[Value of Fractional Exhaled Nitric Oxide after Using a Beta-2 Bronchodilator in the Differential Diagnosis of Bronchial Asthma and Chronic Obstructive Pulmonary Disease].
It has been established that an increase in fractional exhaled nitric oxide (FeNO) is one of the indicators of bronchial asthma (BA) in clinical settings. However, the differential diagnosis of BA and chronic obstructive pulmonary disease (COPD) is difficult due to pathological similarities. Therefore, to determine if FeNO may be utilized in the differential diagnosis of BA and COPD, we compared FeNO values before and after inhalation of a short-acting beta-2 agonist (SABA). There were 3 groups of subjects recruited to this study: (1) 23 normal healthy controls, (2) 36 patients with BA, and (3) 13 patients with COPD. We measured FeNO, forced vital capacity, forced expiratory volume in 1 second (FEV1), and FEV1%, calculated using spirometry. Then, after the subjects inhaled the SABA, we measured these data after 10 and 30 minutes. Here we found that after inhalation of a SABA, 8 cases in the BA group who showed reversibility of airway obstruction demonstrated significantly increased FeNO values compared to the BA patients with non-reversible airway obstruction, those with COPD, and healthy subjects. This finding may be because the obstructed pulmonary peripheral airway was expanded by inhaling a SABA, and nitric oxide, which had been produced in the peripheral airway, was then exhaled. These results suggest the possibility that FeNO may be utilized in the differential diagnosis of BA and COPD.
Midori
M
Ura
Hitomi
H
Tanaka
Kaori
K
Takahashi
Haruna
H
Yamazaki
Keisaku
K
Fujimoto
D000280:Administration, Inhalation; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008448:Maximal Expiratory Flow Rate; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D013147:Spirometry; D014797:Vital Capacity; D055815:Young Adult
D058666:Adrenergic beta-2 Receptor Agonists; D015415:Biomarkers; D001993:Bronchodilator Agents; D009569:Nitric Oxide