Exhaled Nitric Oxide and Exhaled Breath Condensate pH in Severe Refractory Asthma

Tseliou, Eleni; Bessa, Vasiliki; Hillas, Georgios; Delimpoura, Vasiliki; Papadaki, Georgia; Roussos, Charis; Papiris, Spyros; Bakakos, Petros; Loukides, Stelios

doi:10.1378/chest.09-1257

Cited by 50 publications

(40 citation statements)

References 30 publications

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“…One study found an AUC of blood eosinophils of 0.55 in corticosteroid-treated patients and of 0.73 in untreated patients [31], whereas these numbers were 0.75 and 0.62, respectively, in another study [10]. Three previous studies evaluated the accuracy of FeNO among severe/treated and mild/untreated asthma patients [8,10,32]. None of them found considerable differences in the differences in the AUCs.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers to identify sputum eosinophilia in different adult asthma phenotypes

et al. 2015

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Several biomarkers have been used to assess sputum eosinophilia in asthma. It has been suggested that the diagnostic accuracy of these biomarkers might differ between asthma phenotypes. We investigated the accuracy of biomarkers in detecting sputum eosinophilia (⩾3%) in different adult asthma phenotypes.Levels of eosinophils in blood and sputum, exhaled nitric oxide fraction (FeNO) and total immunoglobulin (Ig)E from 336 adult patients, enrolled in three prospective observational clinical trials and recruited at five pulmonology outpatient departments, were analysed. Areas under the receiver operating characteristics curves (AUC) for detecting sputum eosinophilia were calculated and compared between severe and mild, obese and nonobese, atopic and nonatopic and (ex-)smoking and never-smoking asthma patients.Sputum eosinophilia was present in 116 patients (35%). In the total group the AUC was 0.83 (95% CI 0.78-0.87) for blood eosinophils, 0.82 (0.77-0.87) for FeNO and 0.69 (0.63-0.75) for total IgE. AUCs were similar for blood eosinophils and FeNO between different phenotypes. Total IgE was less accurate in detecting sputum eosinophilia in atopic and obese patients than in nonatopic and nonobese patients.Blood eosinophils and FeNO had comparable diagnostic accuracy (superior to total IgE) in identifying sputum eosinophilia in adult asthma patients, irrespective of asthma phenotype such as severe, nonatopic, obese and smoking-related asthma. @ERSpublications FeNO and blood eosinophils can be used to detect sputum eosinophilia in adult asthma patients regardless of phenotype

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Section: Discussionmentioning

confidence: 99%

Biomarkers to identify sputum eosinophilia in different adult asthma phenotypes

et al. 2015

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“…These analyses are generally of 2 types: analysis of exhaled gases, or analysis of condensates of exhaled droplets of epithelial lining fluid (exhaled breath condensates [EBCs]). [35][36][37] At present, in addition to the traditional measurements of exhaled oxygen, nitrogen, and carbon dioxide gases, analysis of exhaled nitric oxide (NO) is the only exhaled biomarker approved for clinical use. Elevation of exhaled NO is thought to be a marker of airway inflammation, especially in asthma but also in other airway diseases [35][36][37] (Fig.…”

Section: Analysis Of Exhaled Biomarkersmentioning

confidence: 99%

“…Algorithms have been proposed that incorporate this measurement as a tool to adjust medications in asthma and COPD. 36,37 The field of analyzing exhaled biomarkers is expanding rapidly, and newer approaches are described in more detail in the next section. The ability to perform these types of analyses could provide a real opportunity for the pulmonary function laboratory of the future.…”

Section: Analysis Of Exhaled Biomarkersmentioning

confidence: 99%

“…[35][36][37] Exhaled gases contain not only the commonly appreciated physiologic gases noted above, but also contain thousands of volatile organic compounds that can reflect a variety of cellular functions in both normal and pathologic states. These compounds can range from simple hydrocarbons to complex chemical vapors, and have been linked to inflammation, infection, metabolic derangements, and neoplasms.…”

Section: Advanced Exhaled Biomarker Analysismentioning

confidence: 99%

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The Future of Pulmonary Function Testing

MacIntyre

2012

Respir Care

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The pulmonary function lab of today is heavily focused on describing pathophysiology and quantifying the extent of disease. As we move forward, it is important that the results of pulmonary function tests go beyond this and be linked to important outcomes that truly affect clinical decision making. To get there, improvements in device performance are required, high quality technicians are critical, and properly trained interpreting clinicians with good reference standards are mandatory. Moreover, as accessibility to these tests is increased, it is important that quality metrics remain intact. There is a wide array of novel tests that might be performed by pulmonary function labs in the future. These range from modification of current technologies to brand new technologies that are still in early development. Examples include exhaled breath analysis, sophisticated analyses of lung mechanics and gas exchange, cardiac and tissue oxygenation assessments, and imaging technologies. Adoption of any new technology will require, even more than today, clear evidence that the new technology is a real adjunct to clinical decision making.

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“…FeNO was lower in subjects with neutrophils in their sputum, regardless of whether eosinophils were present. 20 Single breath (SB)-FeNO was measured in 44 children under the age of 2 years with recurrent wheezing. SB-FeNO was higher in infants with bronchodilator responsiveness (P Ͻ .001) and was associated with a lower FEV 0.5 measured by the chest compression technique.…”

Section: Exhaled Nitric Oxidementioning

confidence: 99%

Respiratory Care Year in Review 2010: Part 1. Asthma, COPD, Pulmonary Function Testing, Ventilator-Associated Pneumonia

et al. 2011

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The purpose of this paper is to review the recent literature related to asthma, COPD, pulmonary function testing, and ventilator-associated pneumonia. Topics covered related to asthma include genetics and epigenetics; exposures; viruses; diet, obesity and exercise; exhaled nitric oxide; and drug therapy (␤ agonists, macrolides, tiotropium and monteleukast). Topics covered related to COPD include childhood disadvantage factors and COPD; vitamin D deficiency and COPD; ␤-blockers and COPD; corticosteroid therapy during COPD exacerbations; oxygen administration during 488RESPIRATORY CARE • APRIL 2011 VOL 56 NO 4 pre-hospital transport of patients with COPD exacerbation; and prognosis of patients admitted to the hospital for COPD exacerbation. Topics related to pulmonary function testing include methods and techniques; predicted values; natural history, pulmonary function in health and disease; and the COPD controversy. Finally, the paper includes the following topics related to ventilator-associated pneumonia: the tube, the intubation route, and the cuff; mechanical ventilation; the bundle; and cost. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of RESPIRATORY CARE.

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Exhaled Nitric Oxide and Exhaled Breath Condensate pH in Severe Refractory Asthma

Cited by 50 publications

References 30 publications

Biomarkers to identify sputum eosinophilia in different adult asthma phenotypes

Biomarkers to identify sputum eosinophilia in different adult asthma phenotypes

The Future of Pulmonary Function Testing

Respiratory Care Year in Review 2010: Part 1. Asthma, COPD, Pulmonary Function Testing, Ventilator-Associated Pneumonia

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