Increase in Exhaled Nitric Oxide Is Associated with Bronchial Hyperresponsiveness among Apprentices

Tossa, Paul; Paris, Christophe; Zmirou‐Navier, Denis; Demange, Valérie; Acouetey, Dovi-Stéphanie; Michaely, J.-P.; Bohadana, Abraham

doi:10.1164/rccm.200903-0415oc

Cited by 33 publications

(30 citation statements)

References 52 publications

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“…BHR to non-specific bronchoconstrictor stimuli is a key feature of asthma and could be associated with the inflammatory process of the disease. Several studies have shown that BHR to indirect stimuli such as bradykinin, mannitol and adenosine is related to Fe NO or eosinophilic inflammation [12,49,50,51], whilst a relationship between BHR and direct stimuli such as methacholine and Fe NO or eosinophilic inflammation exists [19,52] but is expressed to a lesser extent [51,53] or remains controversial [49,50,54,55]. Finally, on the basis of the present data on Fe NO in BHR-positive compared to BHR-negative patients, it can be postulated that Fe NO might also be a marker potentially able to identify BHR-positive patients with new-onset asthma, and that the link between BHR and Fe NO /eosinophilic inflammation is strictly involved in the pathogenesis of early airflow limitation as detected in newly diagnosed adult asthma cases.…”

Section: Discussionmentioning

confidence: 99%

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Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

et al. 2016

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Background: Forced expiratory flow at 25 and 75% of the pulmonary volume (FEF_25-75%) might be considered as a marker of early airway obstruction. FEF_25-75% impairment might suggest earlier asthma recognition in symptomatic subjects even in the absence of other abnormal spirometry values. Objectives: The study was designed in order to verify whether FEF_25-75% impairment in a cohort of subjects with asthma-like symptoms could be associated with the risk of bronchial hyperresponsiveness (BHR) and with airway inflammation expressed as fractional exhaled nitric oxide (FeNO) and eosinophil counts in induced sputum. Methods: Four hundred adults with a history of asthma-like symptoms (10.5% allergic) underwent spirometry, determination of BHR to methacholine (PD₂₀FEV₁), FeNO analysis and sputum induction. FEF_25-75% <65% of predicted or <-1.64 z-score was considered abnormal. Results: All subjects had normal FVC, FEV₁ and FEV₁/FVC, while FEF_25-75% was abnormal in 27.5% of them. FEF_25-75% (z-score) was associated with PD₂₀FEV₁ (p < 0.001), FeNO (p < 0.001) and sputum eosinophils (p < 0.001). Patients with abnormal FEF_25-75% showed higher levels of FeNO and eosinophils in induced sputum than did patients with normal FEF_25-75% (p < 0.01 and p < 0.01, respectively). Subjects with abnormal FEF_25-75% had an increased probability of being BHR positive (OR = 13.38; 95% CI: 6.7-26.7; p < 0.001). Conclusions: Our data show that abnormal FEF_25-75% might be considered an early marker of airflow limitation associated with eosinophilic inflammation and BHR in subjects with asthma-like symptoms, indicating a role for FEF_25-75% as a predictive marker of newly diagnosed asthma.

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Section: Discussionmentioning

confidence: 99%

“…Ciprandi et al [18] demonstrated a strong and negative correlation between Fe NO and BHR in asthmatic children; these results confirmed the existence of a link between airway inflammation and BHR. Tossa et al [19] as well proved that an increased Fe NO level was associated with BHR among apprentices.…”

Section: Introductionmentioning

confidence: 99%

Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

et al. 2016

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“…Thus, these authors concluded that measuring FeNO is a simple and useful test to differentiate AR candidates who will become asthmatics from those with other atopic conditions in a general allergy clinic. Tossa et al [23] investigated a large group of apprentices. The increase in FeNO was associated with the incidence of BHR (odds ratio 2.00) per unit increase in log parts per billion.…”

Section: Discussionmentioning

confidence: 99%

Exhaled Nitric Oxide May Predict Bronchial Hyperreactivity in Patients with Allergic Rhinitis

Cirillo

Ricciardolo

Medusei

et al. 2012

Int Arch Allergy Immunol

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Background: Nowadays it is possible to assess airway inflammation by measuring the fractional concentration of exhaled nitric oxide (FeNO) during an office visit and there is international consensus on the testing methodology. The aim of this study was to evaluate whether FeNO measurement may be a predictor of bronchial hyperreactivity (BHR) in patients with allergic rhinitis (AR). Methods: Two hundred eleven patients (196 males, median age 28.5 years) suffering from persistent AR were evaluated. Values for bronchial function (FVC, FEV₁, and FEF_25–75), bronchial provocation tests (methacholine), exhaled nitric oxide (FeNO), a visual analogue scale for nasal and bronchial symptoms, and sensitization were assessed. Results: A strong and inverse correlation between FeNO levels and BHR severity was found (r = –0.58). FeNO was a predictive factor for BHR, and 37 ppb was found to be the best cutoff (area under the curve 0.90) to define the presence of BHR in patients with AR. Conclusions: This study highlights the relevance of FeNO as a possible predictive marker for BHR in AR patients and underlines the close link between upper and lower airways. Thus, FeNO measurement could be a useful screening tool in identifying subjects with rhinitis at risk of developing asthma.

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“…However, to-date, there are only a few epidemiological studies (and none among grain workers) using this marker, and the limited evidence available suggests that bronchial hyperresponsiveness is predicted by F E NO increase, rather than by F E NO absolute value [25]. To explore an association between F E NO variation and recent exposure, a study monitoring F E NO values in the same population during the low-exposure season should to be conducted.…”

Section: Discussionmentioning

confidence: 99%

Respiratory health effects of fifteen years of improved collective protection in a wheat-processing worker population

Dorribo¹,

Wild²,

Pralong³

et al. 2015

Ann Agric Environ Med.

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Introduction. Occupational exposure to grain dust causes respiratory symptoms and pathologies. To decrease these effects, major changes have occurred in the grain processing industry in the last twenty years. However, there are no data on the effects of these changes on workers' respiratory health. Objectives. The aim of this study was to evaluate the respiratory health of grain workers and farmers involved in different steps of the processing industry of wheat, the most frequently used cereal in Europe, fifteen years after major improvements in collective protective equipment due to mechanisation. Materials and Method. Information on estimated personal exposure to wheat dust was collected from 87 workers exposed to wheat dust and from 62 controls. Lung function (FEV 1 , FVC, and PEF), exhaled nitrogen monoxide (F E NO) and respiratory symptoms were assessed after the period of highest exposure to wheat during the year. Linear regression models were used to explore the associations between exposure indices and respiratory effects. Results. Acute symptoms -cough, sneezing, runny nose, scratchy throat -were significantly more frequent in exposed workers than in controls. Increased mean exposure level, increased cumulative exposure and chronic exposure to more than 6 mg.m -3 of inhaled wheat dust were significantly associated with decreased spirometric parameters, including FEV 1 and PEF (40 ml and 123 ml.s

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Increase in Exhaled Nitric Oxide Is Associated with Bronchial Hyperresponsiveness among Apprentices

Abstract: Our results suggest that measurement of Fe(NO), a simple and reproducible test, could be useful in the screening of BHR in workers newly exposed to agents known to cause occupational asthma.

Cited by 33 publications

References 52 publications

Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

Exhaled Nitric Oxide May Predict Bronchial Hyperreactivity in Patients with Allergic Rhinitis

Respiratory health effects of fifteen years of improved collective protection in a wheat-processing worker population

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