Daily life negative mood and exhaled nitric oxide in asthma.
Psychosocial stress and negative affect have been linked to asthma exacerbations, but longitudinal studies demonstrating a daily life association between negative affect and airway nitric oxide are missing.



The longitudinal association between negative mood fluctuations, exhaled nitric oxide, and lung function in asthma was examined.



Self-assessments of the fraction of exhaled nitric oxide (FeNO), spirometry (forced expiratory volume in the first second, FEV1), negative mood, and daily activities were obtained from 20 patients with asthma for 2 months, resulting in 1108 assessments for the analyses (approximately 55 per patient). Concurrent and prospective associations between FeNO, FEV1, and negative mood were analyzed using mixed effects regression models for longitudinal data.



Negative mood was positively associated with changes in FeNO during the same day, and to a stronger extent when prior day negative mood was included in the prediction. FeNO and negative mood were positively associated with same-day FEV1, with the latter relation being partially mediated by changes in FeNO. Associations between FeNO and FEV1 were stronger in younger patients, with earlier onset of asthma, or with lower asthma control. Findings were not changed when controlling for physical activity, medication, cold symptoms, air pollution, and hours spent outside.



Daily life changes of negative mood in asthma are positively associated with FeNO changes and FeNO increases are associated with a mild bronchodilation. These findings indicate that psychological influences need to be considered when using FeNO as indicator of airway inflammation and guide for treatment decisions.
Southern Methodist University, Dallas, TX, USA. Electronic address: tritz@smu.edu.
Thomas
T
Ritz
Southern Methodist University, Dallas, TX, USA.
Antje
A
Kullowatz
Southern Methodist University, Dallas, TX, USA.
Michelle N
MN
Bill
Southern Methodist University, Dallas, TX, USA.
David
D
Rosenfield
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D001249:Asthma / Q000378:metabolism / Q000503:physiopathology* / Q000523:psychology*; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism*; D011446:Prospective Studies; D012647:Self-Assessment; D013147:Spirometry; D055815:Young Adult
D015415:Biomarkers; D009569:Nitric Oxide
Airway inflammation; Asthma; Exhaled nitric oxide; Home monitoring; Longitudinal observation; Lung function; Negative mood