Exhaled nitric oxide in chronic obstructive pulmonary disease: relationship to pulmonary function

Abstract

The following study was undertaken in order to determine how exhaled nitric oxide (eNO) levels in former smokers with chronic obstructive pulmonary disease (COPD) compared to eNO levels in patients with asthma and in healthy nonsmoking volunteers. The study also aimed to determine any relationship between eNO levels in COPD and: 1) conventional measures of lung function; and 2) inhaled corticosteroid (ICS) use.In former smokers with COPD, nonsmokers with asthma and volunteers, eNO levels, spirometry, lung volumes, carbon monoxide diffusion capacity of the lung (DL,CO) and resting oxygen saturation (Sa,O 2 ) were measured.Median eNO was significantly higher among patients with COPD than among healthy volunteers (p~0.003) but lower than among patients with asthma (pv0.01). There was no significant difference in eNO levels between COPD patients using ICS and those not using ICS. By contrast, eNO was lower among asthma patients who used ICS (median 32 parts per billion (ppb); 25 -75% range 16 -54) than among asthma patients who did not (51 ppb; 32 -87) (p~0.034). Among patients with COPD, eNO was inversely correlated with forced expiratory volume in one second, DL,CO and Sa,O 2 , and was positively correlated with the residual lung volume/total lung capacity ratio. Among patients with asthma, no significant correlations were found.Exhaled nitric oxide is increased in patients with chronic obstructive pulmonary disease, an increase that is influenced by structural abnormalities of tobacco-induced lung damage. Eur Respir J 2001; 17: 934-938.

Role of the nitric oxide–soluble guanylyl cyclase pathway in obstructive airway diseases

“…Moreover, lung function parameters such as FEV 1 and DL CO were inversely correlated with exhaled NO levels [14]. This increased flux of NO from the airways was significantly decreased after inhalation of aminoguanidine, a relatively selective iNOS inhibitor [25].…”

“…Lung function parameters such as forced expiratory volume in 1 s (FEV 1 ) and carbon monoxide diffusing capacity (DL CO ) were inversely correlated with eNO levels in patients with COPD. In contrast to patients with asthma, the use of inhaled corticosteroids had no significant influence on eNO levels in patients with COPD [14]. Brindicci et al measured eNO at multiple expired flows to make a distinction between alveolar and bronchial NO and found that COPD is associated with elevated alveolar NO [15].…”

“…This finding suggests that sGC could be inhibited in patients with asthma, leading to the observed airway hyperresponsiveness. Also in patients with COPD, the lungs contain ample amounts of NO, but the airway tone remains elevated [14]. Patients with COPD have decreased pulmonary mRNA and protein levels of sGC which are correlated with disease severity [45].…”

“…Ansarin et al [14] have analyzed the exhaled nitric oxide (eNO) levels in patients with COPD, patients with asthma and healthy controls. Patients with COPD had higher eNO levels than healthy controls, but lower levels than patients with asthma.…”

Exhaled nitric oxide after lung transplantation: impact of the native lung

“…However, because other markers of early detection have only been used in recipients of SSLTx/HLTx [7,8] or are difficult to interpret in SLTx recipients (for instance, the FEF25-75%), it still had to be confirmed that eNO values do not depend upon the nature of the transplantation procedure and, hence, that the native lung after SLTx has no major impact on the measurement of eNO. This is of particular interest, since it has previously been demonstrated that the eNO value in COPD patients is increased [17] and that eNO values correlate negatively with FEV1, with the lower FEV1 values corresponding to higher eNO values [18]. Moreover, an association has been found between eNO values and bronchial inflammation in COPD patients, as assessed by using induced sputum neutrophilia and interleukin-8 [19].…”