The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma
Abstract Background Exhaled nitric oxide (FeNO) is a simple, noninvasive, and reproducible test, and FeNO (50 ml/s) is often used to reflect airway inflammation. The peripheral small airway/alveolar nitric oxide (NO) concentration is derived from the output of NO at multiple flow rates. Concentratio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-05-01
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| Series: | The Clinical Respiratory Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/crj.13565 |
| _version_ | 1827940721495113728 |
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| author | Jing Wang Ke Wu Xianliang Cheng Xiangsong Chen Yanan Qi Limin Zhao |
| author_facet | Jing Wang Ke Wu Xianliang Cheng Xiangsong Chen Yanan Qi Limin Zhao |
| author_sort | Jing Wang |
| collection | DOAJ |
| description | Abstract Background Exhaled nitric oxide (FeNO) is a simple, noninvasive, and reproducible test, and FeNO (50 ml/s) is often used to reflect airway inflammation. The peripheral small airway/alveolar nitric oxide (NO) concentration is derived from the output of NO at multiple flow rates. Concentration of alveolar NO (CANO), which has been reported to reflect peripheral small airway inflammation, may be related to parameters that reflect abnormal small airway function. Aim This study aims to investigate the relationship among CANO levels, clinical features, and small airway function‐related indicators in patients with stable asthma and to provide a simple method for monitoring small airway function in asthma. Design and Methods We recruited 144 patients with well‐controlled, stable asthma, including 69 patients with normal small airway function (normal group) and 75 patients with small airway dysfunction (abnormal group). CANO and pulmonary function were measured. Results CANO was significantly higher in the abnormal group ([7.28 ± 3.25] ppb) than the normal group CANO ([2.87 ± 1.50] ppb). FEF25–75%pred ([55.0 ± 16.5]%), FEF50%pred ([46.4 ± 13.2]%), and FEF75%pred ([41.9 ± 13.1]%) in abnormal group were significantly lower compared with normal group ([89.9 ± 7.5]%), ([80.9 ± 6.8]%), and ([73.8 ± 5.0]%). CANO was negatively correlated and FEF25–75%pred, FEF50%pred, and FEF75%pred (r = −0.87, P < 0.001; r = −0.82, P < 0.001; r = −0.78, P < 0.001). CANO was positively correlated with age (r = 0.27, P = 0.001). The area under the ROC curve was 0.875 for CANO. The optimal cutoff point of 5.3 ppb had sensitivity and specificity values of 72% and 92% in diagnosing small airway dysfunction. Conclusion CANO has diagnostic value for small airway dysfunction, and the optimal cutoff value is 5.3 ppb. However, the diagnostic evidence is still insufficient, so it still needs further exploration for its value in detecting small airway dysfunction. |
| first_indexed | 2024-03-13T09:15:42Z |
| format | Article |
| id | doaj.art-f2b52ef77aa24766a530fe1f759bfd17 |
| institution | Directory Open Access Journal |
| issn | 1752-6981 1752-699X |
| language | English |
| last_indexed | 2024-03-13T09:15:42Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
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| series | The Clinical Respiratory Journal |
| spelling | doaj.art-f2b52ef77aa24766a530fe1f759bfd172023-05-26T10:50:31ZengWileyThe Clinical Respiratory Journal1752-69811752-699X2023-05-0117535736310.1111/crj.13565The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthmaJing Wang0Ke Wu1Xianliang Cheng2Xiangsong Chen3Yanan Qi4Limin Zhao5Department of Infectious and Respiratory Critical Care Medicine Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University Xinxiang ChinaSchool of Clinical Medicine, Guizhou Medical University Guiyang ChinaDepartment of Respiratory and Critical Care Medicine Huazhong Fuwai Cardiovascular Disease Hospital Zhengzhou ChinaDepartment of Respiratory and Critical Care Medicine Huazhong Fuwai Cardiovascular Disease Hospital Zhengzhou ChinaDepartment of Respiratory and Critical Care Medicine Huazhong Fuwai Cardiovascular Disease Hospital Zhengzhou ChinaDepartment of Pulmonary and Critical Care Medicine Henan Provincial People’s Hospital; People’s Hospital of Zhengzhou University; People’s Hospital of Henan University Zhengzhou 450003 ChinaAbstract Background Exhaled nitric oxide (FeNO) is a simple, noninvasive, and reproducible test, and FeNO (50 ml/s) is often used to reflect airway inflammation. The peripheral small airway/alveolar nitric oxide (NO) concentration is derived from the output of NO at multiple flow rates. Concentration of alveolar NO (CANO), which has been reported to reflect peripheral small airway inflammation, may be related to parameters that reflect abnormal small airway function. Aim This study aims to investigate the relationship among CANO levels, clinical features, and small airway function‐related indicators in patients with stable asthma and to provide a simple method for monitoring small airway function in asthma. Design and Methods We recruited 144 patients with well‐controlled, stable asthma, including 69 patients with normal small airway function (normal group) and 75 patients with small airway dysfunction (abnormal group). CANO and pulmonary function were measured. Results CANO was significantly higher in the abnormal group ([7.28 ± 3.25] ppb) than the normal group CANO ([2.87 ± 1.50] ppb). FEF25–75%pred ([55.0 ± 16.5]%), FEF50%pred ([46.4 ± 13.2]%), and FEF75%pred ([41.9 ± 13.1]%) in abnormal group were significantly lower compared with normal group ([89.9 ± 7.5]%), ([80.9 ± 6.8]%), and ([73.8 ± 5.0]%). CANO was negatively correlated and FEF25–75%pred, FEF50%pred, and FEF75%pred (r = −0.87, P < 0.001; r = −0.82, P < 0.001; r = −0.78, P < 0.001). CANO was positively correlated with age (r = 0.27, P = 0.001). The area under the ROC curve was 0.875 for CANO. The optimal cutoff point of 5.3 ppb had sensitivity and specificity values of 72% and 92% in diagnosing small airway dysfunction. Conclusion CANO has diagnostic value for small airway dysfunction, and the optimal cutoff value is 5.3 ppb. However, the diagnostic evidence is still insufficient, so it still needs further exploration for its value in detecting small airway dysfunction.https://doi.org/10.1111/crj.13565asthmaCANOlung functionsmall airway function |
| spellingShingle | Jing Wang Ke Wu Xianliang Cheng Xiangsong Chen Yanan Qi Limin Zhao The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma The Clinical Respiratory Journal asthma CANO lung function small airway function |
| title | The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma |
| title_full | The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma |
| title_fullStr | The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma |
| title_full_unstemmed | The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma |
| title_short | The value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma |
| title_sort | value of concentration of alveolar nitric oxide in diagnosing small airway dysfunction in patients with stable asthma |
| topic | asthma CANO lung function small airway function |
| url | https://doi.org/10.1111/crj.13565 |
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