Residual exhaled nitric oxide elevation in asthmatics is associated with eosinophilic chronic rhinosinusitis
Residual exhaled nitric oxide elevation in asthmatics is associated with eosinophilic chronic rhinosinusitis
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DOI：
10.3109/02770903.2015.1054404
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发表时间：
2015-11-26
影响因子：
1.9
通讯作者：
Yasuba, Hirotaka
中科院分区：
文献类型：
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作者：
Kobayashi, Yoshiki;Asako, Mikiya;Yasuba, Hirotaka
目的：嗜酸性慢性鼻窦炎(ECRS)是慢性鼻窦炎(CRS)合并鼻息肉的一个亚型。ECRS是一种与哮喘密切相关的难治性疾病。据报道，经过适当治疗后，部分CRS哮喘患者呼出的部分一氧化氮(FeNO)水平升高，这表明残留的嗜酸性气道炎症或ECRs可能会影响FeNO水平。方法：检测133例哮喘患者(99例有ECRs，34例无ECRs)和13例无哮喘的ECRs患者血清FeNO水平，以探讨哮喘与ECRs的关系。哮喘的严重程度由全球哮喘倡议指南定义，鼻窦炎的严重程度通过基于Lund-Mackay分级的鼻窦CT评分来评估。结果和结论：即使在控制良好的有ECRs的哮喘患者中，FeNO水平也是升高的，而没有ECRs的哮喘患者和无哮喘的ECRs患者的FeNO水平并不高(>；50ppb)。虽然FeNO水平与哮喘严重程度无关，但与鼻窦CT评分呈正相关。在有ECRs的哮喘患者中，FeNO水平较高的患者有更严重的ECRs和哮喘。存在并发ECRs的可能性，特别是在高FeNO水平的哮喘患者，即使经过适当的治疗，包括ICS，这表明哮喘和ECRs可能作为一种呼吸道疾病与嗜酸性炎症密切相关。对于FeNO水平较高的哮喘患者，理想的做法是持续意识到共存的ECRs。
Objective: Eosinophilic chronic rhinosinusitis (ECRS) is as a subgroup of chronic rhinosinusitis (CRS) with nasal polyps. ECRS is a refractory disease closely related to bronchial asthma. Fractionated exhaled nitric oxide (FeNO) levels were reportedly elevated in some asthmatics with CRS after adequate treatment, suggesting that residual eosinophilic airway inflammation or ECRS might affect FeNO levels. Methods: To investigate the association between asthma with ECRS and FeNO levels, we examined FeNO levels in 133 asthmatics (99 with ECRS and 34 without ECRS) and 13 patients with ECRS without asthma. The severity of asthma was defined by the Global Initiative for Asthma guidelines and that of sinusitis was evaluated by the sinus CT score based on the Lund-Mackay scale. Results and conclusions: FeNO levels were elevated even in well-controlled asthmatics with ECRS, whereas asthmatics without ECRS and ECRS patients without asthma did not have high FeNO levels (>50ppb). Although FeNO levels were not correlated with asthma severity, they were positively correlated with the sinus CT score. In asthmatics with ECRS, patients with higher FeNO levels had more severe ECRS and asthma. There is a possibility of having comorbid ECRS, particularly in asthmatics with high FeNO levels even after adequate treatment, including ICS, suggesting that asthma and ECRS may be closely associated as one airway disease with eosinophilic inflammation. Continual awareness of the coexistent ECRS is ideally recommended for asthmatics with high FeNO levels.