Changes in exhaled nitric oxide measured by two offline methods predict improvements in bronchial hyperresponsiveness after inhaled steroid therapy in Japanese adults with asthma.
BACKGROUND
The fraction of exhaled nitric oxide (FeNO) is a useful marker of eosinophilic airway inflammation in asthmatics. No studies have examined the relationship between the change in FeNO levels measured offline and changes in bronchial hyperresponsiveness (BHR) in asthmatic patients treated with inhaled corticosteroids (ICS). The objective of this study was to investigate the relationship between the change in FeNO levels measured offline and the change in BHR to acetylcholine in asthmatic patients taking ICS.


METHODS
The study population comprised 41 ICS-treated asthmatics from our outpatient clinic. We measured FeNO levels by two methods -with a Sievers kit ("FeNOs") and with a kit from the Center for Environmental Information Science, Japan ("FeNOc") at baseline and after 1 year of regular treatment. We also used spirometry to test BHR to acetylcholine (PC(20Ach)).


RESULTS
The mean of duration of observation was 406 days. There were significant relationships between DeltalogPC(20Ach) and logPC(20Ach) (r = -0.877, P < 0.001), FeNOs (r = 0.465, P = 0.002), and FeNOc (r = 0.524, P = 0.004) at baseline, but not with age, the dose of ICS, FEV(1), or %FEV(1). Moreover, there was a significant relationship between DeltalogPC(20Ach) and DeltaFeNOs (r = -0.386, P = 0.013) and DeltaFeNOc (r = -0.473, P = 0.004), but not with DeltaFEV(1).


CONCLUSIONS
Changes in FeNOs and FeNOc correlated with improvements in BHR to acetylcholine in adult asthmatics after ICS therapy. Our findings suggest that offline monitoring of FeNO will facilitate the management of bronchial asthma in patients treated with ICS.
Tsuburai
Takahiro
T
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan. t-tuburai@Sagamihara-hosp.gr.jp
Tsurikisawa
Naomi
N
Tatsuno
Sayaka
S
Fukutomi
Yuma
Y
Tanimoto
Hidenori
H
Ono
Emiko
E
Oshikata
Chiyako
C
Sekiya
Kiyoshi
K
Otomo
Mamoru
M
Maeda
Yuji
Y
Taniguchi
Masami
M
Ikehara
Kunihiko
K
Akiyama
Kazuo
K
D000280:Administration, Inhalation; D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis* / Q000188:drug therapy; D003948:Diagnostic Techniques, Respiratory System; D018450:Disease Progression; D045853:Exhalation; D005260:Female; D006801:Humans; D007249:Inflammation; D007564:Japan; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D011379:Prognosis; D012137:Respiratory System / Q000276:immunology*; D013256:Steroids / Q000627:therapeutic use*
D015415:Biomarkers; D013256:Steroids; D009569:Nitric Oxide