Off-Line Fractional Exhaled Nitric Oxide Measurement Is Useful to Screen Allergic Airway Inflammation in an Adult Population

Saito, Junpei; Sato, Suguru; Hasunuma, Hideki; Ishimaru, Yasushi; Kanegae, Hiroshi; Kudoh, Shoji; Munakata, Mitsuru

doi:10.1080/02770900701645595

Cited by 14 publications

(14 citation statements)

References 26 publications

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“…NO reacts with superoxides (O·) to form the highly reactive peroxynitrites (ONOO – ) that have been shown to produce airway inflammation7 and cause airway remodelling 8 9. Furthermore, the fractional concentration of NO in exhaled breath, a marker of airway inflammation,10 is predominantly of iNOS origin 11. Increased expression of iNOS may play a role in inflammation of the upper and lower airways, and contribute to both allergic rhinitis and asthma 12…”

Section: Introductionmentioning

confidence: 99%

Role of inducible nitric oxide synthase in asthma risk and lung function growth during adolescence

Islam

Breton²,

Salam³

et al. 2009

Thorax

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Background Inducible nitric oxide (NO) synthase (iNOS, encoded by NOS2A) produces NO in response to environmental stimuli, which can result in nitrosative stress. Because nitrosative stress affects respiratory health, it was hypothesised that variants in NOS2A are associated with asthma incidence and lung function growth during adolescence. Methods In this prospective study, spirometric testing was performed at school and a presence or absence of asthma was ascertained annually by questionnaire among children participating in the Southern California Children's Health Study. 24 single nucleotide polymorphisms (SNPs) of the NOS2A region (with seven promoter SNPs in one haplotype block), spanning 20 kb upstream and 10 kb downstream were genotyped. Association between the NOS2A region and asthma or lung function growth was tested using genetic blockspecific principal component and haplotype analyses. This study was restricted to children with Latino and Caucasian ancestry for analyses of both asthma (n¼1596) and lung function growth (n¼2108). Result A pair of "yineyang" haplotypes in the promoter region showed strong association with new-onset asthma and lung function growth. The "yin" haplotype (h0111101) was associated with 44% increased asthma risk (p¼0.003) and reduced forced expiratory volume in 1 s (FEV 1 ) growth from 10 to 18 years of age (À29.46 ml, p¼0.07), whereas the "yang"(h1000010) haplotype was associated with 23% reduced asthma risk (p¼0.13) and better FEV 1 growth (43.84 ml, p¼0.01). Furthermore, the increased asthma risk associated with h0111101 was restricted to children with the GSTM1 "null" genotype (interaction p¼0.002, HR 1.89, 95% CI 1.34 to 2.60). Conclusion Common haplotypes in the NOS2A promoter are associated with new-onset asthma and lung function growth. These effects are stronger in adolescents with the GSTM1 "null" genotype.

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Section: Introductionmentioning

confidence: 99%

Role of inducible nitric oxide synthase in asthma risk and lung function growth during adolescence

Islam

Breton²,

Salam³

et al. 2009

Thorax

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“…Strictly, current asthma symptoms on the ECRHS questionnaire are not equal to clinically current symptoms because this questionnaire is designed to detect asthma symptoms over 1 year. Although we must also emphasize that the ROC curve was constructed only to classify subjects of this study and that it was not constructed to help diagnose asthma, a previous study using the same offline method proposed that the optimal cut-off value of FENO was 38.0 ppb for detecting allergic airway inflammation in an adult population [10]. This cut-off value was equal to that we used in this study.…”

Section: Discussionmentioning

confidence: 96%

“…Breath samples were obtained using an offline kit produced by the Center for Environmental Information Science (Tokyo, Japan) to measure F E NO under the same conditions as with online measurement [10,11]. In this device, the expiratory flow rate is adjusted to 50 mL/s when subjects exhale at 1.5 kPa oral pressure after inhaling deeply.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence of asthma symptoms based on the European Community Respiratory Health Survey questionnaire and FE NO in university students: gender differences in symptoms and FE NO

Ishizuka

Matsuzaki

Aoki

et al. 2011

All Asth Clin Immun

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BackgroundThe fractional concentration of nitric oxide in exhaled air (FENO) is used as a biomarker of eosinophilic airway inflammation. FENO is increased in patients with asthma. The relationship between subjective asthma symptoms and airway inflammation is an important issue. We expected that the subjective asthma symptoms in women might be different from those in men. Therefore, we investigated the gender differences of asthma symptoms and FENO in a survey of asthma prevalence in university students.MethodsThe information about asthma symptoms was obtained from answers to the European Community Respiratory Health Survey (ECRHS) questionnaire, and FENO was measured by an offline method in 640 students who were informed of this study and consented to participate.ResultsThe prevalence of asthma symptoms on the basis of data obtained from 584 students (266 men and 318 women), ranging in age from 18 to 24 years, was analyzed. Wheeze, chest tightness, an attack of shortness of breath, or an attack of cough within the last year was observed in 13.2% of 584 students. When 38.0 ppb was used as the cut-off value of FENO to make the diagnosis of asthma, the sensitivity was 86.8% and the specificity was 74.0%. FENO was ≥ 38.0 ppb in 32.7% of students. FENO was higher in men than in women. The prevalence of asthma symptoms estimated by considering FENO was 7.2%; the prevalence was greater in men (9.4%) than women (5.3%). A FENO ≥ 38.0 ppb was common in students who reported wheeze, but not in students, especially women, who reported cough attacks.ConclusionsThe prevalence of asthma symptoms in university students age 18 to 24 years in Japan was estimated to be 7.2% on the basis of FENO levels as well as subjective symptoms. Gender differences were observed in both FENO levels and asthma symptoms reflecting the presence of eosinophilic airway inflammation.Trial registration numberUMIN000003244

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“…Although reasonable agreement has been shown between online and offline measurements [18-20], the measured FeNO values may increase or decrease over time [14,21]. Some investigators found that FeNO levels in the reservoir bag increased after collection [20,22], but others reported that the samples were stable for 24–48 hours [23].…”

Section: Introductionmentioning

confidence: 99%

Storage conditions for stability of offline measurement of fractional exhaled nitric oxide after collection for epidemiologic research

et al. 2012

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BackgroundThe measurement of fractional concentration of nitric oxide in exhaled air (FeNO) is valuable for the assessment of airway inflammation. Offline measurement of FeNO has been used in some epidemiologic studies. However, the time course of the changes in FeNO after collection has not been fully clarified. In this study, the effects of storage conditions on the stability of FeNO measurement in exhaled air after collection for epidemiologic research were examined.MethodsExhaled air samples were collected from 48 healthy adults (mean age 43.4 ± 12.1 years) in Mylar bags. FeNO levels in the bags were measured immediately after collection. The bags were then stored at 4°C or room temperature to measure FeNO levels repeatedly for up to 168 hours.ResultsIn the bags stored at room temperature after collection, FeNO levels were stable for 9 hours, but increased starting at 24 hours. FeNO levels remained stable for a long time at 4°C, and they were 99.7% ± 7.7% and 101.3% ± 15.0% relative to the baseline values at 24 and 96 hours, respectively. When the samples were stored at 4°C, FeNO levels gradually decreased with time among the subjects with FeNO ≥ 51 ppb immediately after collection, although there were almost no changes among the other subjects. FeNO levels among current smokers increased even at 4°C, although the values among ex-smokers decreased gradually, and those among nonsmokers remained stable. The rate of increase was significantly higher among current smokers than among nonsmokers and ex-smokers from 9 hours after collection onwards.ConclusionsStorage at 4°C could prolong the stability of FeNO levels after collection. This result suggests that valid measurements can be performed within several days if the samples are stored at 4°C. However, the time course of the changes in FeNO levels differed in relation to initial FeNO values and cigarette smoking.

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Off-Line Fractional Exhaled Nitric Oxide Measurement Is Useful to Screen Allergic Airway Inflammation in an Adult Population

Cited by 14 publications

References 26 publications

Role of inducible nitric oxide synthase in asthma risk and lung function growth during adolescence

Role of inducible nitric oxide synthase in asthma risk and lung function growth during adolescence

Prevalence of asthma symptoms based on the European Community Respiratory Health Survey questionnaire and FE NO in university students: gender differences in symptoms and FE NO

Storage conditions for stability of offline measurement of fractional exhaled nitric oxide after collection for epidemiologic research

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