Both exhaled nitric oxide and blood eosinophil count were associated with mild allergic asthma only in non-smokers

Autor:	Jonathan Giovannelli, Régis Matran, Guillaume Clement, Philippe Amouyel, Sébastien Hulo, Alina Ciuchete, Luc Dauchet, Nathalie Chérot-Kornobis
Rok vydání:	2016
Předmět:	Adult Male medicine.medical_specialty Immunology Population Nitric Oxide medicine.disease_cause Severity of Illness Index Atopy Leukocyte Count 03 medical and health sciences 0302 clinical medicine Allergen Risk Factors immune system diseases Internal medicine medicine Humans Immunology and Allergy Clinical significance 030212 general & internal medicine education Asthma education.field_of_study business.industry Smoking Middle Aged medicine.disease Former Smoker respiratory tract diseases Eosinophils Breath Tests 030228 respiratory system Exhalation Population Surveillance Exhaled nitric oxide Female business Biomarkers Glucocorticoid medicine.drug
Zdroj:	Clinical & Experimental Allergy. 46:543-554
ISSN:	0954-7894
Popis:	SummaryBackground The fractional exhaled nitric oxide (FENO) and the blood eosinophil count (B-eos) are markers of eosinophilic inflammation used in the diagnosis and management of asthma. The relationships between smoking cigarette and both FENO and B-eos are complex and raise questions about the association between these markers and asthma in smokers. Objective To determine the relationships between both FENO and B-eos on one hand and asthma and atopy on the other, according to smoking status. Methods FENO and B-eos were measured in, respectively, 1579 and 1496 of the 1607 middle-aged adults randomly selected from the general population in the cross-sectional ELISABET survey. Allergic asthma was defined as asthma (a self-report of physician-diagnosed asthma, and wheezing in the previous 12 months or the use of asthma medications) with atopy (allergic rhinitis or hayfever in the previous 12 months, or a previous positive prick test or allergen desensitization therapy). Non-allergic asthma was defined as asthma without atopy. Results The analysis included 812 (51.4%) never, 473 (30%) former and 294 (18.6%) current smokers. A total of 490 (32%) participants were atopic, 80 (5.1%) had allergic asthma, and 31 (2%) had non-allergic asthma. Only 16.2% (18/111) of asthmatics were treated with glucocorticoid inhalants, suggesting that among them a majority of participants had mild asthma. A positive interaction between smoking status and allergic asthma was observed in multivariate models explaining FENO (P = 0.003) and B-eos (P = 0.001). Thus, compared to those without allergic asthma, participants with allergic asthma had higher FENO values (+ 63.4%, 95% CI = [39; 92]) and higher B-eos (+ 63.2% [38.2; 92.7]) in never and former smokers, but not in current smokers. Lastly, an analysis of receiver-operating characteristic curves showed that each of the two markers was able to discriminate moderately allergic asthma but only in non-smokers. Conclusions & Clinical Relevance FENO and B-eos were associated with the presence of mild allergic asthma only in non-smokers, not in current smokers. These findings raise questions about the clinical value of FENO and B-eos in smokers.
Databáze:	OpenAIRE
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