Clinical features in patients of cough variant asthma with normal and high level of exhaled fractional nitric oxide

Tang, Wei; Zhou, Jun; Miao, Lili; Shi, G

doi:10.1111/crj.12568

Cited by 12 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously published studies have reported that levels of FeNO in patients with cough variant asthma were significantly increased when compared with other patients with chronic cough [1,19]. However, there have been some controversial findings for the diagnostic role of FeNO for cough variant asthma due to the differences in the optimal threshold for FeNO and the diagnostic sensitivity and specificity [1,20–22]. The findings of the present study showed that the levels of FeNO in the patients with cough variant asthma were significantly increased when compared with the other patients with chronic cough, including patients with UACS.…”

Section: Discussionmentioning

confidence: 99%

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

et al. 2019

View full text Add to dashboard Cite

Background Cough variant asthma in children presents with a dry nonproductive cough. This study aimed to investigate the diagnostic value of fractional exhaled nitric oxide (FeNO) combined with small airway functional parameters in cough variant asthma. Material/Methods Children with asthma (n=136) were divided into a cough variant asthma (CVA) group (n=57; mean age, 8.03±2.1 years) and a non-cough variant asthma (nCVA) group (n=79; mean age, 8.61±1.7 years). In both groups, FeNO and other pulmonary function parameters were measured including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF), forced expiratory flow (FEF), and maximum expiratory flow at 25%, 50%, and 75% expired volume (MEF25, MEF50, and MEF75). Receiver-operating characteristic (ROC) curve analysis compared the sensitivity and specificity between the diagnostic parameters. Results The FeNO values were significantly increased in the CVA group compared with the nCVA group (Z=6.890, p<0.001). The MMEF, MEF25, MEF50, and MEF75 values were significantly lower in the CVA group compared with the nCVA group (p=0.000, p=0.014, p=0.000, and p=0.000, respectively). The FeNO values were negatively correlated with MEF25, MEF50, and MMEF (r=−0.334, r=−0.257 and r=−0.276, respectively). FeNO was significantly more efficient diagnosing cough variant asthma comparing with pulmonary parameters (p<0.05), and was most sensitive and specific when combined with MMEF/MEF50 compared with single diagnostic parameters (p<0.05). Conclusions FeNO combined with pulmonary function parameters of MMEF/MEF50 showed increased sensitivity and specificity for the diagnosis of cough variant asthma.

show abstract

Section: Discussionmentioning

confidence: 99%

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

et al. 2019

View full text Add to dashboard Cite

show abstract

“…A decline of fractional nitric oxide concentration in exhaled breath (FeNO) was observed in WG ( p =0.010). FeNO is a simple and safe method of measuring eosinophilic airway inflammation, and CVA patients with high FeNO levels tend to have more cough-related symptoms [ 13 , 14 ]. This may mean that participants could achieve better recovery from use of the WeChat platform assistant in both asthma-related symptoms and airway inflammation.…”

Section: Discussionmentioning

confidence: 99%

WeChat Public Account Use Improves Clinical Control of Cough-Variant Asthma: A Randomized Controlled Trial

et al. 2018

View full text Add to dashboard Cite

BackgroundWeChat is a convenient and popular social medium, and it seems to be an appropriate platform for education and management of patients. This study sought to identify usefulness in clinical control of cough-variant asthma (CVA).Material/MethodsA randomized controlled trial was conducted among 80 CVA patients. After being assigned to either the traditional group (TG) or the WeChat group (WG), they received the same inhalation therapy, but patients in WG received additional education and instruction via our public account on the WeChat application. Questionnaires on asthma and chronic cough, data on pulmonary function, blood-related items, follow-up adherence, and Emergency Department (ED) visits were collected at the initial visit and at 3 months.ResultsA total of 67 participants completed the trial for analysis. FEV1/predicted and FEV1/FVC were significantly increased in WG (p<0.001; p=0.012) after 3 months. PD20-FEV1 was increased in both groups compared with baseline, but more pronounced in WG (p=0.004). ACQ-7 scores were improved in both groups (p=0.024; p<0.001). Participants allocated to WG experienced a greater improvement in AQLQ and LCQ scores, and between-group differences were significant at 3 months (p=0.040; p=0.001). Furthermore, we observed decreases in blood eosinophil count and FeNO in WG (p=0.048; p=0.014), and WG presented better follow-up compliance (p=0.034).ConclusionsUsing WeChat as part of treatment and management of CVA can help patients learn about their disease and medications, as well as improve disease control and therapy outcomes.

show abstract

“…Although some studies have reported the presence of high levels of FeNO in AR subjects with CVA or NAEB,101637 to date the precise role of FeNO has not been well established in the diagnosis of NAEB. FeNO is usually used to exclude NAEB at low levels 38.…”

Section: Discussionmentioning

confidence: 99%

Value of Exhaled Nitric Oxide and FEF_25–75 in Identifying Factors Associated With Chronic Cough in Allergic Rhinitis

Liu

Wang

Yao

et al. 2019

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

PurposeChronic cough in allergic rhinitis (AR) patients is common with multiple etiologies including cough variant asthma (CVA), non-asthmatic eosinophilic bronchitis (NAEB), gastroesophageal reflux-related cough (GERC), and upper airway cough syndrome (UACS). Practical indicators that distinguish these categories are lacking. We aimed to explore the diagnostic value of the fraction of exhaled nitric oxide (FeNO) and forced expiratory flow at 25% and 75% of pulmonary volume (FEF25–75) in specifically identifying CVA and NAEB in these patients.MethodsConsecutive AR patients with chronic cough were screened and underwent induced sputum, FeNO, nasal nitric oxide, spirometry, and methacholine bronchial provocation testing. All patients also completed gastroesophageal reflux disease questionnaires.ResultsAmong 1,680 AR patients, 324 (19.3%) were identified with chronic cough, of whom 316 (97.5%) underwent etiology analyses. Overall, 87 (27.5%) patients had chronic cough caused by NAEB, 78 (24.7%) by CVA, 16 (5.1%) by GERC, and 81 (25.6%) by UACS. Patients with either NAEB or CVA (n = 165, in total) were further assigned to a common group designated as CVA/NAEB, because they both responded to corticosteroid therapy. Receiver operating characteristic curves of FeNO revealed obvious differences among CVA, NAEB, and CVA/NAEB (area under the curve = 0.855, 0.699, and 0.923, respectively). The cutoff values of FeNO at 43.5 and 32.5 ppb were shown to best differentiate CVA and CVA/NAEB, respectively. FEF25–75 was significantly lower in patients with CVA than in those with other causes. A FEF25–75 value of 74.6% showed good sensitivity and specificity for identifying patients with CVA.ConclusionsNAEB, CVA, and UACS are common causes of chronic cough in patients with AR. FeNO can first be used to discriminate patients with CVA/NAEB, then FEF25–75 (or combined with FeNO) can further discriminate patients with CVA from those with CVA/NAEB.

show abstract

Clinical features in patients of cough variant asthma with normal and high level of exhaled fractional nitric oxide

Abstract: CVA patients showed heterogeneity according to FeNO level. Patients with high FeNO level are more likely to experience symptoms associated with allergies.

Cited by 12 publications

References 20 publications

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

WeChat Public Account Use Improves Clinical Control of Cough-Variant Asthma: A Randomized Controlled Trial

Value of Exhaled Nitric Oxide and FEF_25–75 in Identifying Factors Associated With Chronic Cough in Allergic Rhinitis

Contact Info

Product

Resources

About

Clinical features in patients of cough variant asthma with normal and high level of exhaled fractional nitric oxide

Abstract: CVA patients showed heterogeneity according to FeNO level. Patients with high FeNO level are more likely to experience symptoms associated with allergies.

Cited by 12 publications

References 20 publications

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

WeChat Public Account Use Improves Clinical Control of Cough-Variant Asthma: A Randomized Controlled Trial

Value of Exhaled Nitric Oxide and FEF25–75 in Identifying Factors Associated With Chronic Cough in Allergic Rhinitis

Contact Info

Product

Resources

About

Value of Exhaled Nitric Oxide and FEF_25–75 in Identifying Factors Associated With Chronic Cough in Allergic Rhinitis