title: [Influence of bronchoscopy on nitric oxide in exhaled air].
abstract: Nitric oxide has been extensively studied as a noninvasive marker of airway inflammation, especially in asthma. Assuming, bronchoscopy can produced not only systemic but also local inflammatory response we hypothesized that bronchofiberoscopy can be responsible for an increase in nitric oxide synthesis with resulting increase in fractional concentration of exhaled nitric oxide (FE(NO)). Seventeen subjects (10 M, 7 F), at mean age of 53.8+/-14.1 yrs undergoing diagnostic bronchoscopy participated in the study. The indications for bronchoscopy were as follows: lung cancer (n=5; 29%), interstitial lung diseases (n=3; 18%), slowly resolving pneumonia (n=3; 18%), hemoptysis (n=3; 18%), differential diagnosis of asthma/ dyspnea (n=3; 18%). During bronchoscopy bronchial washing (n=7) and bronchoalveolar lavage (BAL) (n=10) has been performed. FE(NO) has been analyzed on-line with chemiluminescence analyzer (NIOX, Aerocrine, Sweden) according to American Thoracic Society guidelines, before and at 1, 2, 3 and 24 hours after bronchoscopy. Mean FE(NO) before bronchoscopy was 19.7+/-4.5 ppb (mean +/- SEM), post - bronchoscopy a decrease with a nadir at second hour (12.1+/-1.5 ppb, p<0.05) was observed, FE(NO) 24 hours after bronchoscopy was not different than baseline (18.4+/-2.5 ppb). There were no differences in the FE(NO) profile in BAL patients when compared to those in whom only the bronchial washing has been performed.
  
  
  CONCLUSIONS
  Bronchoscopy leads to a significant decrease in exhaled nitric oxide. The underlying mechanisms are unclear. Future studies including analysis of other inflammatory markers are needed to explain these changes.
authors.affiliation: Katedra i Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii. AM w Warszawie. khildebr@amwaw.edu.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Hildebrand
authors.forename: Rafał
authors.initials: R
authors.lastname: Krenke
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Przybyłowski
authors.forename: Adam
authors.initials: A
authors.lastname: Fangrat
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Górska
authors.forename: Ryszarda
authors.initials: R
authors.lastname: Chazan
mesh_terms: D001249:Asthma / Q000150:complications / Q000175:diagnosis; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D001991:Bronchitis / Q000175:diagnosis / Q000209:etiology*; D001999:Bronchoscopy / Q000009:adverse effects*; D003937:Diagnosis, Differential; D015536:Down-Regulation; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009058:Mouth Breathing; D009569:Nitric Oxide / Q000032:analysis*; D011659:Pulmonary Gas Exchange; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide