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Background: In type I diabetes mellitus, lung function has been investigated in several clinical studies, but there are few data concerning pulmonary function abnormalities in patients with non-insulin-dependent diabetes mellitus (NIDDM). Objectives: The aim of this study was to assess the presence of pulmonary function abnormalities in patients with NIDDM and to verify the possible associations between diabetic renal microangiopathy, retinopathy and diabetes control. Method and Patients: Thirty patients with NIDDM were collected and divided into two similar groups: subjects with retinopathy and/or diabetic glomerulopathy (group 1, n = 15) and patients without any complications (group 2, n = 15). 17 were males and 13 females, aged from 45 to 81 years. They had had diabetes for 3–23 years and were studied at the Division of Internal Medicine, with an outpatient service for diabetic patients. All patients were non-smokers. The presence of diabetic glomerulopathy was determined by measuring the 24-hour protein excretion rate using the nephelometric method. The presence of retinopathy was determined by using ophthalmoscopy. Glycosylated hemoglobin was measured as an indicator of glycemic control. We performed a global spirometry and measured pulmonary diffusion capacity by the single-breath method corrected by alveolar volume. Results: We found a significant reduction in lung diffusion capacity for carbon monoxide (DL_CO) in the group of patients with other signs of diabetic microangiopathy (p < 0.005) and a significative correlation between DL_CO and the grade of albuminuria (r = –0.83, p < 0.001). Conclusions: Pulmonary function abnormalities, in particular a reduction in diffusion capacity, are common in patients with NIDDM and signs of diabetic microangiopathy. A possible explanation is related to an impaired pulmonary microvasculature and alveolar epithelial basal lamina.

In order to characterize neutrophil and eosinophil presence in the airways of patients with chronic obstructive pulmonary disease (COPD), bronchoscopy with bronchial washings and bronchial biopsies was performed in 12 smoking stable COPD subjects and 18 normal non-smoking control subjects. Bronchial biopsies were examined by light microscopy using plastic embedding and histochemical techniques to identify different cell types. Bronchial washing fluid of COPD patients was characterized by a predominance of neutrophils (P = 0.001), and a slight, but significant (P = 0.03), increase of eosinophil fraction. Subjects with COPD had higher number of neutrophils in the epithelium (P = 0.01), and eosinophils in the lamina propria (P = 0.01) than did control subjects. The thickness of reticular basement membrane was increased for COPD patients in comparison to control subjects (P = 0.01). The present study provides evidence of neutrophil infiltration both in bronchial washing and bronchial epithelium of patients with COPD, suggesting that the source of neutrophils in airway lumen may be the bronchial mucosa. Although less common than in asthma, airways of COPD subjects reveal eosinophil presence and airway remodelling.

Background-Measurement of nitric oxide (NO) in exhaled air shows promise as a non-invasive method of detecting lung inflammation. However, variable concentrations of NO are measured in environmental air. The aim of this study was to verify a possible relationship between exhaled NO and atmospheric NO values during high atmospheric NO days. Method-Exhaled air from 78 healthy non-smokers of mean age 35.3 years was examined for the presence of NO using a chemiluminescence NO analyser and NO levels were expressed as part per billion (ppb). The exhaled air from all the subjects was collected into a single bag and into two sequential bags. Before each test atmospheric NO was measured. Conclusions-These results indicate a relationship between atmospheric NO and NO levels measured in exhaled air, therefore exhaled NO should not be measured on very high atmospheric NO days. (Thorax 1998;53:673-676) Keywords: nitric oxide; atmospheric nitric oxide; exhaled nitric oxide Nitric oxide (NO) is a reactive free radical gas detectable in the exhaled air of human subjects.1 NO is produced by many cells within the respiratory tract and endogenous NO may play an important signalling role in the physiological control of airway function and in the pathophysiological control of airway diseases. and hypertensive subjects.7 NO measurement in exhaled air has thus been proposed as a simple and noninvasive method of studying airway diseases. Environmental air is contaminated with various amounts of NO and atmospheric NO (aNO) can change over diVerent days, depending on atmospheric pressure and traYc conditions. 10 The aim of this study was to verify a possible relationship between eNO and aNO values during high aNO days in a group of healthy non-smokers. Methods SUBJECTSA total of 78 healthy non-smoker volunteers (52 men) of mean age 35.3 years (range 26-47) were recruited into the study. None of the subjects complained of respiratory symptoms in the three months preceding the study and all were non-atopic as defined by a negative personal and family history for atopy and negative skin prick tests for common allergens. Spirometric measurements showed a mean forced expiratory volume in one second of 102 (3)% predicted. All subjects gave written informed consent for participation in the protocol as approved by the local ethics committee. EQUIPMENTThe levels of eNO and aNO were measured using a chemiluminescence NO analyser (Model 42S; Thermo Environmental Instruments Inc, Franklin, Massachusetts, USA). The analyser measures photons resulting from oxidisation of NO by ozone, using a photomultiplier. The sampling flow rate was 0.7 l/min with a response time of 10 s (the analyser takes three measurements to reach the highest stable NO value). The instrument was calibrated before use over the range of 0-100 ppb with dilutions of a known NO source by using a multigas precision flow calibrator (Dynamic Gas Calibration System, Model 146, Environmental Instruments Division, USA). Before each test aNO was measured and prior to all NO measu...

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