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Published on: August 6, 2013
Different Relationships between FENO and COPD Characteristics in Smokers and Ex-Smokers
M Högman1, A Thornadtsson1,2, K Bröms2,3
1Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University , Uppsala , Sweden.
Exhaled nitric oxide (FENO) levels are lower in current smokers with COPD. FENO is linked to inflammation and lung function in ex-smokers, but less so in current smokers, suggesting limited clinical utility in active smokers.
Area of Science:
- Pulmonary Medicine
- Respiratory Inflammation
- Biomarker Research
Background:
- Exhaled nitric oxide (FENO) indicates type-2 airway inflammation in asthma.
- Clinical utility of FENO in COPD is unclear, particularly in smokers and ex-smokers who exhibit lower FENO levels.
Purpose of the Study:
- To investigate the relationship between FENO and COPD characteristics in current smokers and ex-smokers.
- To assess FENO's association with blood cell counts, lung function, and medication use in COPD patients.
Main Methods:
- Studied 533 stable COPD patients (58% female).
- Measured FENO50, blood cell counts, IgE sensitization, and lung function.
- Utilized medication reconciliation to determine drug usage.
Main Results:
- Smokers (n=150) had lower FENO50 (9 ppb) than ex-smokers (n=383) (15 ppb).
- FENO50 correlated with eosinophils and lung function (FEV1) in ex-smokers, but not in smokers.
- Ex-smokers on inhaled corticosteroids (ICS) showed lower FENO50 compared to untreated ex-smokers.
Conclusions:
- FENO is associated with eosinophilic inflammation and ICS use in ex-smoking COPD patients.
- The value of FENO as an inflammatory marker appears limited in current smokers with COPD.
- The link between low FENO and reduced lung function in COPD warrants further investigation.
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