How Does Smoking Impact Susceptibility To Adenovirus Infection?

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Introduction

Around the world, smoking is one of the biggest threats to public health. Smoking causes 9% of all global deaths, and smoking-related diseases claim the lives of over half of smokers, according to the World Health Organisation (WHO) Global Report on Trends in Prevalence of Tobacco Use from 2000–2025. Around 26.6% of adults over the age of 15 smoked at least once in 2018, accounting for 308 million persons.

Additionally, 44.9% of adults or 515 million were exposed to secondhand smoke at home. Human health is severely harmed by secondhand and cigarette smoke exposure. 7000 chemical elements are included in tobacco smoke, and more than 250 of such chemicals are harmful or carcinogenic. The nitrides, aldehydes and other chemicals present in cigarettes also cause inflammation in the respiratory system.

Furthermore, the nicotine present in cigarettes leads to tobacco addiction, the red blood cell oxygen present in the lungs is decreased by nitric oxide and the other ingredients present such as benzpyrene, arsenic, and cadmium have carcinogenic effects. Smoking is one of the primary risk factors for respiratory infections and infectious disorders in other body systems, its effects depend on how often a person smokes and that can harm almost all of the body's organs.1

Up to 15,000 children per year are admitted to hospitals due to respiratory tract diseases caused by exposure to secondhand smoke. The two main causes of death for adults worldwide are chronic obstructive pulmonary disease (COPD) and acute respiratory infections. Hence smoking is considered to be the main cause of COPD and leads to viral respiratory infections. Research has also connected long-term adenovirus infection to the onset or advancement of COPD.2

Adenovirus infection

What is adenovirus

Adenovirus is a widespread virus that causes various cold and flu-like diseases. Approximately 50 varieties of adenoviruses that can infect people have been found by researchers. Although they can happen at any time of year, adenovirus infections usually peak in the winter and early spring and fluctuate in severity as major illnesses rarely occur.3

How is the adenovirus infection transmitted? 

The adenovirus can infect individuals of all ages, but children under 5 are more likely to become infected due to daycare centres. In this environment, babies and children are close to one another and might wash their hands less regularly, making them more likely to infect each other. Adults who are in crowded surroundings may also contract the virus. Examples of these surroundings include dorms, military housing, hospitals and nursing homes.4 

An adenovirus infection increases your risk of developing a life-threatening illness if you already following issues:3

  • Compromised immune system
  • Undergone organ or stem cell transplants
  • Have HIV/AIDS
  • Cancer
  • Respiratory or heart conditions

Symptoms of an adenovirus infection

The symptoms of adenovirus infections vary depending on whatever region of your body the virus affects. Most often, the infection affects the respiratory system and gastrointestinal tract but also rarely affects the nervous system and the bladder.3

The symptoms of adenovirus infection include:3

  • Cough
  • Fever
  • Runny nose
  • Sore throat (pharyngitis)
  • Pink eye (conjunctivitis)
  • Chest cold (bronchitis)
  • Pneumonia
  • Diarrhea
  • Encephalitis 
  • Meningitis 

Impact of smoking on the respiratory system

Effects of smoking on lung health

The respiratory epithelium is the main defence against microorganisms and breathed contaminants in the lungs. Smoking cigarettes can reduce the integrity of the airway epithelial barrier by destroying the structures that connect cells. The respiratory epithelium is composed of goblet cells, basal cells, submucosal secretory glands and ciliated cells.

The rotation (oscillation) of cilia, short microscopic hair-like structures, causes mucus to be secreted into the airways as well as the clearing of this mucus from the airways. Cigarettes and e-cigarettes impact the consistency of cilia oscillation because they increase the lungs’ exposure to pathogens and they also reduce the sensitivity of the human cough reflex. Gladly, cough sensitivity can be gradually regained as soon as two weeks after quitting smoking.1,5

Increased susceptibility to respiratory infections

According to numerous extensive national and international studies, there is sufficient data to support the link of smoking to several respiratory diseases, such as acute respiratory tract infections (ARTI) and community-acquired pneumonia (CAP), with an evident dose response. There are a variety of pathogens such as fungi, bacteria and Mycobacterium Tuberculosis. Quitting smoking can reduce the risk of being exposed to these pathogens.1,6

How smoking impacted the immune system response

While smoking can weaken the immune system's ability to fight off infections, it can also lead to chronic inflammation in the body. This increases the risk of developing various diseases and conditions. Thus, high-dose or prolonged cigarette smoking exposure can seriously impair immunity and throw off the body's natural inflammatory response. Smoking also affects innate and adaptive immunity which causes cells to malfunction and reduces the amount of effector molecules.1

Innate immunity

Innate immunity is composed of natural killer cells, dendritic cells, macrophages and epithelial cells. Smoking for a brief period can increase the immune response as it activates macrophages, neutrophils and inflammatory mediators. However, smoking for a long period results in chronic inflammation that can affect the innate immune cells and hinder the production of molecules that kill pathogens. This leads to rapid growth and invasion of pathogens in the body.1,5

Adaptive immunity

According to studies on smoking, the release of molecules that are important in the immune response and adaptive immune cells is hindered by smoking cigarettes.1

  1. Increase in the probability of developing lymphopenia 
  2. The B cell and T cell responses and the production of antibodies are reduced for a long-term passive smoker. This is demonstrated by bronchoalveolar lavage samples 
  3. Active smoking was found to considerably increase the amount of circulating immune cells. Circulating CD45+ cells are increased by 23% and circulating conventional lymphocytes are increased by 26% 
  4. The IgG, saliva and serum levels of immunoglobulin in a smoker are less than those of a healthy individual

Studies on smoking and adenovirus infection

Investigations suggest that smoking increases the chances of viral infection while the molecular mechanisms in the respiratory tract increase vulnerability to viral infections. The main causes of respiratory disease in the body are adenovirus or non-enveloped DNA viruses. Furthermore, the main receptor is the Coxsackievirus and Adenovirus Receptor (CAR) for various adenoviruses.2

Based on studies conducted by Sharma et al., in 2012 The development of chronic obstructive pulmonary disease (COPD) is related to environmental and hereditary inflammation. There is a higher chance of children developing COPD if they have a respiratory disease.

Additionally, with the data gathered, chronic adenovirus infections are increased in passive smokers. Passive smokers are at high risk of polarised lung epithelial cells to adenoviral infection when compared with active smokers. The direct suppression of GSK3β in polarised CaLu-3 cells can impact the adenoviral infection and coxsackievirus and adenovirus receptor expression in a passive smoker.

Passive smoker exposure highly downregulates the cellular kinase GSK3β. The findings provide a new concept in the various biological responses that occur after exposure to cigarette smoke. Furthermore, establishing an immune response is vital to the airway epithelium, to reduce the risk of viral infections.2

Summary

Smoking cigarettes has a major impact on the respiratory system and immune system, making it a major threat to human health. The risks of adenovirus infection are high for smokers. As innate and adaptive immunity are impacted by smoking, the respiratory epithelium is damaged, leading to increased adenoviral infections.

Researches highlight that smoking causes adenovirus infection-related diseases such as COPD. These issues emphasise the urgency of implementing specific medical treatments. By understanding the complex diseases associated with smoking, healthcare professionals can come up with different techniques to handle the health issues that come with smoking and ensure the well-being of the general public. 

References

  1. Jiang C, Chen Q, Xie M. Smoking increases the risk of infectious diseases: A narrative review. Tob Induc Dis [Internet]. 2020 Jul 14 [cited 2024 May 3];18:60. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398598/
  2. Sharma P, Kolawole AO, Core SB, Kajon AE, Excoffon KJDA. Sidestream smoke exposure increases the susceptibility of airway epithelia to adenoviral infection. PLoS One [Internet]. 2012 Nov 15 [cited 2024 May 3];7(11):e49930. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499494/
  3. What is adenovirus? - klarity health library [Internet]. 2023 [cited 2024 Sep 5]. Available from: https://my.klarity.health/what-is-adenovirus/
  4. Usman N, Suarez M. Adenoviruses. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Sep 5]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK559072/
  5. Prevention (US) C for DC and, Promotion (US) NC for CDP and H, Health (US) O on S and. Pulmonary diseases. In: How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General [Internet]. Centers for Disease Control and Prevention (US); 2010 [cited 2024 Sep 5]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53021/
  6. Varghese J, Muntode Gharde P. A comprehensive review on the impacts of smoking on the health of an individual. Cureus [Internet]. [cited 2024 Sep 5];15(10):e46532. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625450/

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Nahom Mohammed Berhan Omer

Bachelor of Biotechnology (HONS) - Infrastructure University Kuala Lumpur (IUKL)

Nahom is a skilled writer with a background in Biotechnology. With a passion for microbiology and molecular biology, he brings a wealth of knowledge and expertise to the topics he covers. Nahom has several years of experience writing where he is known for delivering insightful and engaging content.

In addition to writing, he has worked as a research assistant that further enhances his ability to provide valuable perspectives. As a dedicated professional, He is committed to producing high-quality articles that inform and inspire readers. Nahom strives to provide readers with useful information that will improve their lives and help them make educated medical decisions regarding their well-being

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