Relationship between Fractional Exhaled Nitric Oxide Level and Efficacy of Inhaled Corticosteroid in Asthma-COPD Overlap Syndrome Patients with Different Disease Severity.
This study explored the relationship between the fractional exhaled nitric oxide (FeNO) level and the efficacy of inhaled corticosteroid (ICS) in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) patients with different disease severity. A total of 127 ACOS patients with ACOS (case group) and 131 healthy people (control group) were enrolled in this study. Based on the severity of COPD, the ACOS patients were divided into: mild ACOS; moderate ACOS; severe ACOS; and extremely severe ACOS groups. We compared FeNO levels, pulmonary function parameters including percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), ratio of FEV1 to forced vital capacity (FEV1/FVC), inspiratory capacity to total lung capacity (IC/TLC) and residual volume to total lung capacity (RV/TLC), arterial blood gas parameters, including PH, arterial partial pressure of oxygen (PaO₂) and arterial partial pressure of carbon dioxide (PaCO₂), total serum immunoglobulin E (IgE), induced sputum eosinophil (EOS), plasma surfactant protein A (SP-A), plasma soluble receptor for advanced glycation end products (sRAGE), sputum myeloperoxidase (MPO), sputum neutrophil gelatinase-associated lipocalin (NGAL) and Asthma Control Test (ACT) scores, and COPD Assessment Test (CAT) scores. Compared with pre-treatment parameters, the FeNO levels, RV/TLC, PaCO₂, total serum IgE, induced sputum EOS, plasma SP-A, sputum MPO, sputum NGAL, and CAT scores were significantly decreased after 6 months of ICS treatment, while FEV1%pred, FEV1/FVC, IC/TLC, PH, PaO2, plasma sRAGE, and ACT scores were significantly increased in ACOS patients with different disease severity after 6 months of ICS treatment. This finding suggests that the FeNO level may accurately predict the efficacy of ICS in the treatment of ACOS patients.
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China.
Jia Xi
http://orcid.org/0000-0003-4814-8648
JX
Feng
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China.
Yun
http://orcid.org/0000-0002-2576-3827
Y
Lin
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China.
Jian
http://orcid.org/0000-0003-2510-9064
J
Lin
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China.
Su Su
http://orcid.org/0000-0003-0035-0003
SS
He
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China.
Mei Fang
http://orcid.org/0000-0003-0070-0931
MF
Chen
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China.
Xiao Mai
http://orcid.org/0000-0002-3115-3988
XM
Wu
Department of Respiratory Medicine, Taizhou Hospital of Zhejiang Province, Linhai, China. Youzuxu@163.com.
You Zu
http://orcid.org/0000-0002-1252-9564
YZ
Xu
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001784:Blood Gas Analysis; D016022:Case-Control Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D000071068:Lipocalin-2 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D009195:Peroxidase / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D037662:Pulmonary Surfactant-Associated Protein A / Q000097:blood; D000067759:Receptor for Advanced Glycation End Products / Q000097:blood; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013183:Sputum / Q000201:enzymology / Q000378:metabolism
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D000071068:Lipocalin-2; D037662:Pulmonary Surfactant-Associated Protein A; D000067759:Receptor for Advanced Glycation End Products; D009569:Nitric Oxide; D007073:Immunoglobulin E; D009195:Peroxidase
Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome; Efficacy; Fractional Exhaled Nitric Oxide; Inhaled Corticosteroid