Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
doi:10.1378/chest.06-2531
(Chest. 2007; 131:1353-1362)
© 2007 American College of Chest Physicians
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Brindicci, C.
Right arrow Articles by Kharitonov, S. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Brindicci, C.
Right arrow Articles by Kharitonov, S. A.

Differential Flow Analysis of Exhaled Nitric Oxide in Patients With Asthma of Differing Severity*

Caterina Brindicci, MD; Kazuhiro Ito, PhD; Peter J. Barnes, DM, DSc, FCCP and Sergei A. Kharitonov, MD, PhD

* From the Section of Airway Diseases, National Heart and Lung Institute, Imperial College, London, UK.

Correspondence to: Sergei A. Kharitonov, MD, PhD, Section of Airway Disease, National Heart and Lung Institute, Imperial College, Dovehouse St, London, SW3 6LY, UK; e-mail: s.kharitonov{at}imperial.ac.uk

Abstract

Background: The majority of asthmatic patients achieve control of their illness; others do not. It is therefore crucial to validate/develop strategies that help the clinician monitor the disease, improving the response to treatment.

Methods: We have quantified the inflammation in central and peripheral airways by measuring exhaled nitric oxide (NO) at multiple exhalation flows in 56 asthmatics at different levels of severity (mild, n = 10; moderate stable, n = 17; moderate during exacerbation, n = 11; severe, n = 18, 7 of whom were receiving oral corticosteroids) and 18 healthy control subjects. The reproducibility of the measurement was also assessed.

Results: Bronchial NO (JNO) in patients with mild asthma (2,363 ± 330 pL/s) [mean ± SD] was higher than in patients with moderate stable asthma (1,300 ± 59 pL/s, p < 0.0005), in patients with severe asthma receiving inhaled corticosteroids (ICS) [1,015 ± 67 pL/s, p < 0.0005], and healthy control subjects (721 ± 22 pL/s, p < 0.0001). There were no differences between JNO in patients with mild asthma compared to patients with severe asthma receiving ICS and oral corticosteroids (2,225 ± 246 pL/s). Patients with exacerbations showed a higher JNO (3,475 ± 368.9 pL/s, p < 0.05) compared to the other groups. Alveolar NO was higher in patients with severe asthma receiving oral corticosteroids (3.0 ± 0.1 parts per billion [ppb], p < 0.0001) than in the other groups but was not significantly higher than in patients with moderate asthma during exacerbation (2.8 ± 0.3 ppb). No differences were seen in NO diffusion levels between the different asthma groups. All the measurements were highly reproducible and free of day-to-day and diurnal variations.

Conclusions: Differential flow analysis of exhaled NO provides additional information about the site of inflammation in asthma and may be useful in assessing the response of peripheral inflammation to therapy.

Key Words: asthma • different flow rates • exhaled nitric oxide • inflammation • small airways






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American College of Chest Physicians.