Measurement of Fractional Exhaled Nitric Oxide (FeNO) as a Marker of Disease Activity in IBD

Ikonomi, Erkanda; Bathula, Vikram; Ahmed, Ovais; Ehrlich, Adam C.; Rothstein, Robin D.; Friedenberg, Frank K.

doi:10.14309/00000434-201310001-01689

Cited by 4 publications

(5 citation statements)

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“…FeNO originates from the airway epithelial cells through the upregulation of inducible nitric oxide synthase (i-NOS) activity. Of note, FeNO has not only been found elevated in patients with IBD but is also positively associated with disease activity [55][56][57][58][59]. However, CANO represents a marker of small airway inflammation, extensively investigated in conditions such as asthma [38,[60][61][62][63][64] and other pulmonary diseases [65][66][67][68][69][70][71][72].…”

Section: Discussionmentioning

confidence: 99%

Lung Involvement in Patients with Ulcerative Colitis: Relationship between Exhaled Nitric Oxide and Lung Function

Ragnoli,

Cena,

Pochetti

et al. 2024

JCM

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Ulcerative colitis (UC) is characterized by immune system dysregulation with frequent extraintestinal manifestations, including airway involvement. A reduction in CO diffusing capacity and functional alterations in small airways have been described. An extended analysis of fractional exhaled nitric oxide (FeNO) may distinguish the sites of production, and the presence of small airway inflammation may be a useful, non-invasive marker for patient follow-up. The aim of our study was to compare the PFTs as well as FeNO and CANO values of UC patients with different clinical disease activities and healthy subjects to reveal lung function abnormalities and the presence of subclinical airway inflammation. We enrolled 42 adult outpatients at different clinical activity stages of UC (39 ± 13 years) and a healthy control group of 41 subjects (29 ± 3 years). C-reactive protein (CRP) and FeNO values at different flows (50,100, and 200 mL/s) were collected. All patients performed pulmonary function tests (PFTs) with static volumes and diffusing capacity (DLCO). FeNO and CANO values were significantly increased in UC patients when compared with controls (p = 0.0008 and p < 0.0001, respectively) and were proportional to disease activity (FeNO class 3: 28.1 ppb vs. classes 1–2: 7.7 ppb; CANO values class 3: 8.6 ppb vs. classes 1–2: 2.7 ppb (p < 0.0001)). TLC and DLCO were significantly reduced in severe (Mayo 3) UC patients (p = 0.010 and p = 0.003, respectively). The results of this study show significant lung functional abnormalities in UC patients and suggest the presence of airway inflammation directly correlated with disease activity, suggesting the need for an integrated approach in routine assessment.

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Section: Discussionmentioning

confidence: 99%

Lung Involvement in Patients with Ulcerative Colitis: Relationship between Exhaled Nitric Oxide and Lung Function

Ragnoli,

Cena,

Pochetti

et al. 2024

JCM

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“…FeNO originates from the airway epithelial cells through upregulation of inducible nitric oxide synthase (i-NOS) activity. Of note, FeNO has not only been found elevated in patients with IBD but is also positively associated with disease activity [55][56][57][58][59]. On the other hand, CANO represents a marker of small airway inflammation, extensively investigated in conditions such as asthma [60][61][62][63][64][65] and other pulmonary diseases [66][67][68][69][70][71][72][73][74].…”

Section: Discussionmentioning

confidence: 99%

Lung Involvement in Patients with Ulcerative Colitis: Interlink between Exhaled Nitric Oxide and Lung Function

Ragnoli,

Cena,

Pochetti

et al. 2023

Preprint

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(1) Background: Ulcerative colitis (UC) is characterized by immune system dysregulation with frequent extraintestinal manifestations, including airways involvement. Reduction in CO diffusing capacity and functional alterations in small airways have been described. The extended analysis of Fractional Exhaled Nitric Oxide (FeNO), may distinguish the sites of production and the presence of small airways inflammation being a useful, non-invasive marker for these patient’s follow up. The aim of our study was to compare PFTs, FeNO and CANO values of UC patients with different clinical disease activity and healthy subjects to reveal lung function abnormalities and the presence of subclinical airway inflammation. (2) Methods: We enrolled 42 adult outpatients with different clinical activity stages of UC (mean age 39±13 years) and a healthy control group of 41 subjects (mean age 29±3 years). C-reactive protein (CRP) and FeNO values at different flows (50,100 and 200 ml/sec) were collected. All patients performed pulmonary function tests (PFT’s) with static volumes and diffusing capacity (DLCO). (3) Results: FENO, CANO and CRP values were significantly increased in UC patients when compared with controls (p=0.02 and p&lt;0.0001, respectively) and proportionally to the disease activity (FeNO class 3: 27.1 ppb vs class 1-2: 6.2 ppb; CANO values class 3: 8.1 ppb vs class 1-2: 2.0 ppb (p &lt; 0.0001). TLC and DLCO were significantly reduced in UC patients compared to controls (p=0.011 and p&lt;0.0001, respectively). (4) The results of this study show significant lung functional abnormalities in UC patients and suggest the presence of airway inflammation directly correlated with the disease activity suggesting an integrated approach in routine assessment.

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“…Clinical experience and early reports have documented a consistent response to ICS (and systemic corticosteroids) . How these improvements correlate to observations of elevated exhaled nitric oxide known to be present in some IBD patients remains unclear …”

Section: Bronchiectasis and Coexisting Ibd In Adultsmentioning

confidence: 96%

Paediatric and adult bronchiectasis: Specific management with coexisting asthma, COPD, rheumatological disease and inflammatory bowel disease

2019

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Bronchiectasis, conventionally defined as irreversible dilatation of the bronchial tree, is generally suspected on a clinical basis and confirmed by means of chest high-resolution computed tomography. Clinical manifestations, including chronic productive cough and endobronchial suppuration with persistent chest infection and inflammation, may deeply affect quality of life, both in children/adolescents and adults. Despite many cases being idiopathic or post-infectious, a number of specific aetiologies have been traditionally associated with bronchiectasis, such as cystic fibrosis (CF), primary ciliary dyskinesia or immunodeficiencies. Nevertheless, bronchiectasis may also develop in patients with bronchial asthma; chronic obstructive pulmonary disease; and, less commonly, rheumatological disorders and inflammatory bowel diseases. Available literature on the development of bronchiectasis in these conditions and on its management is limited, particularly in children. However, bronchiectasis may complicate the clinical course of the underlying condition at any age, and appropriate management requires an integration of multiple skills in a team of complementary experts to provide the most appropriate care to affected children and adolescents. The present review aims at summarizing the current knowledge and available evidence on the management of bronchiectasis in the other conditions mentioned and focuses on the new therapeutic strategies that are emerging as promising tools for improving patients' quality of life.

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Measurement of Fractional Exhaled Nitric Oxide (FeNO) as a Marker of Disease Activity in IBD

Cited by 4 publications

References 0 publications

Lung Involvement in Patients with Ulcerative Colitis: Relationship between Exhaled Nitric Oxide and Lung Function

Lung Involvement in Patients with Ulcerative Colitis: Relationship between Exhaled Nitric Oxide and Lung Function

Lung Involvement in Patients with Ulcerative Colitis: Interlink between Exhaled Nitric Oxide and Lung Function

Paediatric and adult bronchiectasis: Specific management with coexisting asthma, COPD, rheumatological disease and inflammatory bowel disease

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