Differential effect of cigarette smoke exposure on exhaled nitric oxide and blood eosinophils in healthy and asthmatic individuals

Jacinto, Tiago; Malinovschi, Andreï; Janson, Christer; Fonseca, João; Alving, Kjell

doi:10.1088/1752-7163/aa746b

Cited by 30 publications

(30 citation statements)

References 46 publications

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“…Finally, adjusting for sampling locations, FeNO shows a negative association with cotinine levels, although not significant (p = 0.07). This result is consistent with previous studies [41,44,45], since tobacco smoke is a recognised factor in the downregulation of the nitric oxide synthase, resulting in lower FeNO levels [42]. At this concern, several mechanisms have been proposed to explain the influence of tobacco smoke on FeNO levels.…”

Section: Discussionsupporting

confidence: 93%

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Formaldehyde, Oxidative Stress, and FeNO in Traffic Police Officers Working in Two Cities of Northern Italy

Squillacioti¹,

Bellisario²,

Grosso

et al. 2020

IJERPH

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Personal air formaldehyde (air-FA) was measured as risk factor of airways inflammation and oxidative stress (SO) induction. Overall, 154 police officers were enrolled from two differently urbanised Italian cities, Turin and Pavia. Urinary F2t-isoprostane (15-F2t-IsoP), a prostaglandin-like compound, was quantified as a biomarker of general OS in vivo and fractional exhaled nitric oxide (FeNO) was measured for monitoring local inflammatory processes. Urinary cotinine was quantified as a biomarker of tobacco smoking exposure. Traffic police officers living in Turin showed an increased level of log air-FA (p < 0.001), equal to +53.6% (p < 0.001). Log air-(FA) mean values were 3.38 (C.I. 95% 3.33–3.43) and 2.84 (C.I. 95% 2.77–2.92) in Turin and Pavia, respectively. Log (air-FA) was higher in “outdoor workers” (3.18, C.I. 95% 3.13–3.24, p = 0.035) compared to “indoor workers”, showing an increase of +9.3%, even controlling for sex and city. The analyses on 15-F2t-IsoP and FeNO, both adjusted for log air-FA, highlighted that OS and inflammation were higher (+66.8%, p < 0.001 and +75%, p < 0.001, respectively) in Turin traffic police officers compared to those from Pavia. Our findings suggest that even low exposures to traffic-related emissions and urbanisation may influence both general oxidative stress levels and local inflammation.

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Section: Discussionsupporting

confidence: 93%

“…Nitrogen oxide in respiratory tract originates from inducible NO synthase (iNOS), regulated by interferon gamma (IFN-γ). Tobacco smoke may interfere in this pathway by reducing IFN-γ or directly inducing oxidative processes in the airways leading to the scavenging of NO [44].…”

Section: Discussionmentioning

confidence: 99%

Formaldehyde, Oxidative Stress, and FeNO in Traffic Police Officers Working in Two Cities of Northern Italy

Squillacioti¹,

Bellisario²,

Grosso

et al. 2020

IJERPH

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“…Addition of FeNO to our model removed the significant effect of smoke exposure on BD response. Smoke exposure may have an effect on FeNO levels thus there may be some interaction between these variables we did not detect in our correlations ( P = .08) . FeNO is considered a marker of airway inflammation, typically eosinophilic or type 2 inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…Smoke exposure may have an effect on FeNO levels thus there may be some interaction between these variables we did not detect in our correlations (P = .08). 21,22 FeNO is considered a marker of airway inflammation, typically eosinophilic or type 2 inflammation. Individuals with elevated FeNO as well as IgE levels are more likely to respond with increases in FEV 1 upon treatment with ICS.…”

Section: Replication Analysis Using Sarp III Pediatric Cohortmentioning

confidence: 99%

Clinical significance of the bronchodilator response in children with severe asthma

Coverstone

Bacharier

Wilson

et al. 2019

Pediatric Pulmonology

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Background Our objective was to determine those characteristics associated with reversibility of airflow obstruction and response to maximal bronchodilation in children with severe asthma through the Severe Asthma Research Program (SARP). Methods We performed a cross‐sectional analysis evaluating children ages 6 to 17 years with nonsevere asthma (NSA) and severe asthma (SA). Participants underwent spirometry before and after 180 µg of albuterol to determine reversibility (≥12% increase in FEV1). Participants were then given escalating doses up to 720 µg of albuterol to determine their maximum reversibility. Results We evaluated 230 children (n = 129 SA, n = 101 NSA) from five centers across the United States in the SARP I and II cohorts. SA (odds ratio [OR], 2.08, 95% confidence interval [CI], 1.05‐4.13), second‐hand smoke exposure (OR, 2.81, 95%CI, 1.23‐6.43), and fractional exhaled nitric oxide (FeNO; OR, 1.97, 95%CI, 1.35‐2.87) were associated with increased odds of airway reversibility after maximal bronchodilation, while higher prebronchodilator (BD) FEV1% predicted (OR, 0.91, 95%CI, 0.88‐0.94) was associated with decreased odds. In an analysis using the SARP III cohort (n = 186), blood neutrophils, immunoglobulin E (IgE), and FEV1% predicted were significantly associated with BD reversibility. In addition, children with BD response have greater healthcare utilization. BD reversibility was associated with reduced lung function at enrollment and 1‐year follow‐up though less decline in lung function over 1 year compared to those without reversibility. Conclusions Lung function, that is FEV1% predicted, is a predictor of BD response in children with asthma. Additionally, smoke exposure, higher FeNO or IgE level, and low peripheral blood neutrophils are associated with a greater likelihood of BD reversibility. BD response can identify a phenotype of pediatric asthma associated with low lung function and poor asthma control.

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“…Further, there was a relation between previous smoking and F E NO in men in form of a 5% reduction in F E NO levels. Other authors diverge on this matter, reporting a decrease, 36 no effect, 25,37 or an increase of F E NO levels. 38 We also found that in men, there was an association with time since they stopped smoking, suggesting that the decrease might be seen among all men who stopped smoking recently.…”

Section: (95% Ci)mentioning

confidence: 96%

Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III

Nerpin

Olivieri

Gislason

et al. 2019

Clin Experimental Allergy

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Introduction The fractional exhaled nitric oxide (FENO) is a marker for type 2 inflammation used in diagnostics and management of asthma. In order to use FENO as a reliable biomarker, it is important to investigate factors that influence FENO in healthy individuals. Men have higher levels of FENO than women, but it is unclear whether determinants of FENO differ by sex. Objective To identify determinants of FENO in men and women without lung diseases. Method Fractional exhaled nitric oxide was validly measured in 3881 healthy subjects that had answered the main questionnaire of the European Community Respiratory Health Survey III without airways or lung disease. Results Exhaled NO levels were 21.3% higher in men compared with women P < 0.001. Being in the upper age quartile (60.3‐67.6 years), men had 19.2 ppb (95% CI: 18.3, 20.2) higher FENO than subjects in the lowest age quartile (39.7‐48.3 years) P = 0.02. Women in the two highest age quartiles (54.6‐60.2 and 60.3‐67.6 years) had 15.4 ppb (14.7, 16.2), P = 0.03 and 16.4 ppb (15.6, 17.1), P = <0.001 higher FENO, compared with the lowest age quartile. Height was related to 8% higher FENO level in men (P < 0.001) and 5% higher FENO levels in women (P = 0.008). Men who smoked had 37% lower FENO levels and women had 30% lower levels compared with never‐smokers (P < 0.001 for both). Men and women sensitized to both grass and perennial allergens had higher FENO levels compared with non‐sensitized subjects 26% and 29%, P < 0.001 for both. Conclusion and Clinical Relevance Fractional exhaled nitric oxide levels were higher in men than women. Similar effects of current smoking, height, and IgE sensitization were found in both sexes. FENO started increasing at lower age in women than in men, suggesting that interpretation of FENO levels in adults aged over 50 years should take into account age and sex.

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Differential effect of cigarette smoke exposure on exhaled nitric oxide and blood eosinophils in healthy and asthmatic individuals

Abstract: Smoke exposure decreases FeNO and increases B-Eos count. These effects should be considered in the development of normalized values and their interpretation in clinical practice. The persistence of elevated B-Eos in former smokers warrants further studies.

Cited by 30 publications

References 46 publications

Formaldehyde, Oxidative Stress, and FeNO in Traffic Police Officers Working in Two Cities of Northern Italy

Formaldehyde, Oxidative Stress, and FeNO in Traffic Police Officers Working in Two Cities of Northern Italy

Clinical significance of the bronchodilator response in children with severe asthma

Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III

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