Alveolar nitric oxide and asthma control in mild untreated asthma
Autor: | Salvatore Taormina, Salvatore Battaglia, Elena Pozzecco, Nicola Scichilone, Viviana Modica, Vincenzo Bellia |
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Přispěvatelé: | Scichilone, N, Battaglia, S, Taormina, S, Modica, V, Pozzecco, E, Bellia, V |
Rok vydání: | 2013 |
Předmět: |
Adult
Male medicine.medical_specialty Vital capacity Immunology Settore MED/10 - Malattie Dell'Apparato Respiratorio Nitric Oxide Gastroenterology Nitric oxide Young Adult chemistry.chemical_compound FEV1/FVC ratio Asthma control Internal medicine medicine Humans Immunology and Allergy Young adult Asthma business.industry Exhalation medicine.disease Respiratory Function Tests respiratory tract diseases chemistry Anesthesia Female business Asthma Control Test |
Zdroj: | Journal of Allergy and Clinical Immunology. 131:1513-1517 |
ISSN: | 0091-6749 |
Popis: | Background The role of the peripheral airways in asthma is increasingly being recognized as a potential target for the achievement of optimal control of the disease. We postulated that the inflammatory changes of the small airways are implicated in the lack of asthma control in mild asthma. Objective To test this hypothesis, we measured the alveolar fraction of exhaled NO (C alv NO) in patients with mild asthma with different levels of control of symptoms. Methods Seventy-eight patients with asthma (35 men, age, 37 ± 15 years; FEV 1 percentage of predicted, 100% ± 9%) were studied. Asthma control was assessed by using the Asthma Control Test (ACT). Measurements of exhaled NO at multiple constant flows were performed. Results Bronchial NO concentrations were 27.1 ± 20 ppb, and C alv NO levels were 5.7 ± 3.4 ppb. The ACT score was 20 ± 4.2. The level of asthma control was not associated with bronchial NO concentrations ( r s = 0.16, P = .15). However, a significant correlation was found between the ACT score and C alv NO ( r s = 0.25, P = .03). Moreover, C alv NO was significantly higher in patients with uncontrolled asthma than in patients with controlled/partially controlled asthma (6.7 ± 2.6 ppb vs 4.9 ± 2.6 ppb, respectively, P = .02). In the subgroup of patients with asthma who underwent extrafine inhaled corticosteroid treatment, the magnitude of the inhaled corticosteroid–induced improvement in asthma control positively correlated with baseline C alv NO at 1 month ( r s = 0.39, P = .003) and at 3 months ( r s = 0.49, P Conclusions The alveolar component of exhaled NO is associated with the lack of asthma control in patients with mild, untreated asthma. This observation supports the notion that abnormalities of the peripheral airways are implicated in the mildest forms of asthma. |
Databáze: | OpenAIRE |
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