scholarly journals Fractional exhaled nitric oxide could identify early spirometry change in clinically suspected asthma patients without airway obstruction

2021 ◽  
Vol 19 ◽  
pp. 205873922110041
Author(s):  
Qingbo Gao ◽  
Qiaozhen Wu ◽  
Fei Li ◽  
Cheng Chen
Keyword(s):  
Nitric Oxide ◽  
Airway Obstruction ◽  
Significant Proportion ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide ◽  
Maximal Expiratory Flow ◽  
Increased Risk ◽  
Significant Difference ◽  
Expiratory Flow ◽  
Feno Level

Fractional exhaled nitric oxide (FeNO) has been proposed as a non-invasive biomarker for allergic inflammation seen in asthma. The aim of this study was to assess the ability of FeNO to discriminate spirometry and lung volume measurements between those with and without airway obstruction among subjects with clinically suspected asthma. A retrospective study was conducted. Diagnostic evaluations including spirometry and FeNO testing (NO electrochemical equipment: NIOX VERO; Aerocrine AB, Solna, Sweden) were performed in all subjects. Airway obstruction was defined according to the Standardization of Spirometry of the American Thoracic Society (ATS)/European Respiratory Society (ERS), and 2014 recommendations of the Chinese National Guidelines of Pulmonary Function Test. It was used the Student t test for analysis of continuous variables and the χ2 test for analysis of discrete variables including FeNO levels and lung function metrics. Of the 138 subjects with clinically suspected asthma, airway obstruction was found in 61. There was no significant difference in the mean FeNO levels among subjects with or without airway obstruction ( p = 0.241) among un-selected subjects. Likewise, there was no difference in the FeNO levels between aged (>50 years) and younger subjects (⩽50 years) ( p = 0.804). A significant proportion of subjects had a normal FeNO level (<25 part per billion, ppb) in spite of having airway obstruction (39/138), 25 had an elevated FeNO level (⩾25 ppb) in spite of having no airway obstruction (25/138). Additionally, the airway-obstructed subjects with increased FeNO level had comparable spirometry to those with normal FeNO level ( p > 0.05). However, among subjects without airway obstruction, the forced expiratory volume in 1 s (FEV1)/predicted (pred), maximal expiratory flow at 25% of forced vital capacity (FVC) (MEF25%)/pred, maximal expiratory flow at 50% of FVC (MEF50%)/pred and maximum mid-expiratory flow (MMEF)/pred were significantly lower in the FeNO ⩾ 25 ppb group compared to those in the FeNO < 25 ppb group. These analyses indicated that increased FeNO levels could help to determinate early spirometry change within clinically suspected asthma subjects without airway obstruction. It is highlighted the importance of FeNO as a phenotype associated with an increased risk of airway obstruction in some subjects in this study.

The Utility of Serum IL-1β and CRP Together with Fractional Exhaled Nitric Oxide in the Diagnosis of Asthma in Adults

2021 ◽  
Vol 19 (8) ◽  
pp. 119-124
Author(s):  
Hayder Abdul-Amir Makki Al-Hindy ◽  
Ali Jihad Hemid Al-Athari ◽  
Mazin J. Mousa ◽  
Safa Jihad Hameed ◽  
Suhad Hafidh Obeed
Keyword(s):  
Nitric Oxide ◽  
Sensitivity And Specificity ◽  
Bronchial Asthma ◽  
High Sensitivity ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide ◽  
Asthmatic Patients ◽  
Significant Difference ◽  
Asthma Patients ◽  
Hs Crp

Background: Bronchial asthma (BrA), recognized lately as an umbrella, covers various subtypes rather than only one disease. Asthma is a chronic inflammation of the airways, in which cytokines could play a crucial role in its pathogenesis. Hence, labors to progress noninvasive markers for asthma had centered through this era. Presently, the fractional exhaled nitric oxide (FeNO), serum C-reactive protein (CRP), and interleukin levels are emerging analytical biomarkers in this field. FeNO is a noninvasive and practical tool even in mild asthma. This study aimed to evaluate the utility of serum IL-1β and CRP together with fractional exhaled nitric oxide in the diagnosis of adult bronchial asthma. Method: The study was a case control, including 150-patients and 100-healthy controls. FeNO tests, measurements of plasma levels IL-1β and HS-CRP had undertaken for all the participants. The statistical data had examined by SPSS (V/27) for Windows. Descriptive data of the variables had compatibly used. A significance lower than or identical to 0.05 had intended. ROC curve examination of FeNO tests, IL-1β, and HS-CRP, to predict asthma from healthy control had applied. Results: there was a significant difference in the FeNo test, HS-CRP levels, and BMI, while no significant difference in all other variables between the groups. The FeNo results correlate positively, though not significantly, with the levels of IL-1β in asthmatic patients (> 0.05). There was a nonsignificant negative correlation between the FeNo results with the level of HSCRP. The accuracy, sensitivity, and specificity of the IL-1β to distinguish asthma were 68.6% and 58% at 95% CI [0.41-0.745], respectively, which was not significant (p>0.05). However, ROC analysis of HS-CRP revealed predictability for asthma patients (p-0.000), with higher accuracy, sensitivity, and specificity: 89.9%, and 68.1% at 95% CI [0.820-0.979], respectively. The FeNo tests revealed highly significant (0.000), high sensitivity, and specific (91% for both) with high 95% CI [0.938-1.000] predictability for asthma. Conclusion: The utility of circulating HS-CRP is more valuable than IL-1β when combined with fractional exhaled nitric oxide in the diagnosis of asthma. Novel biomarkers could improve the precision of this field.

scholarly journals The Effect of Physical Activity on Spirometry and Fractional Exhaled Nitric Oxide in Adolescents—Longitudinal Study

2021 ◽  
Vol 13 (11) ◽  
pp. 5770
Author(s):  
Kamil Barański ◽  
Krzysztof Kocot ◽  
Edyta Melaniuk-Wolny ◽  
Elwira Zajusz-Zubek ◽  
Małgorzata Kowalska
Keyword(s):  
Physical Activity ◽  
Nitric Oxide ◽  
Inflammatory Process ◽  
Internal Variability ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide ◽  
Significant Difference ◽  
Before And After ◽  
Medium Level ◽  
Physical Activity Classes

Highly intense and chronic physical activity may cause an inflammatory process in the airways. The inflammatory process in the respiratory system can be measured either by the spirometry test and exhaled nitric oxide. The aim of this study was to assess the effect of different levels of physical activity on fractional exhaled nitric oxide (FeNO) and spirometry parameters. Fifty healthy students (volunteers) who were participating in physical activity classes (low level of physical activity) and attending sports training (high and medium level of physical activity) completed two indoor exercise training two to three weeks apart. FeNO was measured twice, at baseline and after 45–60 min of exercise followed by spirometry. There was no significant difference in FeNO values and spirometry parameters between the groups with different physical activity. However, students with the highest level of physical activity presented a higher and significant variance of FeNO levels in comparison to students with lower physical activity. Healthy young adults (professional sportspersons) have a higher internal variability of FeNO. That suggests the initial ongoing inflammatory process in the airways. Any level of physical activity does not affect spirometry parameters before and after training in young healthy adults.

scholarly journals Fração Exalada de Óxido Nítrico no Controlo e Abordagem Terapêutica da Asma

2014 ◽  
Vol 27 (1) ◽  
pp. 59 ◽  
Author(s):  
Bruno Melo ◽  
Patrício Costa ◽  
Ariana Afonso ◽  
Vânia Machado ◽  
Carla Moreira ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Asthma Control ◽  
Peak Expiratory Flow ◽  
Chronic Respiratory Disease ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Bronchial Inflammation ◽  
Expiratory Flow

<strong>Introduction:</strong> Asthma is a chronic respiratory disease characterized by hyper-responsiveness and bronchial inflammation. The bronchial inflammation in these patients can be monitored by measuring the fractional exhaled nitric oxide. This study aims to determine fractional exhaled nitric oxide association with peak expiratory flow and with asthma control inferred by the Global Initiative for Asthma.<br /><strong>Material and Methods:</strong> Observational, analytical and cross-sectional study of children with asthma, 6-12 years-old, followed in the Outpatient Respiratory Pathology of Braga Hospital. Sociodemographic and clinical information were collected through a questionnaire. fractional exhaled nitric oxide and peak expiratory flow were determined by portable analyzer Niox Mino® and flow meter, respectively.<br /><strong>Results:</strong> The sample is constituted by 101 asthmatic children, 63 (62.4%) of males and 38 (37.6%) females. The mean age of participants in the sample is 9.18 (1.99) years. The logistic regression performed with the cutoff value obtained by ROC curve, revealed that fractional exhaled nitric oxide (bFENO classes = 0.85; χ2 Wald (1) = 8.71; OR = 2.33; p = 0.003) has a statistical significant effect on the probability of changing level of asthma control. The odds ratio of going from “controlled” to “partly controlled/uncontrolled” is 2.33 per each level of fractional exhaled nitric oxide.<br /><strong>Discussion and Conclusion: </strong>The probability of an asthmatic children change their level of asthma control, from ‘controlled’ to ‘partly controlled/uncontrolled’, taking into account a change in their fractional exhaled nitric oxide level, increases 133%.

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