title: Effects of pollen season on central and peripheral nitric oxide production in subjects with pollen asthma.
abstract: BACKGROUND
  Pollen exposure of allergic subjects with asthma causes increased nitric oxide (NO) in exhaled air (FENO) suggestive of increased airway inflammation. It is, however, unclear to what extent NO production in peripheral airways and alveoli are involved.
  
  
  OBJECTIVE
  The aim of the present investigation was to analyze the relationship between central and peripheral components of FENO to clarify the distribution of pollen induced inflammation in asthma.
  
  
  METHODS
  13 pollen allergic non-smoking subjects with mild-intermittent asthma and 12 healthy non-smoking control subjects were examined with spirometry and FENO at flows between 50 and 270 mL/s during and out of pollen season.
  
  
  RESULTS
  Spirometry was normal and unaffected by season in subjects with asthma as well as controls. Out of season subjects with asthma had significantly higher FENO, elevated airway production (JáwNO) and preacinar/acinar production (CANO) than controls. Pollen exposure resulted in significantly increased FENO and JáwNO but not CANO. FENO among controls were not affected by season. Individual results showed, however, that CANO increased substantially in a few subjects with asthma. The increased CANO in subjects with asthma may be explained by increased NO production in preacinar/acinar airways and back diffusion towards the alveoli.
  
  
  CONCLUSIONS
  The findings may indicate that subjects with allergic asthma have airway inflammation without alveolar involvement outside the pollen season and pollen exposure causes a further increase of airway inflammation and in a few subjects obstruction of intra acinar airways causing impeded back diffusion. Increased NO production in central airways, unassociated with airway obstruction could be an alternative explanation. These effects were not disclosed by spirometry.
authors: Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden; Respiratory Medicine and Allergology, Sahlgrenska Academy at University of Gothenburg, Sweden.
authors: Björn
authors: B
authors: Bake
authors: Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
authors: Emilia
authors: E
authors: Viklund
authors: Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden; Respiratory Medicine and Allergology, Sahlgrenska Academy at University of Gothenburg, Sweden. Electronic address: anna-carin.olin@amm.gu.se.
authors: Anna-Carin
authors: AC
authors: Olin
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D001944:Breath Tests / Q000379:methods; D016022:Case-Control Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008875:Middle Aged; D009569:Nitric Oxide / Q000096:biosynthesis*; D011058:Pollen / Q000276:immunology*; D011650:Pulmonary Alveoli / Q000378:metabolism; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000276:immunology / Q000503:physiopathology; D012621:Seasons; D013147:Spirometry / Q000379:methods; D014797:Vital Capacity / Q000502:physiology
chemical_list: D000485:Allergens; D009569:Nitric Oxide; D007073:Immunoglobulin E
keywords: Alveolar; Asthma; FENO; NO; Peripheral; Pollen