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Inhaled glucocorticoids decrease nitric oxide in exhaled air of asthmatic patients

S A Kharitonov1, D H Yates, P J Barnes

  • 1Department of Thoracic Medicine, National Heart and Lung Institute, London, United Kingdom.

American Journal of Respiratory and Critical Care Medicine
|January 1, 1996
PubMed
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Inhaled glucocorticoids significantly reduce exhaled nitric oxide (NO) in asthma patients, suggesting NO monitoring can track anti-inflammatory treatment effectiveness.

Area of Science:

  • Respiratory Medicine
  • Pharmacology
  • Biochemistry

Background:

  • Elevated exhaled nitric oxide (NO) is a hallmark of untreated asthma.
  • Inhaled glucocorticoids are standard asthma therapy, but their effect on NO production is not fully understood.
  • Glucocorticoids may inhibit nitric oxide synthase (NOS) induction in the airways.

Purpose of the Study:

  • To investigate the effect of inhaled budesonide on exhaled NO levels in mild asthma.
  • To assess if exhaled NO can serve as a biomarker for glucocorticoid anti-inflammatory action.

Main Methods:

  • A double-blind, placebo-controlled, crossover study involving 11 mild asthma patients.
  • Patients received budesonide (800 mcg BID) or placebo via dry powder inhaler for 3 weeks.
  • Exhaled NO, FEV1, and airway responsiveness to methacholine were measured.

Related Experiment Videos

Main Results:

  • Inhaled budesonide significantly reduced exhaled NO from 203 +/- 29 ppb to 120 +/- 26 ppb (p < 0.01).
  • Placebo treatment showed no significant change in exhaled NO.
  • A progressive decrease in exhaled NO was observed over the 3-week treatment period.
  • No significant change in FEV1 was noted, but airway responsiveness to methacholine decreased.

Conclusions:

  • Inhaled glucocorticoids effectively lower exhaled NO in asthma patients.
  • The reduction in NO supports the role of inducible nitric oxide synthase (iNOS) in asthma.
  • Exhaled NO is a promising non-invasive marker for monitoring anti-inflammatory therapy in asthma.