Exhaled Nitric Oxide and Exhaled Breath Temperature as Potential Biomarkers in Patients with Pulmonary Hypertension

Carpagnano, Giovanna Elisiana; Radaeli, Alessandro; Lacedonia, Donato; Correale, Michele; Carpagnano, Giuseppe; Palmiotti, Antonio; Barbaro, Maria Pia Foschino; Scioscia, Giulia; Malerba, Mario

doi:10.1155/2018/7292045

Cited by 12 publications

(6 citation statements)

References 33 publications

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“…In COPD patients, reduced TL CO usually reflects the presence of emphysema, pulmonary arterial hypertension or CHF that are all associated with increased risk of longterm mortality 27,31,32 . In Central Europe, COPD patients are cared for mainly by pulmonary physicians, unlike Western Europe, where GPs are the prevailing caregiv-women may be somewhat limited.…”

Section: Discussionmentioning

confidence: 99%

Introducing a new prognostic instrument for long-term mortality prediction in COPD patients: the CADOT index

Brat¹,

Svoboda²,

Hejduk³

et al. 2021

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Objectives. The BODE (BMI, Obstruction-FEV 1 , Dyspnoea-mMRC, Exercise-6-MWT) and the ADO (Age, Dyspnoea-mMRC, Obstruction-FEV 1) indices are widely used prognosis assessment tools for long-term mortality prediction in COPD patients but subject to limitations for use in daily clinical practice. The aim of this research was to construct a prognostic instrument that prevents these limitations and which would serve as a complementary prognostic tool for clinical use in these patients. Methods and Participants. The data of 699 COPD subjects were extracted from the Czech Multicentre Research Database (CMRD) of COPD patients (the derivation cohort) and analysed to identify factors associated with the longterm risk of mortality. These were entered into the ROC analysis and reclassification analysis. Those with the strongest discriminative power were used to construct the new index (CADOT). The new index was validated on 187 patients of the CIROCO+ cohort (Netherlands; the validation cohort). Results. The CADOT was constructed by adding two newly identified prognosis-determining factors, chronic heart failure (CHF) and TL CO , to the ADO index. In a head-to-head comparison, the CADOT index showed highest c-statistic values compared to the BODE and ADO indices (0.701 vs 0.677 vs 0.644, respectively). The prognostic power was more definitive when applied to the Dutch validation (CIROCO+) cohort (0.842 vs 0.799 vs 0.825, respectively). Conclusions. The CADOT index has comparable prognostic power to the BODE and ADO indices. The CADOT is complementary/an alternative to the BODE (if 6-MWT is not feasible) and ADO (with less dependence on the age factor) indices. Trial registration: ClinicalTrials.gov (NCT01923051).

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Section: Discussionmentioning

confidence: 99%

Introducing a new prognostic instrument for long-term mortality prediction in COPD patients: the CADOT index

Brat¹,

Svoboda²,

Hejduk³

et al. 2021

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Elevated levels of exhaled nitric oxide from airways is observed in asthma [6,7], combined asthma and allergic rhinitis (AR) [8] and chronic obstructive pulmonary disease [9]. On the other hand, reduced level of NO is associated with pulmonary hypertension [10] and primary ciliary dyskinesia [11]. Furthermore, assessment of NO in the lower airways might be used as a predictor of a loss of asthma control after withdrawing corticosteroid treatment [12].…”

Section: Introductionmentioning

confidence: 99%

Exhaled nitric oxide in pediatric patients with respiratory disease

et al. 2019

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Measurement of nitric oxide (NO) levels in exhaled air from the upper and lower airways is currently used as a non-invasive marker of inflammation in respiratory diseases. Assessment of NO exhaled from the lower air respiratory tract is considered to be a quick method for confirmation and control of asthma in patients as well as an estimation of treatment efficiency. The main aim of this study was to determine differences between levels of exhaled nitric oxide (fractional exhaled NO; FeNO) in patients with respiratory disease as measured by an electrochemical analyzer. Measurements were taken in 352 pediatric patients aged 4-17 with cystic fibrosis (CF) (n=43), asthma (n=69), allergic rhinitis (AR) (n=70), asthma and AR (n=128) and non-diseased children (n=42) recruited from the Allergology Outpatient Department, Provincial Hospital No 2, Rzeszów. The second objective of this study was to assess any correlations between FeNO and clinical parameters of patients. The level of FeNO in patients with CF was normal when compared with control subjects (10.8±2.9 versus 11.4±6 ppb). We found significantly higher FeNO in patients with asthma (26.6±15.3 ppb, p<0.001), AR (18.4±9.6 ppb, p<0.01) as well as in patients with both asthma and AR (43.3±31.1 ppb, p<0.001) when compared to healthy children. Statistical analysis revealed a positive correlation between FeNO and age, height and weight of control subjects, and height in children with AR. FeNO was independent of sex, BMI, spirometry and blood results as well as the type of residence in control children and subjects with CF, asthma, AR and combined asthma and AR. In conclusion, we found normal levels of FeNO in children with CF and elevated levels in patients with asthma, AR and combined asthma and AR as compared to control subjects. Due to conflicting data, there is still a need for additional research, especially related to regarding factors that affect FeNO levels in respiratory disease.

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“…NO deficiency of the pulmonary vasculature can be assessed by detecting FeNO, a non-invasive biomarker that may be useful to correlate with changes in pulmonary hemodynamics and predicting therapies response. It has been shown that patients with PAH may have lower, [95][96][97][98] similar 97,[99][100][101] or elevated FeNO levels compared to health 102 and that patients who respond to therapy replacing NO (phosphodiesterase Type 5 inhibitors, prostacyclin and endothelin receptor antagonists, other pharmacological strategies) show higher FeNO levels compared to those who do not, suggesting a role of FeNO in monitoring response to therapy. 97,[103][104][105][106][107] However, this remains controversial as some studies failed to confirm this correlation.…”

Section: Copd and Related Comorbiditiesmentioning

confidence: 99%

Fractional nitric oxide measurement in exhaled air (FeNO): perspectives in the management of respiratory diseases

Ragnoli,

Radaeli,

Pochetti

et al. 2023

Therapeutic Advances in Chronic Disease

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Exhaled nitric oxide (NO) production, upregulated by inflammatory cytokines and mediators in central and peripheral airways, can be easily and non-invasively detected in exhaled air in asthma and other respiratory conditions as a promising tool for disease monitoring. The American Thoracic Society and European Respiratory Society released recommendations that standardize the measurement of the fractional exhaled NO (FeNO). In asthma, increased FeNO reflects eosinophilic-mediated inflammatory pathways and, as a biomarker of T2 inflammation can be used to identify asthma T2 phenotype. In this setting its measurement has shown to be an important tool especially in the diagnostic process, in the assessment and evaluation of poor adherence or predicting positive response to inhaled corticosteroids treatment, in phenotyping severe asthma patients and as a biomarker to predict the response to biologic treatments. The discovery of the role of NO in the pathogenesis of different diseases affecting the airways and the possibility to estimate the predominant site of increased NO production has provided new insight on its regulatory role in the airways, making it suitable for a potential extended use in clinical practice for different pulmonary diseases, even though its role remains less clear than in asthma. Monitoring FeNO in pulmonary obstructive lung diseases including chronic bronchitis and emphysema, interstitial lung diseases, obstructive sleep apnea and other pulmonary diseases is still under debate but has opened up a window to the role NO may play in the management of these diseases. The use of FeNO is reliable, cost effective and recommendable in both adults and children, and should be implemented in the management of patients with asthma and other respiratory conditions.

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Exhaled Nitric Oxide and Exhaled Breath Temperature as Potential Biomarkers in Patients with Pulmonary Hypertension

Cited by 12 publications

References 33 publications

Introducing a new prognostic instrument for long-term mortality prediction in COPD patients: the CADOT index

Introducing a new prognostic instrument for long-term mortality prediction in COPD patients: the CADOT index

Exhaled nitric oxide in pediatric patients with respiratory disease

Fractional nitric oxide measurement in exhaled air (FeNO): perspectives in the management of respiratory diseases

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