Exhaled Nitric Oxide in COPD

Chronic obstructive pulmonary disease (COPD) is a common and progressive disorder which is characterised by pathological abnormalities driven by chronic airway inflammation. The assessment of airway inflammation in routine clinical practice in COPD is limited to surrogate blood markers. Fractional exhaled nitric oxide (FENO) is a marker of eosinophilic airway inflammation in asthma, and it can predict steroid responsiveness and help tailor corticosteroid treatment. The clinical value of FENO in COPD is less evident, but some studies suggest that it may be a marker of the eosinophilic endotype. More importantly, mathematical methods allow investigation of the alveolar/small airway production of NO which potentially better reflects inflammatory changes in anatomical sites, most affected by COPD. This review summarises the pathophysiological role of nitric oxide in COPD, explains the methodology of its measurement in exhaled air and discusses clinical findings of FENO in COPD.

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Exhaled nitric oxide in smokers and former smokers with chronic obstructive pulmonary disease

HIGHER SCHOOL’S PULSE ◽

10.5604/01.3001.0014.2399 ◽

2020 ◽

Vol 14 (1) ◽

pp. 1-16

Author(s):

Sabina Galiniak ◽

David Aebisher ◽

Marta Rachel

Keyword(s):

Nitric Oxide ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Corticosteroid Treatment ◽

Exhaled Nitric Oxide ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Secondary Objective ◽

Former Smokers ◽

Electrochemical Analyzer

Background: Measurement of fractional exhaled nitric oxide (FeNO) is a useful technique for detection of eosinophilic airway inflammation and assessment of efficiency of corticosteroid treatment in patents with respiratory disease. Generally studies agree that measurement of FeNO is a useful non-invasive biomarker in patients with chronic obstructive pulmonary disease (COPD), however, there are reports that do not confirm such a relationship between FeNO and COPD. Aim of the study: The main objective of this study was to investigate FeNO levels in Polish patients with COPD compared to healthy controls. As a secondary objective, we assessed the influence of smoking on FeNO levels in healthy patients, and patients with COPD. Material and methods: FeNO concentration was measured using an electrochemical analyzer in healthy non-smokers (n=21), healthy smokers (n=25), and former smokers with COPD (n=30) and smokers with COPD (n=38). General characteristics, hematological variables and serum biochemical parameters were also obtained and analyzed using the Kruskal-Wallis test. Results: FeNO measurement revealed significantly reduced NO levels in healthy smokers compared to healthy non-smokers, former smokers with COPD and smokers with COPD (median [range]: 14 [6–17] vs. 21 [15–29], 25 [15–53], and 19 [11–32] ppb, respectively, p<0.001). Moreover, we found increased FeNO levels in ex-smokers with COPD compared with smokers with COPD (p<0.05). No associations between FeNO and other analyzed parameters were found. Conclusions: Levels of FeNO, measured by with an electrochemical analyzer, were elevated among patients with COPD compared to healthy non-smoking controls. Moreover, our study confirms that smoking results in a reduction in FeNO concentration in both healthy patients and patients with COPD.

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Role of exhaled nitric oxide in predicting steroid response in chronic obstructive pulmonary disease

Orvosi Hetilap ◽

10.1556/oh.2010.28972 ◽

2010 ◽

Vol 151 (51) ◽

pp. 2083-2088 ◽

Cited By ~ 5

Author(s):

Balázs Antus

Keyword(s):

Nitric Oxide ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Exhaled Nitric Oxide ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Steroid Response

A kilégzett levegőben mérhető nitrogén-monoxid a legszélesebb körben vizsgált légúti biomarker. A stabil állapotú krónikus obstruktív tüdőbetegségben a kilégzett nitrogén-monoxid-szint hasonló vagy csak kismértékben emelkedett az egészségesekhez képest. Mivel a nitrogén-monoxid-szint szoros összefüggést mutat a légúti eosinophilia mértékével, és mivel az eosinophil típusú légúti gyulladás szteroidokra érzékenyebb, az emelkedett nitrogén-monoxid-szinttel rendelkező betegek jobb válaszkészséget mutatnak az inhalációs vagy szisztémás kortikoszteroidkezelésre. A krónikus obstruktív tüdőbetegség akut exacerbatiója során a kilégzett nitrogén-monoxid szintje megemelkedik, majd ennek kezelése után csökken. Mivel a nitrogén-monoxid-szint és a kezelés során elért légzésfunkciós javulás szoros korrelációt mutat egymással, a nitrogén-monoxid-méréssel a terápiás válasz megjósolható. Összefoglalva: a nitrogén-monoxid-méréssel a krónikus obstruktív tüdőbetegségben szenvedő betegek olyan alcsoportját lehet elkülöníteni, amelynek szteroidérzékenysége nagyobb. Orv. Hetil., 2010, 151, 2083–2088.

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