Exhaled nitric oxide in relation to asthma control: A real-life survey

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• 作者：F.L.M. Ricciardolo^a ; V. Sorbello^a ; R. Bellezza Fontana^a ; I. Schiavetti^b ; G. Ciprandi^c ; ^{gio.cip@libero.it" class="auth_mail" title="E-mail the corresponding author}
• 关键词：ACT ; asthma control test ; BHR ; bronchial hyperresponsiveness ; FeNO ; fraction of exhaled nitric oxide ; FEF25&ndash ; 75 ; forced expiratory flow at 25&ndash ; 75% of vital capacity ; FEV1 ; forced expiratory volume at 1st second ; FVC ; forced vital capacity ; ICS ; inhaled corticosteroids
• 刊名：Allergologia et Immunopathologia
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：44
• 期：3
• 页码：197-205
• 全文大小：947 K

文摘

Asthma is characterised by chronic airway inflammation, a complex cascade of events, mostly sustained by eosinophil recruitment and activation. Fractional exhaled nitric oxide (FeNO) is a surrogate marker of airway inflammation closely associated with bronchial eosinophilia. FeNO is used to define asthma phenotype, to assess eosinophilic inflammatory severity and to predict corticosteroid responsiveness.

Objective

The aim of this study was to investigate whether FeNO may be associated with some clinical and functional factors in asthmatics evaluated in a real life setting.

Methods

Globally 363 patients (150 males, mean age 46.3 years) with asthma were consecutively evaluated. The following parameters were assessed: history, including comorbidities, physical examination, body mass index (BMI), lung function, asthma control grade, asthma control test (ACT), and FeNO.

Results

FeNO values were significantly higher in patients with poorly controlled asthma (p < 0.01), asthma symptoms (p = 0.015), wheezing (p < 0.001), rhinitis diagnosis, (p = 0.049) and rhinitis symptoms (p = 0.019), but lower in patients with GERD (p = 0.024) and pneumonia history (p = 0.048). FeNO values increased in patients with the lowest corticosteroid dose (p = 0.031). FeNO values > 25 ppb were associated with poorly controlled asthma (OR 3.71), asthma signs (OR 3.5) and symptoms (OR 1.79). A FeNO value cut-off of 29.9 ppb was fairly predictive of (AUC 0.7) poorly controlled asthma.

Conclusions

FeNO assessment in clinical practice may be a useful tool for monitoring asthmatics as it is associated with several clinical factors, including asthma control.