The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.

BACKGROUND: Assessment of eosinophilic airway inflammation may be helpful in the management of asthma. Nitric oxide (NO) has potential advantages as a tool to monitor airway inflammation although little is known about the relationship between NO and eosinophilic airway inflammation and the factors w...

Full description

Bibliographic Details
Main Authors: Berry, M, Shaw, D, Green, R, Brightling, C, Wardlaw, A, Pavord, I
Format: Journal article
Language:English
Published: 2005
_version_ 1797058987798036480
author Berry, M
Shaw, D
Green, R
Brightling, C
Wardlaw, A
Pavord, I
author_facet Berry, M
Shaw, D
Green, R
Brightling, C
Wardlaw, A
Pavord, I
author_sort Berry, M
collection OXFORD
description BACKGROUND: Assessment of eosinophilic airway inflammation may be helpful in the management of asthma. Nitric oxide (NO) has potential advantages as a tool to monitor airway inflammation although little is known about the relationship between NO and eosinophilic airway inflammation and the factors which influence it. METHODS: We set out to define the relationship between exhaled NO and the sputum eosinophil count, identify the exhaled NO concentration that best identified a sputum eosinophil count >3% and investigate the impact of several potential confounding factors in 566 consecutive patients with varying severity of asthma. Finally we examined the ability of exhaled NO concentrations measured at differing exhalation flows to identify the presence of a sputum eosinophilia. RESULTS: We found a significant positive relationship between exhaled NO and sputum eosinophil count (R(2)=0.26, P<0.001) which was best described using a non-linear model. There were no clinically important confounding factors to this model. In non-smokers an exhaled NO concentration of >8.3 p.p.b. at 250 mL/s gave 71% sensitivity and 72% specificity for identifying a sputum eosinophil count of >3%. CONCLUSIONS: This value of exhaled NO would seem to be the best for identifying significant eosinophilic airway inflammation. It is applicable to a wide range of non-smoking patients with asthma; exhalation flow does not alter the ability of exhaled NO concentration to detect a sputum eosinophilia.
first_indexed 2024-03-06T19:57:51Z
format Journal article
id oxford-uuid:26422374-81c3-4588-bfe6-f5cbbad4b1e1
institution University of Oxford
language English
last_indexed 2024-03-06T19:57:51Z
publishDate 2005
record_format dspace
spelling oxford-uuid:26422374-81c3-4588-bfe6-f5cbbad4b1e12022-03-26T11:59:54ZThe use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:26422374-81c3-4588-bfe6-f5cbbad4b1e1EnglishSymplectic Elements at Oxford2005Berry, MShaw, DGreen, RBrightling, CWardlaw, APavord, IBACKGROUND: Assessment of eosinophilic airway inflammation may be helpful in the management of asthma. Nitric oxide (NO) has potential advantages as a tool to monitor airway inflammation although little is known about the relationship between NO and eosinophilic airway inflammation and the factors which influence it. METHODS: We set out to define the relationship between exhaled NO and the sputum eosinophil count, identify the exhaled NO concentration that best identified a sputum eosinophil count >3% and investigate the impact of several potential confounding factors in 566 consecutive patients with varying severity of asthma. Finally we examined the ability of exhaled NO concentrations measured at differing exhalation flows to identify the presence of a sputum eosinophilia. RESULTS: We found a significant positive relationship between exhaled NO and sputum eosinophil count (R(2)=0.26, P<0.001) which was best described using a non-linear model. There were no clinically important confounding factors to this model. In non-smokers an exhaled NO concentration of >8.3 p.p.b. at 250 mL/s gave 71% sensitivity and 72% specificity for identifying a sputum eosinophil count of >3%. CONCLUSIONS: This value of exhaled NO would seem to be the best for identifying significant eosinophilic airway inflammation. It is applicable to a wide range of non-smoking patients with asthma; exhalation flow does not alter the ability of exhaled NO concentration to detect a sputum eosinophilia.
spellingShingle Berry, M
Shaw, D
Green, R
Brightling, C
Wardlaw, A
Pavord, I
The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.
title The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.
title_full The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.
title_fullStr The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.
title_full_unstemmed The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.
title_short The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma.
title_sort use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation an observational study in adults with asthma
work_keys_str_mv AT berrym theuseofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT shawd theuseofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT greenr theuseofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT brightlingc theuseofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT wardlawa theuseofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT pavordi theuseofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT berrym useofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT shawd useofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT greenr useofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT brightlingc useofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT wardlawa useofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma
AT pavordi useofexhalednitricoxideconcentrationtoidentifyeosinophilicairwayinflammationanobservationalstudyinadultswithasthma