Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing
To explore whether exhaled nitric oxide (FeNO) non-suppression identifies corticosteroid resistance, we analysed inflammatory mediator changes during a FeNO suppression test with monitored high-intensity corticosteroid therapy. In linear mixed-effects models analysed over time, the 15 clinically-dis...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022
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| _version_ | 1797108121927155712 |
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| author | Couillard, S Shrimanker, R Lemaire-Paquette, S Hynes, GM Borg, C Connolly, C Thulborn, S Moran, AM Poole, S Morgan, S Powell, T Pavord, I Hinks, T Couillard Castonguay, S |
| author_facet | Couillard, S Shrimanker, R Lemaire-Paquette, S Hynes, GM Borg, C Connolly, C Thulborn, S Moran, AM Poole, S Morgan, S Powell, T Pavord, I Hinks, T Couillard Castonguay, S |
| author_sort | Couillard, S |
| collection | OXFORD |
| description | To explore whether exhaled nitric oxide (FeNO) non-suppression identifies corticosteroid resistance, we analysed inflammatory mediator changes during a FeNO suppression test with monitored high-intensity corticosteroid therapy. In linear mixed-effects models analysed over time, the 15 clinically-distinct ‘suppressors’ (i.e. ≥42% FeNO suppression) normalised asthma control questionnaire scores (mean±SD: 2.8±1.4 to 1.4±0.9, p<0.0001) and sputum eosinophil counts (median [IQR]: 29 [6-41] to 1 [1-5]%, p=0.0003) while significantly decreasing sputum prostaglandin D2 (254 [89-894] to 93 [49-209] pg/mL, p=0.004) and numerically decreasing other type-2 cytokine, chemokine and alarmin levels. In comparison, the 19 non-suppressors had persistent sputum eosinophilia (10 [1-67]% despite high-intensity therapy) with raised end-test inflammatory mediator levels (1.9 [0.9-2.8]-fold greater than suppressors). FeNO non-suppression during monitored treatment implies biological corticosteroid resistance. |
| first_indexed | 2024-03-07T07:23:08Z |
| format | Journal article |
| id | oxford-uuid:9c542942-22d6-457d-82ba-c66c8b3215b7 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:23:08Z |
| publishDate | 2022 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:9c542942-22d6-457d-82ba-c66c8b3215b72022-11-07T10:13:18ZLongitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testingJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9c542942-22d6-457d-82ba-c66c8b3215b7EnglishSymplectic Elements BMJ Publishing Group2022Couillard, SShrimanker, RLemaire-Paquette, SHynes, GMBorg, CConnolly, CThulborn, SMoran, AMPoole, SMorgan, SPowell, TPavord, IHinks, TCouillard Castonguay, STo explore whether exhaled nitric oxide (FeNO) non-suppression identifies corticosteroid resistance, we analysed inflammatory mediator changes during a FeNO suppression test with monitored high-intensity corticosteroid therapy. In linear mixed-effects models analysed over time, the 15 clinically-distinct ‘suppressors’ (i.e. ≥42% FeNO suppression) normalised asthma control questionnaire scores (mean±SD: 2.8±1.4 to 1.4±0.9, p<0.0001) and sputum eosinophil counts (median [IQR]: 29 [6-41] to 1 [1-5]%, p=0.0003) while significantly decreasing sputum prostaglandin D2 (254 [89-894] to 93 [49-209] pg/mL, p=0.004) and numerically decreasing other type-2 cytokine, chemokine and alarmin levels. In comparison, the 19 non-suppressors had persistent sputum eosinophilia (10 [1-67]% despite high-intensity therapy) with raised end-test inflammatory mediator levels (1.9 [0.9-2.8]-fold greater than suppressors). FeNO non-suppression during monitored treatment implies biological corticosteroid resistance. |
| spellingShingle | Couillard, S Shrimanker, R Lemaire-Paquette, S Hynes, GM Borg, C Connolly, C Thulborn, S Moran, AM Poole, S Morgan, S Powell, T Pavord, I Hinks, T Couillard Castonguay, S Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing |
| title | Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing |
| title_full | Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing |
| title_fullStr | Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing |
| title_full_unstemmed | Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing |
| title_short | Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing |
| title_sort | longitudinal changes in sputum and blood inflammatory mediators during feno suppression testing |
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