Exhaled Nitric Oxide and Nitric Oxide Synthase Expression in Hodgkin's Disease

Abstract

Hodgkin's disease (HD) is a malignant lymphoma with frequent mediastinal involvement, characterized by a significant inflammatory infiltration. Exhaled Nitric Oxide (FENO), is present in healthy humans, and has been proven to be increased in eosinophilic diseases such as allergic asthma. We investigated whether FENO is increased in mediastinal HD and whether NO is produced by lymphoma tissue. To this aim FENO was measured in 56 HD patients, 17 with and 39 without bulky mediastinal involvement, in the period from January 2007 to December 2008. Thirty-seven patients were reassessed after remission. Lymph node biopsies of 10 patients were evaluated for inducible (iNOS) and constitutive (eNOS) nitric oxide synthase expression by immunohistochemistry. FENO resulted significantly related to the mediastinal mass maximum diameter (p=0.009) and was significantly higher in patients with as compared to those without bulky mediastinal disease (38.7 ppb, CI Nitric oxide (NO) is an intracellular and intercellular signalling molecule involved in the regulation of the immunological mechanisms, that, as free oxygen radical, takes part in inflammatory disorders (1). NO is synthesized from L-arginine by nitric oxide synthase (NOS) that exists in several isoforms: constitutive (eNOS) (endothelial NOS and neuronal NOS) and inducible (iNOS). Increased iNOS expression can be induced by immunostimulatory cytokines and has been found in many tumours, including B cell lymphoid neoplasms (2-3).Hodgkin's disease (HD) is a malignant lymphoma originating from B cells, characterized by typical malignant cells, Hodgkin cells (HC) and Reed-Stenberg cells (HRS) (4). These cells represent less than I% of the total tumour mass, and are surrounded by an extensive inflammatory infiltrate, characterized by lymphocytes, histiocytes, eosinophils, fibroblasts, neutrophils and plasma cells

Measurement of exhaled nitric oxide and serum surfactant protein D levels for monitoring radiation pneumonitis following thoracic radiotherapy

“…eNO levels increase in patients with Hodgkin lymphoma and normalize following remission (13,14). A similar effect has been reported for patients with lung cancer, which exhibit increased eNO levels, including in our previous study (6,15).…”

Assessment of fractionated exhaled nitric oxide as a biomarker for the treatment of eosinophilic esophagitis

“…16 -18 More recent studies found elevated FeNO levels in patients who were atopic but did not have asthma 6,19 and in nonatopic, nonasthmatic patients with Hodgkin's lymphoma. 20 Atopic dermatitis has also been associated with elevated FeNO levels. 11 These observations suggested a possible role for FeNO in immunologic diseases not restricted to the airways.…”

Psoriasis and Respiratory Comorbidities: The Added Value of Fraction of Exhaled Nitric Oxide as a New Method to Detect, Evaluate, and Monitor Psoriatic Systemic Involvement and Therapeutic Efficacy

“…Although CANO is decreased in OSAS, overall FeNO is increased because the main component is produced by the upper airways [ 96 ]. Conversely, increased FeNO levels might reflect excessive vasodilation as in hepatopulmonary syndrome (HPS) [ 97 ] or be the consequence of a systemic high level of inflammatory cytokines as in Hodgkin's Lymphoma (HL) [ 98 ], systemic sclerosis (SSc) [ 99 ], Crohn's disease (CD) [ 91 ], and other inflammatory bowel diseases (IBDs) [ 92 ]. Perturbation of metabolism, such as in obesity, that leads to a proinflammatory condition may elevate FeNO as demonstrated by the correlation between body mass index (BMI) and FeNO [ 47 ].…”