[The effect of asthma and COPD exacerbation on exhaled nitric oxide (FE(NO))].
Exhaled nitric oxide is a marker of airway inflammation and it is significantly decreased by glucocorticosteroid therapy, especially in patients with asthma.


OBJECTIVE
Evaluation of changes in FE(NO) in asthma and COPD exacerbation.


METHODS
17 patients with acute asthma and 19 patients with an exacerbation of COPD were enrolled to the study. FE(NO) (chemiluminescence, on-line, restricted breath technique measurement in accordance with the ATS recommendations) was performed for five consecutive days following admission to hospital. Results of the following additional blood investigations: peripheral white blood cell count, ESR, C-reactive protein level, arterial blood gases, spirometry or peak expiratory flow were also analyzed.


RESULTS
The average value of FE(NO) on admission was 41.5+/-10.7 ppb (95% CI: 18.8-64.2 ppb) asthma patients and 28.6+/-5.4 ppb (95% CI: 17.4-40.0 ppb) in COPD patients. In asthma patients a significant decrease of FE(NO) on the third day of therapy was observed (41.5 vs 26.1 ppb, p < 0.05). We found a positive correlation between FE(NO) on admission and the peripheral blood eosinophil count. In COPD patients a significant decrease of FE(NO) on the 4th day was noted (28.6 vs 17.5 ppb, p < 0.05). FE(NO) in both groups was higher than that of 19 healthy volunteers previously studied in our laboratory (14.1+/-4.7 ppb; 95% CI: 11.8+/-16.4 ppb).


CONCLUSIONS
Exacerbations of asthma and COPD are associated with an increased FE(NO). FE(NO) measurement is a useful tool in the assessment of treatment efficacy. Exhaled nitric oxide may indicate the intensity of allergic inflammation in patients with asthma.
Maskey-Warzechowska
Marta
M
Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii, AM w Warszawie.
Przybyłowski
Tadeusz
T
Hildebrand
Katarzyna
K
Kumor
Marta
M
Górska
Katarzyna
K
Fangrat
Adam
A
Kucińska
Joanna
J
Kościuch
Justyna
J
Chazan
Ryszarda
R
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001249:Asthma / Q000378:metabolism / Q000503:physiopathology*; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism*; D029424:Pulmonary Disease, Chronic Obstructive / Q000378:metabolism / Q000503:physiopathology*; D012720:Severity of Illness Index
D009569:Nitric Oxide