Diagnostic significance of nitric oxide concentrations in exhaled air from the airways in allergic rhinitis patients

Abstract

IntroductionThe effect of nitric oxide (NO) on the human body is very important due its physiological regulation of the following functions of airways: modulation of ciliary movement and maintenance of sterility in sinuses.AimTo evaluate the diagnostic significance of NO concentrations in exhaled air from the upper and lower airways in patients diagnosed with allergic rhinitis (AR).Material and methodsThe subjects included in the study were a group of 30 people diagnosed with sensitivity to environmental allergens and a control group consisting of 30 healthy subjects. The measurement of NO in the air exhaled from the lower and upper airways was performed using an on-line method by means of Restricted Exhaled Breath (REB), as well as using the measurement procedure (chemiluminescence) set out in the guidelines prepared in 2005 by the American Thoracic Society and the European Respiratory Society.ResultsIn the late phase of the allergic reaction, higher values of the level of exhaled NO concentration from the lower airways were observed in the groups of subjects up to the threshold values of 25.17 ppb in the group of subjects with year-round allergic rhinitis and 21.78 ppb in the group with diagnosed seasonal allergic rhinitis. The difference in the concentration of NO exhaled from the lungs between the test group and the control group in the 4th h of the test was statistically significant (p = 0.045).ConclusionsExhaled NO should be considered as a marker of airway inflammation. It plays an important role in the differential diagnosis of allergy.

Specificity and sensitivity assessment of selected nasal provocation testing techniques

“…Increased reactivity of the mucous membrane and a change, over time, of the minimal cross-sectional area of the nasal cavity in the region of the head of the inferior nasal concha (CSA-2, reactivity – 21.97%) were observed at minute 15 and 20 of the test in the groups of patients with AR [8]. The intensifying nasal obstruction was accompanied by a reduction in the concentration of nitrogen oxide in the air exhaled from the upper airways (from 1253.42 ppb to 927.83 ppb on average in the case of the chronic rhinitis patients and from 1059.44 to 847.33 ppb in the seasonal rhinitis group) [9], with an increase in the concentration of tryptase (2.16 µg/l within the chronic rhinitis group and 2.39 µg/l within the seasonal rhinitis group) in the nasal lavage fluid. As regards non-nasal symptoms, coughing was observed especially among the chronic rhinitis patients at minute 15 ( p = 0.044) and at minute 20 ( p = 0.040) of the test.…”