Evidence of Chronic Damage to the Pulmonary Microcirculation in Habitual Users of Alkaloidal (“Crack”) Cocaine

Baldwin, Gayle Cocita; Choi, Rachel; Roth, Michael D.; Shay, Angela Hanchi; Kleerup, Eric C.; Simmons, Michael; Tashkin, Donald P.

doi:10.1378/chest.121.4.1231

Cited by 57 publications

(32 citation statements)

References 36 publications

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“…However, 3 of 10 CS admitted to limited tobacco smoking. Cell pellets recovered from these subjects were routinely 185% AMs, with !2% neutrophils, as was reported in a related study [7].…”

supporting

confidence: 86%

Impairment of Antimicrobial Activity and Nitric Oxide Production in Alveolar Macrophages from Smokers of Marijuana and Cocaine

et al. 2003

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. These results confirm that NO plays a significant role as an effector molecule used by normal human AMs, but this capacity is suppressed in AMs from MS and CS because of a lack of intrinsic cytokine priming.Nitric oxide (NO) acts as an important effector molecule in activated rodent macrophages, and its inhibition reduces macrophage responses against fungi, bacteria, parasites, and tumor cells [1]. In addition to this role in innate immunity, NO functions as an important signaling and regulatory molecule in

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“…However, 3 of 10 CS admitted to limited tobacco smoking. Cell pellets recovered from these subjects were routinely 185% AMs, with !2% neutrophils, as was reported in a related study [7].…”

supporting

confidence: 86%

Impairment of Antimicrobial Activity and Nitric Oxide Production in Alveolar Macrophages from Smokers of Marijuana and Cocaine

et al. 2003

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“…In this study, the current authors found a nonsignificant predominance of tobacco smokers in PVOD patients. It has been speculated that a toxic exposure could be responsible for occult alveolar haemorrhage and impaired function of alveolar macrophages: increased percentages of haemosiderin-laden alveolar macrophages were found in BAL fluid of cocaine smokers [31] and an impairment in nitric oxide production was observed in alveolar macrophages from smokers of marijuana and cocaine [32,33]. This chronic damage of the alveoli and of pulmonary microcirculation is not clear as far as tobacco exposure is concerned [31].…”

Section: Discussionmentioning

confidence: 99%

Occult alveolar haemorrhage in pulmonary veno-occlusive disease

Rabiller¹

2006

European Respiratory Journal

131

111

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Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary arterial hypertension that affects predominantly post-capillary pulmonary vessels. A major concern with PVOD is the poor response to available therapies and the risk of pulmonary oedema with continuous intravenous epoprostenol.The present authors hypothesised that alveolar haemorrhage may be a characteristic feature of pulmonary veno-occlusive disease, as compared with other forms of pulmonary arterial hypertension that predominantly involve pre-capillary pulmonary arteries.This paper reports a series of 19 patients with either PVOD (n58) or idiopathic pulmonary arterial hypertension (IPAH; n511) who underwent bronchoalveolar lavage. Cytological analyses were performed and differential counts were made on Perls-stained preparations. The Golde score was used to assess alveolar haemorrhage. As compared with IPAH, PVOD was characterised by a higher percentage of haemosiderin-laden macrophages (40¡37 versus 3¡6%), resulting in elevated Golde scores (81¡88 versus 4¡10).It was concluded that occult alveolar haemorrhage is a common feature of pulmonary venoocclusive disease. Detecting occult alveolar haemorrhage may be of interest in the diagnostic approach of pulmonary veno-occlusive disease.

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“…3 Under physiologic conditions, the lung interstitium and pleural space behave as functionally independent compartments. [5][6][7] However, because of chronic damage to the pulmonary microcirculation in crack smokers, 8 it is conceivable for carbon-laden macrophages in their damaged lungs to shift into the pleura. It is unclear if a similar mechanism applies to our elderly HIV-negative patient.…”

Section: Discussionmentioning

confidence: 99%