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USE OF FRACTIONAL EXHALED NITRIC OXIDE AS A POTENTIAL PREDICTOR OF BRONCHODILATOR RESPONSE
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Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Abstract
Nitric oxide (NO) is an important product of eosinophilic metabolism, and its increase is associated with bronchial remodeling and airway hyperresponsiveness. Fractional exhaled NO (FENO) in the expired air of patients with suspected or diagnosed asthma has been used as a marker for eosinophilic inflammation. This cohort study included asthmatic patients classified under steps 3, 4, or 5 of the global strategy for asthma management and prevention. In the morning of the same day, all patien ts underwent blood collection for eosinophil counts, followed by FENO measurement and spirometry. We considered 2 groups based on the
bronchodilation (BD) response on spirometry (>10% of FVC or FEV1 ): positive (BD+) and negative (BD−). Differences between the 2 groups were analyzed for demographic features, FENO values, and predictive correlations between FENO and BD. Both groups of patients showed an increase in the eosinophil count (BD+, P = .03; BD−, P = .04) and FENO values (P = .015 for both) with an increase in the asthma severity from step 3 to step 5 of the global strategy for asthma management and prevention. The correlations of FENO and eosinophils as well as FENO values and BD + were 0.127 (95% confidence interval,–0.269 to –0.486)
and 0.696 (95% confidence interval, 0.246–0.899; P = .007), respectively. Measuring FENO levels may be useful for identifying patients with BD+.
Abbreviations: ATS = American Thoracic Society, BD = bronchodilation, BMI = body mass index, CI = confidence intervals, FENO = Fractional Exhaled Nitric Oxide, FEV1 = Forced Expiratory Volume in One Second, FVC = Forced Vital Capacity, GINA = Global Strategy for Asthma Management and Prevention, NO = nitric oxide.
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