Fractioned exhaled nitric oxide (FENO) is not a sufficiently reliable test for monitoring asthma in pregnancy

Nittner-Marszalska, Marita; Liebhart, Jerzy; Pawłowicz, Robert; Kazimierczak, A; Marszalska, Hanna; Kraus-Filarska, M; Panaszek, Bernard; Dor-Wojnarowska, Anna

doi:10.1016/j.niox.2013.06.001

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…Regarding FeNO and %FEV1, Kavitha et al reported that FeNO had a strong correlation with FEV1 (n=151, r =−0.78, P<0.001) (16) and Torre et al (17), Leung et al (18) and Surja et al (62) found that FeNO correlated with FEV1 with coefficients of r =−0.2 (n=96, P=0.03), r =−0.221 (n=92, P=0.014) and r 2 =0.403 (n=56, P=0.001), respectively. In pregnant women, Nittner-Marszalska et al also found a correlation between FeNO and FEV1 (n=72, r =−0.21; P=0.0014) (19). Nevertheless, many researchers reported that no such association was found such as Senna (n=27, r =−0.24, P=0.…”

Section: Discussionmentioning

confidence: 93%

“…Each item has five response choices (each with a score ranging from 1-5). Accordingly, the level of asthma control is categorized as follows: controlled (scores 20-25), partially controlled (scores [15][16][17][18][19], and uncontrolled (scores <15) (8).…”

Section: Data Collectionmentioning

confidence: 99%

“…For asthma severity, although GINA (from 2014 onwards) recommends to use their treatment steps to determine patients' asthma severity, spirometry is still used in many countries (including Vietnam) as an important indicator for potential adverse outcomes and for information on asthma severity (10,11). To evaluate the role of FeNO in asthma management, the relationship between FeNO and asthma control and asthma severity was tested and an association was found between FeNO and the ACT score, as well between FeNO and spirometry parameters (12)(13)(14)(15)(16)(17)(18)(19). However, no data are available to confirm whether this relationship also exists in asthmatic patients in Vietnam.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between fractional exhaled nitric oxide and Asthma Control Test score and spirometry parameters in on-treatment- asthmatics in Ho Chi Minh City

Nguyen¹,

Chavannes²

2020

J Thorac Dis

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Background: Although fractional exhaled nitric oxide (FeNO) is a reliable and easily applied marker of airway inflammation in asthma, the relationship between FeNO and indicators of asthma control [Asthma Control Test (ACT) score] and/or severity (spirometry parameters) remains unclear. This study aims to determine possible correlations between FeNO and ACT score; and between FeNO and spirometry parameters. Methods: A cross-sectional study with convenience sampling was conducted among ambulatory patients in the Asthma & COPD clinic at the University Medical Center, Ho Chi Minh City from March 2016 to March 2017. Using measurement of FeNO, the ACT questionnaire and a spirometry test, correlations were determined between FeNO and the ACT score and spirometry parameters. Results: Four hundred and ten asthmatic patients (mean age 42 years; 65% female) were included and analyzed; their mean time since onset of asthma was 9.5 years. All patients were treated following step 2 to 4 of GINA guidelines. Mean (SD) FeNO was 29.5 (24.4) parts per billion (ppb) and mean (SD) ACT score was 20.5 (40). A significant difference in FeNO values was found among the three groups with different asthma control levels categorized according to the ACT score (P=0.001) but was not found among the three groups with different asthma treatment levels (P=0.425). FeNO was significantly inversely correlated with the ACT score (Spearman's r =−0.224, P<0.001) and with spirometry parameters indicate airway obstruction such as predicted FEV1, FEV1/FVC, predicted PEF and predicted FEF25-75% with Spearman's r were −0.187; −0.143; −0.091 and −0.195, respectively (all P<0.05), whereas no correlation between FeNO and FVC-an indicator of airway restriction-was found.Conclusions: In these asthmatic patients in Vietnam, an inverse correlation was found between FeNO and the ACT score and between FeNO and spirometry indicators of airway obstruction. Therefore, FeNO may be a useful tool in asthma management.

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Section: Discussionmentioning

confidence: 93%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Correlation between fractional exhaled nitric oxide and Asthma Control Test score and spirometry parameters in on-treatment- asthmatics in Ho Chi Minh City

Nguyen¹,

Chavannes²

2020

J Thorac Dis

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“…FeNO obtained at 50 mL/s is a reliable source of the production of NO in respiratory airways, but there is no simple surrogate for determining the distal airway/alveolar concentration of NO (CANO), because FeNO must be obtained at multiple expiratory flow rates in order to be able to distinguish between the airway production and CANO: 30, 50, 100, and 200 mL/s [ 89 ]. Physiological and pathological conditions responsible for affecting FeNO measurements are reviewed and summarized in Table 2 [ 35 – 62 ]. According to the American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines, nondisease related patient factors influencing FeNO values are very young age (children), female sex (during menses or pregnancy), respiratory maneuvers (performing spirometry reduces FeNO), airway calibrating, some food and beverages, smoking (which reduces FeNO chronically and acutely), infections, hypoxia, exercise, and medications directly related to NO synthesis [ 89 ] ( Table 2 ).…”

Section: Exhaled Nitric Oxide (Feno) Measurementmentioning

confidence: 99%

Psoriasis and Respiratory Comorbidities: The Added Value of Fraction of Exhaled Nitric Oxide as a New Method to Detect, Evaluate, and Monitor Psoriatic Systemic Involvement and Therapeutic Efficacy

Santus

Rizzi

Radovanovic

et al. 2018

BioMed Research International

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Psoriasis is a chronic inflammatory systemic disease characterized by a wide range of comorbidities. Respiratory comorbidities are currently poorly characterized and with discordant results. The systemic state of inflammation caused by psoriasis acts de novo on respiratory tissues and amplifies preexisting inflammation from asthma or chronic obstructive pulmonary disease. Because the lungs act as a gas exchanger between the internal and external environment, the impact of chronic psoriasis inflammation may be easily assessed through the analysis of exhaled breath. The fraction of exhaled nitric oxide test (FeNO) is a potential noninvasive solution that can provide quantitative and qualitative indices of respiratory airway inflammation. FeNO is routinely used to screen and manage asthmatic patients. Recent pilot studies contain encouraging data that underscore its possible use with systemic inflammatory nonpulmonary diseases, such as psoriasis. FeNO may therefore be a useful tool to evaluate underestimated airway inflammation and at the same time globally evaluate the impact of systemically antipsoriatic therapies.

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“…Fractional exhaled nitric oxide (FE NO ) measurement is a promising non-invasive method which can be utilized also in pregnancy [8], moreover, asthma treatment based on FE NO during pregnancy was able to decrease the occurrence of exacerbations, together with improving life quality and decreasing neonatal hospitalizations compared with traditional asthma management [9]. However, a more recent longitudinal study detected large intraindividual variability in asthmatic pregnant women independently of asthma control [10]. Furthermore, perception of asthma control is subjective and can vary from patient to patient.…”

Section: Introductionmentioning

confidence: 99%

Circulating periostin level in asthmatic pregnancy

et al. 2016

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Objective: Asthma often complicates pregnancy and represents a risk for complications.Periostin is considered as a biomarker of asthma; however, as it also plays a role in normal gestation, pregnancy may influence circulating periostin levels. This is the first study assessing periostin in asthmatic pregnancy.Methods: Plasma periostin levels were investigated in asthma (asthmatic non-pregnant, ANP; N = 19) and asthmatic pregnancy (AP; N = 14), compared to healthy non-pregnant controls (HNP; N = 12) and healthy pregnant women (HP; N = 17). The relationship between periostin levels and asthma control determinants was also evaluated. The diagnostic efficacy of periostin to detect uncontrolled asthma was analyzed using ROC analysis. (54.02 [44.30-74.94] ng/mL, p = 0.0346 vs. ANP). Periostin levels of the two pregnant groups were similar (p > 0.05). In AP women periostin correlated negatively with FEV 1 (r = -0.5516) and positively with Raw (r = 0.5535; both p < 0.05).Conclusions: Pregnancy itself increases circulating periostin levels and this elevation is detectable in asthmatic pregnancy as well. Although periostin correlates with lung function in asthmatic pregnancy, periostin as a biomarker has to be handled with caution in pregnant patients due to the influence of pregnancy on its plasma level.

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Fractioned exhaled nitric oxide (FENO) is not a sufficiently reliable test for monitoring asthma in pregnancy

Cited by 7 publications

References 30 publications

Correlation between fractional exhaled nitric oxide and Asthma Control Test score and spirometry parameters in on-treatment- asthmatics in Ho Chi Minh City

Correlation between fractional exhaled nitric oxide and Asthma Control Test score and spirometry parameters in on-treatment- asthmatics in Ho Chi Minh City

Psoriasis and Respiratory Comorbidities: The Added Value of Fraction of Exhaled Nitric Oxide as a New Method to Detect, Evaluate, and Monitor Psoriatic Systemic Involvement and Therapeutic Efficacy

Circulating periostin level in asthmatic pregnancy

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