio), SII, MDA, 8-Oxo-dG, and IL6 (ELISA assay), as well as DNA damage (comet assay), were investigated. Virus infection, i.e., influenza A virus subtype H1N1, JC polyomavirus (JCPyV), BK polyomavirus (BKPyV), and Torquetenovirus (TTV), was also tested. Results: Current smokers exhibit higher levels of comorbidity (CIRS; p<0.001), Platelets/Lymphocytes ratio (p<0.001), SII (p<0.05), and DNA damage (p<0.001). Former smokers showed also higher values for parameters associated to oxidative damage, and showed a much lower probability of surviving over 5 years compared to never and current-smokers (p<0.0017). Conclusions: This study showed a clear interaction between events which are relevant to the oxidative pathway and cigarette smoking. A category of particular interest is represented by former smokers, especially for the lower survival, possibly due to the presence of more health problems. Our findings raise also the attention to other parameters which are significantly affected by smoking, useful to monitor COPD patients starting a program of pulmonary rehabilitation (DNA damage, inflammation parameters, selected viral infections)