• Mauricio González-García, Dario Maldonado Gomez, Carlos A Torres-Duque, Margarita Barrero, Claudia Jaramillo Villegas, Juan Manuel Pérez, and Humberto Varon.
• Research Department, Colombian Pulmonology Foundation, Bogotá, Colombia. mgonzalez@neumologica.org
• J Bras Pneumol. 2013 Mar 1; 39 (2): 147-54.

ObjectiveWood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD.MethodsTwenty-two women with severe COPD (FEV₁/FVC ratio < 70% and FEV₁ < 50%) were divided into two groups: those with wood smoke-related COPD (n = 12) and those with smoking-related COPD (n = 10). The two groups were compared regarding emphysema scores and airway involvement (as determined by HRCT); and functional abnormalities-spirometry results, DLCO, alveolar volume (VA), the DLCO/VA ratio, lung volumes, and specific airway resistance (sRaw).ResultsThere were no significant differences between the two groups in terms of FEV₁, sRaw, or lung hyperinflation. Decreases in DLCO and in the DLCO/VA ratio were greater in the smoking-related COPD group subjects, who also had higher emphysema scores, in comparison with the wood smoke-related COPD group subjects. In the wood smoke-related COPD group, HRCT scans showed no significant emphysema, the main findings being peribronchial thickening, bronchial dilation, and subsegmental atelectasis.ConclusionsFemale patients with severe wood smoke-related COPD do not appear to develop emphysema, although they do show severe airway involvement. The reduction in DLCO and VA, with a normal DLCO/VA ratio, is probably due to severe bronchial obstruction and incomplete mixing of inspired gas during the determination of single-breath DLCO.

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