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Exhaled nitric oxide from lung periphery is increased in COPD
1Section of Airway Disease, National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK.
The European Respiratory Journal
|July 5, 2005
Summary
Measurements of exhaled nitric oxide (eNO) at multiple flows reveal increased alveolar nitric oxide in chronic obstructive pulmonary disease (COPD). This method may help monitor COPD progression and inflammation.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Biomarkers of Inflammation
Background:
- Single constant flow exhaled nitric oxide (eNO) measurements are limited in distinguishing NO sources.
- Chronic obstructive pulmonary disease (COPD) involves complex airway and alveolar inflammation.
- Peripheral lung NO contribution to eNO in COPD requires further investigation.
Purpose of the Study:
- To partition eNO into alveolar (Calv,NO) and bronchial (Jaw,NO) fractions using multiple expired flows (MEFeNO).
- To investigate the peripheral lung contribution to eNO in COPD patients of varying severity.
- To assess the correlation between COPD severity and NO fractions.
Main Methods:
- MEFeNO measurements were performed in 81 subjects: 18 nonsmokers, 16 smokers, and 47 COPD patients (GOLD stages 0-4).
- NO fractions (Calv,NO, Jaw,NO) and diffusion (Daw,NO) were calculated.
- Reproducibility and stability of MEFeNO measurements were evaluated.
Main Results:
- COPD severity correlated with increased Calv,NO, irrespective of smoking status or treatment.
- Calv,NO levels were significantly higher in COPD patients compared to nonsmokers and smokers-GOLD0.
- Bronchial NO (Jaw,NO) and diffusion (Daw,NO) showed distinct patterns related to COPD severity and smoking status.
Conclusions:
- Chronic obstructive pulmonary disease is associated with elevated alveolar nitric oxide.
- MEFeNO measurements are reproducible and unaffected by bronchodilators or diurnal variations.
- MEFeNO may serve as a valuable tool for monitoring COPD inflammation, progression, and treatment response.
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