Oral bacteria – The missing link to ambiguous findings of exhaled nitrogen oxides in cystic fibrosis

Zetterquist, Wilhelm; Marteus, H; Kalm-Stephens, Pia; nas, E. Due; Nordvall, Lennart; Johannesson, Marie; Alving, Kjell

doi:10.1016/j.rmed.2008.09.009

Cited by 38 publications

(33 citation statements)

References 43 publications

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“…Furthermore, a decrease in NO 2 concentration in saliva after chlorhexidine mouthwash is coupled with an increase in NO 3 concentration. However, EBC concentration of NO 3 is not affected by oropharyngeal disinfection (15). In accordance with these fi ndings, EBC concentration of NO 2 in CF patients is not correlated to pulmonary function (FEV 1 ), chest radiograph (Crispin-Norman score) and clinical status (modifi ed Shwachman-Kulczycki score) and also do not predict pulmonary exacerbation (36).…”

Section: Tab 4 Spearman's Correlations (R S ) Between Clinical Charsupporting

confidence: 64%

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Nitrites and nitrates in exhaled breath condensate in cystic fibrosis: relation to clinical parameters

Fila¹,

Chládek²,

Malý³

et al. 2013

BLL

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Abstract:Objectives: To evaluate correlation of exhaled breath condensate (EBC) nitrite and nitrate concentrations with disease severity in cystic fi brosis (CF) patients. Background: Nitrites and nitrates are products of oxidative metabolism of nitric oxide. Impaired metabolism of nitric oxide plays a role in pathogenesis of CF. Methods: EBC was collected from 46 stable CF patients and from 21 healthy controls. EBC concentrations of nitrites and nitrates were correlated with parameters of lung disease and nutritional status and with systemic infl ammatory markers. Results: EBC nitrates concentrations in CF patients were lower than in healthy subjects (5.8 vs 14.3 μmol/l, p<0.001). They correlated positively with FEV 1 (p=0.025) and serum albumin values (p=0.016) and negatively with chest radiograph Northern score (p=0.015) and serum C-reactive protein values (p=0.005). EBC nitrites concentrations in CF patients did not differ from those in healthy subjects and were not correlated to any studied parameter. Conclusions: EBC nitrates concentrations correlate with disease severity in CF patients and are lower than in healthy subjects (Tab. 4, Fig. 1

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Section: Tab 4 Spearman's Correlations (R S ) Between Clinical Charsupporting

confidence: 64%

“…The concentrations of NO 2 in EBC in CF patients were similar or higher when compared with healthy controls and did not correlate with pulmonary function (11,12). On the other hand, the concentrations of NO 3 in EBC were similar or lower in CF patients than in controls (13,14,15).…”

mentioning

confidence: 97%

Nitrites and nitrates in exhaled breath condensate in cystic fibrosis: relation to clinical parameters

Fila¹,

Chládek²,

Malý³

et al. 2013

BLL

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“…There is an increased likelihood of oropharyngeal contamination with volatile biomarkers; e.g., most EBC ammonia arises from bacterial degradation of urea in the oropharynx [ 98 ]. Additionally, oropharyngeal bacterial flora may significantly contribute to EBC nitrite levels, since levels decrease following a chlorhexidine mouthwash [ 99 ]. High concentrations of eicosanoids have been detected in saliva [ 79 ], with prostaglandins and leukotrienes formed in the nose and mixing with oral expiratory air via the nasopharynx [ 79 ].…”

Section: Sample Contaminationmentioning

confidence: 99%

Exhaled breath condensate: a comprehensive update

Ahmadzai

Huang²,

Hettiarachchi³

et al. 2013

Clinical Chemistry and Laboratory Medicine

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Since the late 1990s, a surge in interest in the analysis of exhaled breath condensate (EBC) resulted in the American Thoracic Society and European Respiratory Society (ATS/ERS) organising a Task Force in 2001 to develop guidelines on EBC collection and measurement of biomarkers. This Task Force published their guidelines in 2005 based on literature and expert opinions at that time, and multiple shortcomings and knowledge deficits were also identified. The clinical application of EBC collection and its biomarkers are currently still limited by several of these knowledge gaps, hence further guidelines for standardisation are required to ensure external validity. Using related articles produced since the publication of the ATS/ERS Task Force report, this paper attempts to provide a comprehensive update to the original guideline and review the methodological shortcomings identified. This review can hopefully serve as a yardstick for future studies involving this emerging clinical tool.

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“…FE NO is low in both children [40,63,146,147] and infants [134,148] with CF despite chronic airway inflammation, although FE NO levels similar to or higher than control subjects are also reported in children and infants with CF [93,139,149]. FE NO is negatively correlated with lung clearance index in CF [40] and FE NO is lower in patients with severe CF lung disease than in those with mild disease [147,150].…”

Section: Cystic Fibrosis (Cf)mentioning

confidence: 90%

“…Oral or intravenous l-arginine has been shown to increase FE NO in healthy adults [60,61], but a recent study did not show a significant increase in FE NO after oral arginine administration regardless of history of allergy [62], at the same dose studied in the previous study [60]. The nitrite-reducing conditions in the oral cavity by using antibacterial mouthwash such as chlorhexidine acetate or sodium bicarbonate reduce FE NO [55,63]. Inhaled and oral corticosteroid reduce FE NO in asthma [32,[64][65][66] and leukotriene receptor antagonist such as montelukast also decreases FE NO [67].…”

Section: Medicationsmentioning

confidence: 90%

Fractional Exhaled Nitric Oxide: Indications and Interpretation

Kim

Kercsmar

Davis

2014

Respiratory Medicine

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Exhaled nitric oxide (NO) is a marker for eosinophilic airway inflammation. The correlations between fraction of exhaled NO (FE NO ) and eosinophils in blood, sputum, bronchoalveolar lavage, and mucosal biopsies of the airway have been well studied. A quantitative, noninvasive, and simple methodology has been developed to determine how best to assess FE NO as a measure of airway inflammation. FE NO measurement has been standardized by the American Thoracic Society/ European Respiratory Society (Am J Respir Crit Care Med 171(8): [912][913][914][915][916][917][918][919][920][921][922][923][924][925][926][927][928][929][930] 2005). The gold standard for measuring FE NO is the single-breath online method, which can be performed in young children from the age of 4-5 years. A chemiluminescencebased analyzer or a portable analyzer using an electrochemical sensor can be used to measure FE NO . Many studies have shown that FE NO has potential diagnostic and therapeutic roles in various respiratory diseases, particularly asthma. In asthma, FE NO is useful to diagnose and monitor eosinophilic airway inflammation, and predict steroid responsiveness. It also can be helpful in supporting the diagnosis of asthma and in guiding adjustment of anti-inflammatory medication. ATS Clinical Practice Guidelines have been published for interpretation and clinical applicability of FE NO (Dweik et al., 184(5):602-615, 2011). FE NO can provide additional information on underlying airway inflammation, and is complementary to respiratory symptoms, lung function tests, and bronchial provocation tests for asthma and other respiratory diseases in the clinical setting.

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Oral bacteria – The missing link to ambiguous findings of exhaled nitrogen oxides in cystic fibrosis

Cited by 38 publications

References 43 publications

Nitrites and nitrates in exhaled breath condensate in cystic fibrosis: relation to clinical parameters

Nitrites and nitrates in exhaled breath condensate in cystic fibrosis: relation to clinical parameters

Exhaled breath condensate: a comprehensive update

Fractional Exhaled Nitric Oxide: Indications and Interpretation

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