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A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
Published on: May 4, 2021
Exhaled nitric oxide predicts lung function decline in difficult-to-treat asthma.
I H van Veen1, A Ten Brinke, P J Sterk
1Dept of Pulmonology, Medisch Spectrum Twente, Postbus 50000, 7500 KA Enschede, The Netherlands. h.vanveen@ziekenhuis-mst.nl
The European Respiratory Journal
|May 30, 2008
Summary
High exhaled nitric oxide levels predict faster lung function decline in difficult-to-treat asthma patients. This finding is crucial for identifying individuals at risk of progressive loss of lung function.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Asthma management can be challenging, with some patients experiencing progressive lung function loss despite corticosteroid treatment.
- Identifying predictors of lung function decline is crucial for managing difficult-to-treat asthma.
Purpose of the Study:
- To identify risk factors for the decline in forced expiratory volume in one second (FEV(1)) in patients with difficult-to-treat asthma.
- To investigate the predictive value of baseline clinical characteristics and inflammatory markers on FEV(1) decline.
Main Methods:
- 136 non-smoking patients with difficult-to-treat asthma were recruited.
- Follow-up assessments were conducted 5-6 years later in 98 patients.
- Baseline data included asthma onset, duration, atopy, airway hyperresponsiveness, blood and sputum eosinophils, and fraction of nitric oxide in exhaled air (F(eNO)).
Main Results:
- Patients with high F(eNO) (≥20 ppb) showed an excess decline in FEV(1) of 40.3 mL/yr compared to those with low F(eNO).
- High F(eNO) was associated with a 1.9-fold increased risk of accelerated FEV(1) decline (≥25 mL/yr).
- In patients with normal baseline FEV(1) (≥80% predicted), high F(eNO) showed an even stronger association with accelerated FEV(1) decline (RR 3.1).
Conclusions:
- Exhaled nitric oxide (F(eNO)) is a significant predictor of accelerated lung function decline in difficult-to-treat asthma.
- F(eNO) measurement can help identify patients at high risk for progressive FEV(1) loss, especially when lung function is currently normal.
- This highlights F(eNO) as a valuable biomarker for monitoring and potentially intervening in asthma progression.
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