title: Low levels of nitric oxide and carbon monoxide in alpha 1-antitrypsin deficiency.
abstract: Quantitations of exhaled nitric oxide (NO) and carbon monoxide (CO) have been proposed as noninvasive markers of airway inflammation. We hypothesized that exhaled CO is increased in individuals with alpha(1)-antitrypsin (AT) deficiency, who have lung inflammation and injury related to oxidative and proteolytic processes. Nineteen individuals with alpha(1)-AT deficiency, 22 healthy controls, and 12 patients with non-alpha(1)-AT-deficient chronic obstructive pulmonary disease (COPD) had NO, CO, CO(2), and O(2) measured in exhaled breath. Individuals with alpha(1)-AT deficiency had lower levels of NO and CO than control or COPD individuals. Alpha(1)-AT-deficient and COPD patients had lower exhaled CO(2) than controls, although only alpha(1)-AT-deficient patients had higher exhaled O(2) than healthy controls. NO was correlated inversely with exhaled O(2) and directly with exhaled CO(2), supporting a role for NO in regulation of gas exchange. Exhaled gases were not significantly related to corticosteroid use or lung function. Demonstration of lower than normal CO and NO levels may be useful as an additional noninvasive method to evaluate alpha(1)-AT deficiency in individuals with a severe, early onset of obstructive lung disease.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Roberto F
authors.initials: RF
authors.lastname: Machado
authors.forename: James K
authors.initials: JK
authors.lastname: Stoller
authors.forename: Daniel
authors.initials: D
authors.lastname: Laskowski
authors.forename: Shuo
authors.initials: S
authors.lastname: Zheng
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Lupica
authors.forename: Raed A
authors.initials: RA
authors.lastname: Dweik
authors.forename: Serpil C
authors.initials: SC
authors.lastname: Erzurum
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D015415:Biomarkers; D001944:Breath Tests; D002245:Carbon Dioxide / Q000032:analysis; D002248:Carbon Monoxide / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D010100:Oxygen / Q000032:analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D019896:alpha 1-Antitrypsin Deficiency / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism*
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D002245:Carbon Dioxide; D009569:Nitric Oxide; D002248:Carbon Monoxide; D010100:Oxygen