Asthma and lower airway diseaseExhaled nitric oxide: A biomarker integrating both lung function and airway inflammation changes
Section snippets
Subjects
Patients with intermittent or mild persistent asthma associated with house dust mite allergy were recruited from the outpatient asthma clinic (CUB Erasme University Hospital, Brussels, Belgium). Asthma was diagnosed according to standard criteria,1 and sensitivity to house dust mite was evaluated by using skin prick tests or RASTs with commercially available extracts. Patients had no recent history of smoking or upper airway infection. At least 2 weeks before the challenge procedure, asthma
Patients' characteristics
Fifteen patients (mean age, 26 years; 11 men and 4 women) were included, with 13 exhibiting both EARs and LARs (dual responders). Baseline mean FEV1 was 94.9% of predicted value.
Lung function and Feno values
For Feno values, spirometric values (FEV1), SHe, and SSF6, 5 time points after the allergen challenge were taken into account: EAR, recovery phase, LAR, and 8 and 24 hours after challenge. Fig 1 shows the mean changes in percentage from baseline of FEV1 (Fig 1, black line and circles) and Feno (Fig 1, blue line and
Discussion
This study showed that in patients with mild allergic asthma, airway caliber changes significantly modulated Feno changes resulting from concomitant airway inflammatory reactions.
Feno is generally accepted as an airway inflammation marker because Feno values have been reported to reflect the eosinophilic inflammatory process that occurs in the airways of asthmatic patients.4 However, airway caliber appears to be another relevant determinant of Feno values. FEV1 reduction induced by airway
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Chiesi provided a grant for the Immunobiology of Asthma Unit.
Disclosure of potential conflict of interest: A. Haccuria has received research support from and has a board membership with Chiesi. A. Michils has received research support from Chiesi, Novartis, and AstraZeneca; is on advisory boards for Chiesi, Novartis, and AstraZeneca; has received payment for lectures from AstraZeneca, Stallergenes, and Chiesi; and has received travel support from Novartis and Chiesi. A. Van Muylem has received research support and payment for lectures from Chiesi. S. Michiels declares that he has no relevant conflicts of interest.