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Exhaled and Sputum Nitric Oxide in Bronchiectasis^*

Correlation With Clinical Parameters

^* From the Departments of Medicine (Drs. Tsang, Chin-wan Fung, Lam, Mr. Leung, and Ms. Chan), Anatomy (Dr. Tipoe), and Diagnostic Radiology (Dr. Ooi), The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.

Correspondence to: Kenneth W. Tsang, MD, FCCP, Associate Professor and Honorary Consultant Physician, University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Rd, Hong Kong SAR, China; e-mail: kwttsang{at}hkucc.hku.hk

Study objectives: Although there has been tremendous attention on endogenous nitric oxide (NO) production in many respiratory and systemic diseases, little is known on NO production in bronchiectasis.

Design and setting: We determined exhaled and sputum NO levels in 109 patients with stable bronchiectasis (71 women; mean ± SD age, 58.2 ± 14.1 years) and 78 control subjects (39 women; mean age, 56.7 ± 12.1 years) by using an automatic chemiluminescence analyzer.

Measurements and results: There was no significant difference in exhaled NO between patients with bronchiectasis and control subjects (p = 0.11). Bronchiectasis patients with Pseudomonas aeruginosa infection had a significantly lower exhaled, but not sputum, NO levels than their counterparts and control subjects (p = 0.04 and p = 0.009, respectively). Exhaled NO correlated with 24-h sputum volume in P aeruginosa-infected patients (r = - 0.36; p = 0.002). After adjustment for sputum volume and number of bronchiectatic lung lobes, P aeruginosa-infected patients still had lower exhaled NO levels than their counterparts (p = 0.01). There was no correlation between exhaled NO with FEV₁, FVC, and the number of bronchiectatic lung lobes (p > 0.05). Sputum NO levels were not different between patients and control subjects (p = 0.64), and had no correlation with clinical parameters.

Conclusion: Exhaled NO appears to be reduced among bronchiectasis patients with P aeruginosa infection independent of other clinical parameters, and further studies on the potential mechanisms and pathogenetic implications of this reduction should be pursued.

Key Words: assessment • bronchiectasis • nitric oxide

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