Histopathological changes of the nasal mucosa induced by smoking

Abstract

Changes in the histopathology of the respiratory epithelium in response to cigarette smoking have been studied in depth in the lungs, but data on the nasal lining are lacking. The aim of the present retrospective study was to investigate the histological changes that occur in the nasal mucosa of smokers compared with non-smokers. The study group included 47 patients who underwent partial resection of the inferior turbinates. Archival nasal tissue samples were collected and examined by light microscopy: the number of goblet cells was counted, and the degree of inflammation, congestion, and edema was graded as mild, moderate, or severe. Epithelial thickness was measured as well. Findings were compared between smokers (n = 21) and non-smokers (n = 26). On statistical analysis, significant differences were found between the smokers and non-smokers in mean number of goblet cells in the nasal epithelium, 43.43 +/- 16.80 vs. 16.23 +/- 5.65 respectively (p < 0.0001), mean edema grade, 2.43 +/- 0.75 vs. 1.12 +/- 0.33 respectively (p < 0.0001), and mean epithelial thickness, 111.9 +/- 25.8 microm vs. 60.4 +/- 18.4 microm respectively (p < 0.0001). The corresponding mean values of congestion were 2 +/- 0.71 and 1.27 +/- 0.67 (p < 0.001), and of inflammation, 1.81 +/- 0.60 and 1.81 +/- 0.85 (NS). In conclusion, the histopathological findings in the nasal mucosa of smokers resemble reported findings in the bronchial respiratory epithelium. The main differences from non-smokers are greater goblet cell hyperplasia and thicker epithelium.

Smoker's nose: Structural and functional characteristics

“…It is widely accepted that cigarette smoking causes molecular injury throughout the airway epithelium with chronic inflammation as a common feature 2. In the nasal airway, smoking has been associated with inflammation, cellular hyperplasia, mucosal edema, and impaired ciliary function 3, 11, 12. Our study extends present knowledge by indicating a causal link between smoking and reduced nasal cavity dimensions and air flow, and impaired mucosal compliance.…”

DNA methylation in nasal epithelial cells from smokers: identification of ULBP3-related effects

“…Similar to the NECs studied here, it is likely that host defense responses in lower airway epithelial cells are modulated by epigenetic effects. The nasal epithelium resembles the airway epithelium morphologically, and smoking-related gene expression as well as histological changes, such as mucus production, are similar in nasal and airway epithelial cells (13,19,36). In airway diseases such as asthma, previous studies have demonstrated that DNA methylation changes in NECs from asthmatic children were associated with disease parameters in this population (1), suggesting that epigenetic modification in NECs can reflect changes in the lower airways.…”

Distinct histopathologic features of radiation‐induced chronic sinusitis

“…Hadar et al explored histopathology changes in nasal mucosa of smokers and asserted that chronic toxic injury promotes metaplasia of epithelial cells, goblet cell hyperplasia, and edematous mucus secretion. Hadar et al further asserted that these changes are associated with cytokines interleukin (IL)‐4, IL‐13, and growth factors . Over time, it is conceivable that radiation therapy to the nasopharynx results in radiation‐induced impairment of epithelial proliferation and cell production, leading to hypoplasia and ultimate mucosal ulceration …”