{"id":{"repo_id":"soton","oai_identifier":"oai:eprints.soton.ac.uk:161441"},"canonical_url":"https://search.dev.ndltd.org/etd/soton/oai:eprints.soton.ac.uk:161441","repository":{"repo_id":"soton","name":"University of Southampton","base_url":"https://eprints.soton.ac.uk/cgi/oai2"},"display":{"title":"The effect of smoking on the severity, and mechanisms of acute exacerbations of chronic obstructive pulmonary disease (COPD)","abstract":"COPD (Chronic Obstructive Pulmonary Disease) worldwide has a prevalence of<br/>10% in men and 8.5% in women. Exacerbations of COPD account for<br/>approximately 10% of all acute medical admissions. Projected prevalence<br/>figures suggest that by 2020 COPD will be the third leading cause of mortality<br/>worldwide thus imposing a significant burden on healthcare resources in the<br/>future. Acute exacerbations are not only responsible for a decline in the<br/>patient’s quality of life, but have a major socioeconomic impact. Following a<br/>pilot study that showed current smokers recover lung function much more<br/>slowly from their exacerbation than ex smokers, I initiated a properly powered<br/>prospective study to investigate the difference between the two groups.<br/>A total of 58 patients admitted with acute infectious exacerbations of COPD<br/>were recruited to the study to determine the effect of smoking status on their<br/>exacerbation. Throughout the admission lung function was measured. Sputum<br/>was cultured for bacteria, and PCR used to detect viral infection. Blood and<br/>sputum cells were analyzed by flow cytometry. Serum was collected for CRP<br/>levels.<br/><br/>Ex-smokers recovered significantly more quickly than current smokers in all<br/>spirometric parameters (P&lt;0.01), and were discharged sooner (mean 3.08 vs<br/>5.59 days, P&lt;0.001). Sputum culture was positive for more pathogenic bacteria<br/>in current smokers, especially H. influenzae, which was associated with a<br/>significantly higher CRP rise (p&lt;0.05) than any other organism. CD8+ T cells<br/>predominated in the sputum of ex-smokers while CD4+ T cells were the<br/>dominant cell type in current smokers (p&lt;0.01).<br/>Current smoking is a risk factor for more severe exacerbations, delayed<br/>recovery and prolonged hospitalization. This may result from a variety of factors<br/>including bacterial, immune mediated responses and systemic inflammation.","abstract_html":"COPD (Chronic Obstructive Pulmonary Disease) worldwide has a prevalence of&lt;br/&gt;10% in men and 8.5% in women. Exacerbations of COPD account for&lt;br/&gt;approximately 10% of all acute medical admissions. Projected prevalence&lt;br/&gt;figures suggest that by 2020 COPD will be the third leading cause of mortality&lt;br/&gt;worldwide thus imposing a significant burden on healthcare resources in the&lt;br/&gt;future. Acute exacerbations are not only responsible for a decline in the&lt;br/&gt;patient’s quality of life, but have a major socioeconomic impact. Following a&lt;br/&gt;pilot study that showed current smokers recover lung function much more&lt;br/&gt;slowly from their exacerbation than ex smokers, I initiated a properly powered&lt;br/&gt;prospective study to investigate the difference between the two groups.&lt;br/&gt;A total of 58 patients admitted with acute infectious exacerbations of COPD&lt;br/&gt;were recruited to the study to determine the effect of smoking status on their&lt;br/&gt;exacerbation. Throughout the admission lung function was measured. Sputum&lt;br/&gt;was cultured for bacteria, and PCR used to detect viral infection. Blood and&lt;br/&gt;sputum cells were analyzed by flow cytometry. Serum was collected for CRP&lt;br/&gt;levels.&lt;br/&gt;&lt;br/&gt;Ex-smokers recovered significantly more quickly than current smokers in all&lt;br/&gt;spirometric parameters (P&amp;lt;0.01), and were discharged sooner (mean 3.08 vs&lt;br/&gt;5.59 days, P&amp;lt;0.001). Sputum culture was positive for more pathogenic bacteria&lt;br/&gt;in current smokers, especially H. influenzae, which was associated with a&lt;br/&gt;significantly higher CRP rise (p&amp;lt;0.05) than any other organism. CD8+ T cells&lt;br/&gt;predominated in the sputum of ex-smokers while CD4+ T cells were the&lt;br/&gt;dominant cell type in current smokers (p&amp;lt;0.01).&lt;br/&gt;Current smoking is a risk factor for more severe exacerbations, delayed&lt;br/&gt;recovery and prolonged hospitalization. This may result from a variety of factors&lt;br/&gt;including bacterial, immune mediated responses and systemic inflammation.","abstract_has_math":false,"creators":["Bourne, Simon Charles"],"institution":"University of Southampton","degree_name":"Ph.D.","degree_level":"doctoral","degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Djukanovic, Ratko","Marshall, Ben"],"committee_chairs":[],"committee_members":[],"year":2008,"date_issued":"2008-10","date_published":"2008-10","updated_at":"2026-07-24T04:36:17Z","subjects":[],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":null,"outbound_label":null,"outbound_source":null},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Djukanovic, Ratko","Marshall, Ben"]},{"key":"dc:creator","label":"Author","values":["Bourne, Simon Charles"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2008-10"]},{"key":"dc:date.issued","label":"Date","values":["2008-10"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Infection Inflammation & Immunity (pre 2011 reorg)"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Southampton"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["https://eprints.soton.ac.uk/161441/"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["doctoral"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["Ph.D."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://eprints.soton.ac.uk/161441/1/The_effect_of_smoking_on_the_severity_2C_and_mechanisms_of_acu.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["COPD (Chronic Obstructive Pulmonary Disease) worldwide has a prevalence of<br/>10% in men and 8.5% in women. Exacerbations of COPD account for<br/>approximately 10% of all acute medical admissions. Projected prevalence<br/>figures suggest that by 2020 COPD will be the third leading cause of mortality<br/>worldwide thus imposing a significant burden on healthcare resources in the<br/>future. Acute exacerbations are not only responsible for a decline in the<br/>patient’s quality of life, but have a major socioeconomic impact. Following a<br/>pilot study that showed current smokers recover lung function much more<br/>slowly from their exacerbation than ex smokers, I initiated a properly powered<br/>prospective study to investigate the difference between the two groups.<br/>A total of 58 patients admitted with acute infectious exacerbations of COPD<br/>were recruited to the study to determine the effect of smoking status on their<br/>exacerbation. Throughout the admission lung function was measured. Sputum<br/>was cultured for bacteria, and PCR used to detect viral infection. Blood and<br/>sputum cells were analyzed by flow cytometry. Serum was collected for CRP<br/>levels.<br/><br/>Ex-smokers recovered significantly more quickly than current smokers in all<br/>spirometric parameters (P&lt;0.01), and were discharged sooner (mean 3.08 vs<br/>5.59 days, P&lt;0.001). Sputum culture was positive for more pathogenic bacteria<br/>in current smokers, especially H. influenzae, which was associated with a<br/>significantly higher CRP rise (p&lt;0.05) than any other organism. CD8+ T cells<br/>predominated in the sputum of ex-smokers while CD4+ T cells were the<br/>dominant cell type in current smokers (p&lt;0.01).<br/>Current smoking is a risk factor for more severe exacerbations, delayed<br/>recovery and prolonged hospitalization. This may result from a variety of factors<br/>including bacterial, immune mediated responses and systemic inflammation."]},{"key":"dc:format","label":"Dc Format","values":["text"]},{"key":"dc:title","label":"Title","values":["The effect of smoking on the severity, and mechanisms of acute exacerbations of chronic obstructive pulmonary disease (COPD)"]}]}],"canonical_facts":{"dc:contributor.advisor":["Djukanovic, Ratko","Marshall, Ben"],"dc:creator":["Bourne, Simon Charles"],"dc:date":["2008-10"],"dc:date.issued":["2008-10"],"dc:description.abstract":["COPD (Chronic Obstructive Pulmonary Disease) worldwide has a prevalence of<br/>10% in men and 8.5% in women. Exacerbations of COPD account for<br/>approximately 10% of all acute medical admissions. Projected prevalence<br/>figures suggest that by 2020 COPD will be the third leading cause of mortality<br/>worldwide thus imposing a significant burden on healthcare resources in the<br/>future. Acute exacerbations are not only responsible for a decline in the<br/>patient’s quality of life, but have a major socioeconomic impact. Following a<br/>pilot study that showed current smokers recover lung function much more<br/>slowly from their exacerbation than ex smokers, I initiated a properly powered<br/>prospective study to investigate the difference between the two groups.<br/>A total of 58 patients admitted with acute infectious exacerbations of COPD<br/>were recruited to the study to determine the effect of smoking status on their<br/>exacerbation. Throughout the admission lung function was measured. Sputum<br/>was cultured for bacteria, and PCR used to detect viral infection. Blood and<br/>sputum cells were analyzed by flow cytometry. Serum was collected for CRP<br/>levels.<br/><br/>Ex-smokers recovered significantly more quickly than current smokers in all<br/>spirometric parameters (P&lt;0.01), and were discharged sooner (mean 3.08 vs<br/>5.59 days, P&lt;0.001). Sputum culture was positive for more pathogenic bacteria<br/>in current smokers, especially H. influenzae, which was associated with a<br/>significantly higher CRP rise (p&lt;0.05) than any other organism. CD8+ T cells<br/>predominated in the sputum of ex-smokers while CD4+ T cells were the<br/>dominant cell type in current smokers (p&lt;0.01).<br/>Current smoking is a risk factor for more severe exacerbations, delayed<br/>recovery and prolonged hospitalization. This may result from a variety of factors<br/>including bacterial, immune mediated responses and systemic inflammation."],"dc:format":["text"],"dc:identifier.uri":["https://eprints.soton.ac.uk/161441/1/The_effect_of_smoking_on_the_severity_2C_and_mechanisms_of_acu.pdf"],"dc:publisher.department":["Infection Inflammation & Immunity (pre 2011 reorg)"],"dc:publisher.institution":["University of Southampton"],"dc:relation.isreferencedby":["https://eprints.soton.ac.uk/161441/"],"dc:title":["The effect of smoking on the severity, and mechanisms of acute exacerbations of chronic obstructive pulmonary disease (COPD)"],"dc:type":["Thesis"],"dc:type.qualificationlevel":["doctoral"],"dc:type.qualificationname":["Ph.D."]},"updated_at":"2026-07-24T04:36:17Z"}