Association of Alveolar Nitric Oxide Levels with Pulmonary Function and Its Reversibility in Stable Asthma
Association of Alveolar Nitric Oxide Levels with Pulmonary Function and Its Reversibility in Stable Asthma
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DOI：
10.1159/000319566
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发表时间：
2011-01-01
期刊：
影响因子：
3.7
通讯作者：
Mishima, Michiaki
中科院分区：
文献类型：
--
作者：
Matsumoto, Hisako;Niimi, Akio;Mishima, Michiaki
背景：外周气道炎症与严重哮喘的病理生理有关。然而，周围气道炎症对稳定型哮喘患者（包括轻中度哮喘患者）气道口径/功能的影响仍有待证实。目的：探讨周围气道炎症对哮喘患者气道功能的影响。方法：在70例轻重度哮喘患者中，检测肺泡一氧化氮[CANO(TMAD)]水平，作为周围气道/肺泡炎症的无创生物标志物。采用喇叭形气道和轴向扩散模型，利用不同流量的呼出NO输出，估计气道室的CANO（TMAD）和最大一氧化氮（NO）通量J'awNO。然后通过肺活量测定和脉冲振荡测量系统评估肺功能，并检查其支气管扩张剂可逆性。结果：CANO（TMAD）水平与支气管扩张剂前后的肺量测定值均无相关性，但与支气管扩张剂前低频电抗（Xrs5） （rho = -0.31, p = 0.011）、低频Xrs综合面积（rho = 0.35, p = 0.003）和阻值的负频率依赖性（Rrs5-Rrs20） （rho = 0.35, p = 0.004）显著相关。此外，CANO（TMAD）水平与FEV1、FEF25-75%、Xrs5和AX的支气管扩张剂可逆性相关(rho分别为0.35、0.31、-0.24和-0.31
Background: Inflammation of peripheral airways is implicated in the pathophysiology of severe asthma. However, contributions of peripheral airway inflammation to airway caliber/function in patients with stable asthma, including those with mild to moderate disease, remain to be confirmed. Objectives: To determine whether peripheral airway inflammation affects airway function in patients with asthma. Methods: In 70 patients with mild to severe asthma, alveolar nitric oxide [CANO(TMAD)] levels were examined as a noninvasive biomarker of peripheral airway/alveolar inflammation. CANO(TMAD) and maximal nitric oxide (NO) flux in the airway compartment, J'awNO, were estimated with a model that incorporated trumpet-shaped airways and axial diffusion using exhaled NO output at different flow rates. Measures of pulmonary function were then assessed by spirometry and an impulse oscillometry system, and their bronchodilator reversibility was examined. Results: CANO(TMAD) levels were not correlated with pre- or postbronchodilator spirometric values, but were significantly associated with prebronchodilator reactance at low frequency (Xrs5) (rho = -0.31, p = 0.011), integrated area of low-frequency Xrs (AX) (rho = 0.35, p = 0.003) and negative frequency dependence of resistance (Rrs5-Rrs20) (rho = 0.35, p = 0.004). Furthermore, CANO(TMAD) levels were associated with bronchodilator reversibility of FEV1, FEF25-75%, Xrs5 and AX (rho = 0.35, 0.31, -0.24 and -0.31, respectively; p