Combined use of exhaled hydrogen peroxide and nitric oxide in monitoring asthma
Combined use of exhaled hydrogen peroxide and nitric oxide in monitoring asthma
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DOI：
10.1164/ajrccm.158.4.9710091
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发表时间：
1998-10-01
影响因子：
24.7
通讯作者：
Barnes, PJ
中科院分区：
文献类型：
--
作者：
Horv치th, I;Donnelly, LE;Barnes, PJ
氧化应激会导致气道炎症，哮喘患者呼出的过氧化氢 (H2O2) 和一氧化氮 (NO) 升高。我们测定了 116 名哮喘患者（72 名未接受过类固醇治疗的稳定患者、30 名接受过类固醇治疗的稳定患者和 14 名接受过类固醇治疗的重度不稳定患者）和 35 名健康受试者的呼出 H2O2 和 NO 浓度，并研究了呼出 H2O2、NO、FEV1、气道反应性和诱导痰中嗜酸性粒细胞之间的关系。与正常受试者相比，未使用类固醇的哮喘患者呼出的 H2O2 和 NO 水平均升高（分别为 0.72 +/- 0.06 与 0.27 +/- 0.04 μM 和 29 +/- 1.9 与 6.5 +/- 0.32 ppb；p < 0.001），而在稳定类固醇治疗的患者中则降低（0.43 +/- 0.08 μM，p < 0.05 和 9.9 +/- 0.97 ppb，p < 0.001）。然而，在不稳定类固醇治疗的哮喘患者中，H2O2 水平升高，但呼出的 NO 水平较低（分别为 0.78 +/- 0.16 μM 和 6.7 +/- 1.0 ppb）。呼出的 H2O2、痰嗜酸性粒细胞和气道高反应性（乙酰甲胆碱 PC20）之间存在相关性。呼出一氧化氮也与痰嗜酸性粒细胞相关，但与气道高反应性无关。我们的研究结果表明，测量哮喘患者呼出的 H2O2 和 NO 可以为监测疾病活动性提供补充数据。
Oxidative stress contributes to airway inflammation and exhaled hydrogen peroxide (H2O2) and nitric oxide (NO) are elevated in asthmatic patients. We determined the concentrations of expired H2O2 and NO in 116 asthmatic (72 stable steroid-naive, 30 stable steroid-treated, and 14 severe steroid-treated unstable patients) and in 35 healthy subjects, and studied the relation between exhaled H2O2, NO, FEV1, airway responsiveness, and eosinophils in induced sputum. Both exhaled H2O2 and NO levels were elevated in steroid-naive asthmatic patients compared with normal subjects (0.72 +/- 0.06 versus 0.27 +/- 0.04 mu M and 29 +/- 1.9 versus 6.5 +/- 0.32 ppb, respectively; p < 0.001) and were reduced in stable steroid-treated patients (0.43 +/- 0.08 mu M, p < 0.05, and 9.9 +/- 0.97 ppb, p < 0.001). In unstable steroid-treated asthmatics, however, H2O2 levels were increased, but exhaled NO levels were low (0.78 +/- 0.16 mu M and 6.7 +/- 1.0 ppb, respectively). There was a correlation between expired H2O2, sputum eosinophils and airway hyperresponsiveness (methacholine PC20). Exhaled NO also correlated with sputum eosinophils, but not with airway hyperresponsiveness. Our findings indicate that measurement of expired H2O2 and NO in asthmatic patients provides complementary data for monitoring of disease activity.