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Reduced nasal nitric oxide in diffuse panbronchiolitis
1Department of Internal Medicine, School of Nursing, Asahikawa Medical College, Asahikawa, Hokkaido, Japan. kin@asahikawa-med.ac.jp
Abstract:
Diffuse panbronchiolitis (DPB) is a pulmonary disease of unknown origin with inflammation in the respiratory bronchioles, bronchiectasis, and recurrent sinusitis. Patients with DPB suffer from chronic airway infections resulting from mucociliary dysfunction. Whereas a high concentration of nasal nitric oxide (NO) has been documented in healthy subjects, only two diseases are known to reduce nasal NO: primary ciliary dyskinesia syndrome and cystic fibrosis. We hypothesized that patients with DPB have abnormal levels of nasal NO. To test our hypothesis, we measured NO with the chemiluminescence technique. Air was sampled directly from the nose in 15 healthy subjects and eight patients with DPB. Nasal NO was 88% lower in DPB patients than in the age-matched control subjects (69 +/- 70 versus 556 +/- 87 nl/min; p < 0.001). Treatment with erythromycin for 2 wk did not alter the nasal NO in four control subjects. DPB is the third pulmonary disease in which nasal NO is low. The reduced nasal NO may well be involved in the pathogenesis of DPB, and NO measurements may serve as a noninvasive test in the diagnosis of DPB.
Insights
Diffuse panbronchiolitis (DPB) is a lung disease causing chronic infections. Patients with DPB have significantly lower nasal nitric oxide (NO) levels, suggesting NO may play a role in the disease and aid diagnosis.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Medical Diagnostics
Background:
- Diffuse panbronchiolitis (DPB) is a chronic inflammatory airway disease characterized by respiratory bronchiolitis, bronchiectasis, and sinusitis.
- Patients with DPB experience recurrent airway infections due to impaired mucociliary function.
- Low nasal nitric oxide (NO) is typically associated with primary ciliary dyskinesia syndrome and cystic fibrosis.
Purpose of the Study:
- To investigate whether patients with DPB exhibit abnormal nasal nitric oxide (NO) levels.
- To determine if nasal NO measurement can serve as a diagnostic marker for DPB.
Main Methods:
- Nasal NO levels were measured using the chemiluminescence technique in 15 healthy subjects and 8 patients diagnosed with DPB.
- Air samples were collected directly from the nasal passages of all participants.
- The effect of erythromycin treatment on nasal NO was assessed in four control subjects.
Main Results:
- Nasal NO levels in DPB patients were significantly lower (88%) compared to age-matched healthy controls (69 +/- 70 nl/min vs. 556 +/- 87 nl/min, p < 0.001).
- A 2-week course of erythromycin treatment did not alter nasal NO levels in the control subjects studied.
- This study identifies DPB as the third pulmonary disease associated with reduced nasal NO.
Conclusions:
- Reduced nasal NO is a characteristic finding in patients with diffuse panbronchiolitis (DPB).
- Low nasal NO levels may be implicated in the pathogenesis of DPB.
- Nasal NO measurement presents a potential noninvasive diagnostic tool for identifying DPB.