WEDNESDAY, June 14 (HealthDay News) -- British scientists
have discovered a tantalizing new wrinkle in the understanding
of smoking's unhealthy effects.
Middle-aged smokers whose faces were heavily wrinkled were
five times as likely to have chronic obstructive pulmonary
disease (COPD) as smokers whose faces were relatively smooth,
the study out of Cambridge University found.
The authors speculated that both COPD and wrinkling may be
linked by a common mechanism and that facial wrinkling might
indicate susceptibility to the potentially deadly lung disease.
"The association may help us to understand more about
the effects of smoking on the body and suggest that the disease
process that gives rise to COPD may not be solely confined to
the lung," explained study lead author Dr. Bipen Patel, who
is now a consultant physician in respiratory medicine at Royal
Devon & Exeter Hospital in the United Kingdom.
"It also suggests that premature wrinkling in a smoker
may be an indication that they are developing COPD and should be
screened for the condition, since it is often not diagnosed in
its earliest stages," Patel said. "However, the
benefit of this would need to be confirmed in an additional
study."
The finding is "certainly biologically plausible,"
said Dr. Norman Edelman, chief medical officer for the American
Lung Association. But he remained skeptical of any clinical
implications leading from the study.
"This may be of use in educating patients but, in terms
of detection of lung disease, we [already] have a simple
breathing test. We don't have to look for wrinkles," he
said.
The research appears in the June 14 online edition of Thorax,
and was done while Patel was at Cambridge.
COPD refers to a group of progressive chronic lung diseases,
including emphysema and bronchitis, which block the airways and
restrict oxygen flow.
Some 13.5 million Americans suffer from COPD, and the World
Health Organization predicts that the condition will become the
third leading cause of death worldwide by 2020.
"It is well known that cigarette smoking is a major risk
factor for COPD, although only a proportion of smokers are
affected. It is also known that cigarette smokers can develop
premature ageing of the skin," Patel said. "We
hypothesized that these conditions could be likened to premature
ageing of the lung and skin and therefore that there may be a
common susceptibility to COPD and skin wrinkling."
However, Edelman noted that not all smokers go on to develop
COPD. "Obviously, people vary in their response to what's
in the smoke," he said.
In the study, the team wanted to see if genetic factors that
predispose smokers to COPD might also predispose them to
wrinkles.
The researchers analyzed data on 149 current and former
middle-aged smokers, 68 of whom (45.6 percent) had COPD. The
participants came from 78 families.
Eighty-three percent had no facial wrinkling or only minor
lines, but close to 17 percent had considerable wrinkling.
Lung strength and function, measured in all participants,
turned out to be significantly lower in those with extensive
wrinkling than in those with smoother faces.
People with heavy wrinkles were also five times more likely
to have COPD than those without wrinkles. People with facial
wrinkling also had triple the risk of suffering from more severe
emphysema.
"We do not know the underlying mechanism," Patel
said. "We suspect that the common susceptibility to COPD
and wrinkling has a genetic basis; however, the genes that are
responsible for this have not been identified. The mechanism may
be related to the loss of elastic tissues (such as collagen and
elastin) in the lung and skin, but this is not yet proven."
The findings are more likely to be helpful in spurring new
research than in providing any direct benefit to patients,
Edelman said.
"I think this will be of use to basic biologists,"
he explained. "Maybe you can start doing experiments on the
skin; maybe that's an easier model to use than the lung to
figure out what the mechanisms are."
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