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To the Editor: The Research Letter by Dr Nyirenda and colleagues¹ demonstrated that cigarette smokers compared with nonsmokers showed a much slower reduction in concentrations of thyroid-stimulating hormone (TSH)–receptor antibody, free thyroxine (FT₄), and total triiodothyronine (T₃) with carbimazole treatment. Smokers required higher doses of carbimazole than nonsmokers. As possible causes for these results, the authors speculated about several factors such as kinetic variability among individuals; the effect of smoking on carbimazole absorption, concentration in the thyroid gland, or metabolism; and the effect of smoking on expression of microsomal enzymes, which could influence the concentration of carbimazole or its metabolites.

Although not extensively studied, the immune functions of smokers and nonsmokers may have differences in the soluble IL-2 receptor system, which is associated with activation of T lymphocytes. In one study,² cigarette smokers had significantly higher soluble IL-2 receptor levels than nonsmokers (508 vs 420 U/mL; P = .01) . . . [Full Text of this Article]

Jae Il Shin, MD; Jae Seung Lee, MD
jsyonse@yuhs.ac
Department of Pediatrics
Yonsei University College of Medicine
Seoul, South Korea

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