Abstract
Exhaled nitric oxide (eNO) is elevated in asthmatics and is a purported marker of airway inflammation. The bronchodilator response (BDR) has also been shown to correlate with markers of airway inflammation, including eNO at 50 ml/sec (FENO,50) which is comprised of NO from both the proximal and distal airways. Using eNO at multiple flows and a two-compartment model of NO exchange, the eNO signal can be partitioned into its proximal [J'awNO (nl/sec)] and distal contributions [CANO (ppb)].We hypothesized that theBDRreflects the inflammatory status of the larger airways with smooth muscle, and thuswould correlate with J'awNO. In 179 predominantly (95%) Hispanic children with mild asthma (69 steroid naïve), and 21 non-asthmatic non-atopic controls, spirometry andeNOat multiple flowswere measured prior and 10 min following inhalation of albuterol. A trumpet-shaped axial diffusion model of NO exchange was used to characterize J'awNO and CANO. The BDR correlated moderately (r=0.44) with proximal airway NO (J'awNO), but weakly (r=0.26) with distal airway/alveolar NO (CANO), and only in inhaled corticosteroid naïve asthmatics. A BDR cut point as low as ≥8% had a positive predictive value of 83% for predicting an elevated J'aw NO or FENO,50. We conclude that the BDR reflects inflammation in the large airways, and may be an effective clinical tool to predict elevated large airway inflammation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 174-181 |
| Number of pages | 8 |
| Journal | Pediatric Pulmonology |
| Volume | 45 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2010 |
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Keywords
- Inflammation
- Nitric oxide
- NO
- Pulmonary function
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Pulmonary and Respiratory Medicine
Cite this
An elevated bronchodilator response predicts large airway inflammation in mild asthma. / Puckett, James L.; Taylor, Richard W.E.; Leu, Szu Yun; Guijon, Olga L.; Aledia, Anna S.; Galant, Stanley P.; George, Steven.
In: Pediatric Pulmonology, Vol. 45, No. 2, 01.02.2010, p. 174-181.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - An elevated bronchodilator response predicts large airway inflammation in mild asthma
AU - Puckett, James L.
AU - Taylor, Richard W.E.
AU - Leu, Szu Yun
AU - Guijon, Olga L.
AU - Aledia, Anna S.
AU - Galant, Stanley P.
AU - George, Steven
PY - 2010/2/1
Y1 - 2010/2/1
N2 - Exhaled nitric oxide (eNO) is elevated in asthmatics and is a purported marker of airway inflammation. The bronchodilator response (BDR) has also been shown to correlate with markers of airway inflammation, including eNO at 50 ml/sec (FENO,50) which is comprised of NO from both the proximal and distal airways. Using eNO at multiple flows and a two-compartment model of NO exchange, the eNO signal can be partitioned into its proximal [J'awNO (nl/sec)] and distal contributions [CANO (ppb)].We hypothesized that theBDRreflects the inflammatory status of the larger airways with smooth muscle, and thuswould correlate with J'awNO. In 179 predominantly (95%) Hispanic children with mild asthma (69 steroid naïve), and 21 non-asthmatic non-atopic controls, spirometry andeNOat multiple flowswere measured prior and 10 min following inhalation of albuterol. A trumpet-shaped axial diffusion model of NO exchange was used to characterize J'awNO and CANO. The BDR correlated moderately (r=0.44) with proximal airway NO (J'awNO), but weakly (r=0.26) with distal airway/alveolar NO (CANO), and only in inhaled corticosteroid naïve asthmatics. A BDR cut point as low as ≥8% had a positive predictive value of 83% for predicting an elevated J'aw NO or FENO,50. We conclude that the BDR reflects inflammation in the large airways, and may be an effective clinical tool to predict elevated large airway inflammation.
AB - Exhaled nitric oxide (eNO) is elevated in asthmatics and is a purported marker of airway inflammation. The bronchodilator response (BDR) has also been shown to correlate with markers of airway inflammation, including eNO at 50 ml/sec (FENO,50) which is comprised of NO from both the proximal and distal airways. Using eNO at multiple flows and a two-compartment model of NO exchange, the eNO signal can be partitioned into its proximal [J'awNO (nl/sec)] and distal contributions [CANO (ppb)].We hypothesized that theBDRreflects the inflammatory status of the larger airways with smooth muscle, and thuswould correlate with J'awNO. In 179 predominantly (95%) Hispanic children with mild asthma (69 steroid naïve), and 21 non-asthmatic non-atopic controls, spirometry andeNOat multiple flowswere measured prior and 10 min following inhalation of albuterol. A trumpet-shaped axial diffusion model of NO exchange was used to characterize J'awNO and CANO. The BDR correlated moderately (r=0.44) with proximal airway NO (J'awNO), but weakly (r=0.26) with distal airway/alveolar NO (CANO), and only in inhaled corticosteroid naïve asthmatics. A BDR cut point as low as ≥8% had a positive predictive value of 83% for predicting an elevated J'aw NO or FENO,50. We conclude that the BDR reflects inflammation in the large airways, and may be an effective clinical tool to predict elevated large airway inflammation.
KW - Inflammation
KW - Nitric oxide
KW - NO
KW - Pulmonary function
UR - http://www.scopus.com/inward/record.url?scp=75849160458&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=75849160458&partnerID=8YFLogxK
U2 - 10.1002/ppul.21172
DO - 10.1002/ppul.21172
M3 - Article
C2 - 20082343
AN - SCOPUS:75849160458
VL - 45
SP - 174
EP - 181
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
SN - 8755-6863
IS - 2
ER -