Cigarette Smoke Exposure Alters Bacterial-Host Interactions in the Respiratory Tract to Promote Disease
Pamela Shen 1, Martin R. Stämpfli 2
1 Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada and Department of Microbiology, New York University, New York, NY, USA; 2 Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre, and Department of Medicine, Firestone Institute for Respiratory Health at St. Joseph´s Healthcare, McMaster University, Hamilton, Ontario, Canada
*Correspondence: Martin R. Stämpfli, Email not available
Abstract
Epidemiological studies clearly show an increased incidence of respiratory infections and community-acquired pneumonia (CAP) in smokers. Cigarette smoking is also a significant risk factor for invasive pneumococcal diseases (IPDs), leading to meningitis and sepsis. Moreover, the natural course of chronic obstructive pulmonary disease, a spectrum of lung disorders found predominantly in smokers, is punctuated by periods of disease exacerbation caused most frequently by microbial infections. Overall, these infectious episodes contribute to decreased quality of life and mortality, and place a large burden on healthcare systems. In this article, we review how cigarette smoke affects bacterial-host interactions in the upper and lower respiratory tract. We show that smoking affects multiple facets of bacterial-host interactions and postulate that these changes predispose to infection, as smokers fail to control colonizing bacteria in the upper respiratory tract (URT). Hence, we propose that targeting nasal bacterial colonization offers a novel therapeutic avenue to prevent subsequent disease pathogenesis.
