Exhaled nitric oxide in bronchiectasis: the effects of inhaled corticosteroid therapy.
METHODS
While exhaled nitric oxide (eNO) levels are reduced by inhaled corticosteroid therapy in asthma, such treatment effect is unclear in bronchiectasis.


METHODS
Stable non-smoking bronchiectasis patients were randomised to receive either fluticasone (1 mg/daily) or identical placebo via the Accuhaler device.


RESULTS
Sixty non-smoking patients (38 women; mean age 56.4 +/- 12.7 years) were recruited. Of these, half received inhaled fluticasone and half placebo therapy. eNO was measured using a chemiluminescence analyser at 0, 4, 12, 24, 36 and 52 weeks. There was no significant difference in eNO levels between fluticasone and placebo patients over the study period. There was no correlation between baseline eNO with age, FEV1, FVC, 24 h sputum volume or number of bronchiectatic segments. Patients with Pseudomonas aeruginosa (PA) infection, but not their counterparts, displayed a correlation between 0- and 52-week eNO levels. PA infection was associated with significantly lower eNO levels among the patients.


CONCLUSIONS
Inhaled fluticasone therapy, despite being an effective anti-inflammatory agent, has no significant effect on eNO production, either at individual time points or over the entire 52-week profile, in bronchiectasis. It appears that eNO might not reflect the extent of airway inflammation in bronchiectasis.
Tsang
K W
KW
University Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China. kwttsang@hku.hk
Tan
K C
KC
Ho
P L
PL
Ooi
G C
GC
Khong
P L
PL
Leung
R
R
Mak
J C
JC
Tipoe
G L
GL
Ko
C
C
Lam
W K
WK
D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000730:Androstadienes / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001944:Breath Tests; D001987:Bronchiectasis / Q000188:drug therapy* / Q000378:metabolism*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D045853:Exhalation; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism*
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D009569:Nitric Oxide; D000068298:Fluticasone