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CLINICAL RESEARCH: SMOKING AND PLATELET FUNCTION

Only two-week smoking cessation improves platelet aggregability and intraplatelet redox imbalance of long-term smokers

Department of Internal Medicine III, Kurume University School of Medicine, Kurume, Japan

Manuscript received August 7, 2004; revised manuscript received September 23, 2004, accepted October 20, 2004.

^* Reprint requests and correspondence: Dr. Hisao Ikeda, Department of Internal Medicine III, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan (Email: ikeda_hisao{at}kurume-u.ac.jp).

OBJECTIVES: We investigated whether and how soon smoking cessation ameliorates the smoking-induced intracellular oxidative stress and platelet aggregability in long-term smokers.

BACKGROUND: Smoking is a major risk factor of atherothrombosis. Smoking cessation reduces cardiac events. However, the underlying mechanisms of the beneficial effects remain to be elucidated.

METHODS: Twenty-seven male long-term smokers were divided into two groups. Group A (n = 14) quit smoking for four weeks whereas group B (n = 13) resumed smoking two weeks after quitting. Smoking status was monitored by measurement of urinary cotinine. Using gel-filtered platelets, agonist (adenosine diphosphate and collagen)-induced platelet aggregation, platelet-derived nitric oxide (PDNO), intraplatelet nitrotyrosine production, intraplatelet levels of the reduced form of glutathione (GSH) and its oxidized form (GSSG), and urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and urinary 8-iso-prostaglandin F₂ (8-iso-PGF₂), as markers of systemic oxidative stress, were measured. The baseline measurements were similar between the two groups.

RESULTS: Smoking cessation quickly reduced agonist-induced platelet aggregations, intraplatelet nitrotyrosine level, and urinary productions of 8-OHdG and 8-iso-PGF₂ by two weeks in both groups. In group A, they were maintained at the low levels until four weeks, whereas they were reversed by resmoking in group B; PDNO release and intraplatelet GSH/GSSG ratio were time-dependently increased by smoking cessation but reversed by resmoking.

CONCLUSIONS: The present findings are the first demonstration that only two weeks of smoking cessation can ameliorate the enhanced platelet aggregability and intraplatelet redox imbalance in long-term smokers, possibly by decreasing oxidative stress. Our findings may strengthen the motivation for smokers to quit smoking.

Abbreviations and Acronyms   ADP = adenosine diphosphate   GSH = reduced form of glutathione   GSSG = oxidized form of glutathione   NO = nitric oxide   PDNO = platelet-derived nitric oxide   PRP = platelet-rich plasma   PPP = platelet-poor plasma   8-iso-PGF2 = 8-iso-prostaglandin F2   8-OHdG = 8-hydroxy-2'-deoxyguanosine

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