Airway nitric oxide in patients with cystic fibrosis is associated with pancreatic function, Pseudomonas infection, and polyunsaturated fatty acids.
BACKGROUND
Airway nitric oxide (NO) is low or normal in cystic fibrosis (CF) patients. This may affect bacterial status since NO has antimicrobial properties. Arachidonic acid (AA), which is increased in the serum and airways of CF patients, has been shown to reduce NO levels. The aim of this study was to investigate whether airway NO level correlates with genotype and pancreatic function, and whether low airway NO level is associated with bacterial infection and increased serum AA level in CF patients.


METHODS
Nasal NO (nNO) and exhaled NO (eNO) were measured according to the European Respiratory Society/American Thoracic Society standard in 59 CF patients aged 7 to 55 years, 80% of whom were pancreatic insufficient (PI) and 51% were chronically infected with Pseudomonas aeruginosa.


RESULTS
PI CF patients had significantly lower nNO levels than pancreatic-sufficient (PS) patients. Airway NO level did not correlate with lung function or inflammatory parameters. PI patients chronically infected with P aeruginosa had significantly lower nNO levels than noninfected PI patients. nNO level correlated inversely with the AA/docosahexaenoic acid ratio, and eNO with the essential fatty acid (FA) deficiency index, which is the ratio between mead acid and AA.


CONCLUSIONS
CF patients with PI, which is associated with more severe genotypes, had lower airway NO levels than patients with PS. Low NO level was correlated to chronic P aeruginosa infection, and an association was found between airway NO level and the abnormal serum phospholipid FA pattern.
Keen
Christina
C
Department of Pediatrics, Sahlgrenska Academy, Göteborg, Sweden. Christina.keen@vgregion.se
Olin
Anna-Carin
AC
Edentoft
Asa
A
Gronowitz
Eva
E
Strandvik
Birgitta
B
D000293:Adolescent; D000328:Adult; D016718:Arachidonic Acid / Q000097:blood; D001944:Breath Tests; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000235:genetics / Q000378:metabolism*; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics / Q000378:metabolism; D010188:Exocrine Pancreatic Insufficiency / Q000378:metabolism*; D005228:Fatty Acids, Essential / Q000097:blood; D005231:Fatty Acids, Unsaturated / Q000097:blood*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000737:chemistry; D009569:Nitric Oxide / Q000032:analysis* / Q000378:metabolism; D011552:Pseudomonas Infections / Q000378:metabolism*; D011550:Pseudomonas aeruginosa / Q000472:pathogenicity
C505032:CFTR protein, human; D005228:Fatty Acids, Essential; D005231:Fatty Acids, Unsaturated; D019005:Cystic Fibrosis Transmembrane Conductance Regulator; D016718:Arachidonic Acid; D009569:Nitric Oxide