Exhaled nitric oxide, pulmonary function, and disease activity in children with systemic lupus erythematosus

Deerojanawong, Jitladda; Leartphichalak, Pitchaya; Chanakul, Ankanee; Sritippayawan, Suchada; Samransamruajkit, Rujipat

doi:10.1002/ppul.23742

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Within this assessment, R5 represents the overall airway resistance, while R20 specifically denotes the resistance of the larger airways [ 28 , 29 ]. It’s worth noting that previous studies have indicated no significant correlation between FeNO and abnormal PFTs [ 30 , 31 ]. It is intriguing to note that in our study, FeNO levels exhibited a unique pattern of correlation.…”

Section: Discussionmentioning

confidence: 96%

Fractional exhaled nitric oxide in idiopathic pulmonary arterial hypertension and mixed connective tissue disease complicating pulmonary hypertension

Xu,

Sun,

Cao

et al. 2024

BMC Pulm Med

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Background Fractional exhaled nitric oxide (FeNO) has been extensively studied in various causes of pulmonary hypertension (PH), but its utility as a noninvasive marker remains highly debated. The objective of our study was to assess FeNO levels in patients with idiopathic pulmonary arterial hypertension (IPAH) and mixed connective tissue disease complicating pulmonary hypertension (MCTD-PH), and to correlate them with respiratory functional data, disease severity, and cardiopulmonary function. Methods We collected data from 54 patients diagnosed with IPAH and 78 patients diagnosed with MCTD-PH at the Shanghai Pulmonary Hospital Affiliated to Tongji University. Our data collection included measurements of brain natriuretic peptide (pro-BNP), cardiopulmonary exercise test (CPET), pulmonary function test (PFT), impulse oscillometry (IOS), and FeNO levels. Additionally, we assessed World Health Organization functional class (WHO-FC) of each patient. Results (1) The fractional exhaled concentration of nitric oxide was notably higher in patients with IPAH compared to those with MCTD-PH. Furthermore, within the IPAH group, FeNO levels were found to be lower in cases of severe IPAH compared to mild IPAH (P = 0.024); (2) In severe pulmonary hypertension as per the WHO-FC classification, FeNO levels in IPAH exhibited negative correlations with FEV1/FVC (Forced Expiratory Velocity at one second /Forced Vital Capacity), MEF50% (Maximum Expiratory Flow at 50%), MEF25%, and MMEF75/25% (Maximum Mid-expiratory Flow between 75% and 25%), while in severe MCTD-PH, FeNO levels were negatively correlated with R20% (Resistance at 20 Hz); (3) ROC (Receiving operator characteristic curve) analysis indicated that the optimal cutoff value of FeNO for diagnosing severe IPAH was 23ppb; (4) While FeNO levels tend to be negatively correlated with peakPETO2(peak end-tidal partial pressure for oxygen) in severe IPAH, in mild IPAH they had a positive correlation to peakO2/Heart rate (HR). An interesting find was observed in cases of severe MCTD-PH, where FeNO levels were negatively correlated with HR and respiratory exchange ratio (RER), while positively correlated with O2/HR throughout the cardiopulmonary exercise test. Conclusion FeNO levels serve as a non-invasive measure of IPAH severity. Although FeNO levels may not assess the severity of MCTD-PH, their significant makes them a valuable tool when assessing severe MCTD-PH.

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Section: Discussionmentioning

confidence: 96%

Fractional exhaled nitric oxide in idiopathic pulmonary arterial hypertension and mixed connective tissue disease complicating pulmonary hypertension

Xu,

Sun,

Cao

et al. 2024

BMC Pulm Med

View full text Add to dashboard Cite

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“…Carbon monoxide (NO) in the human body is derived from L-arginine and catalyzed by nitric oxide synthase 33 . The subtype of nitric oxide synthase-2 may be affected by oxidative stress and cytokines produced after inhalation of air pollutants 34 , and the acute effect of PM2.5 exposure on FeNO in c-SLE patients suggests that these patients have a higher degree of epithelial-mediated airway inflammation after exposure to fine particles 35 , 36 . Increasing evidence suggests that vascular effects such as estrogen increasing uterine arterial blood flow may be mediated by NO 37 .…”

Section: Discussionmentioning

confidence: 99%

The relationship of polluted air and drinking water sources with the prevalence of systemic lupus erythematosus: a provincial population-based study

Chen

Sun

et al. 2021

Sci Rep

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Environmental exposures interact with genetic factors has been thought to influence susceptibility of systemic lupus erythematosus (SLE) development. To evaluate the effects of environmental exposures on SLE, we conducted a population-based cohort study across Jiangsu Province, China, to examine the associations between the living environment including air and water pollution, population density, economic income level, etc. and the prevalence and mortality of hospitalized SLE (h-SLE) patients. A total of 2231 h-SLE patients were retrieved from a longitudinal SLE database collected by the Jiangsu Lupus Collaborative Group from 1999 to 2009. The results showed that: It existed regional differences on the prevalence of h-SLE patients in 96 administrative districts; The distribution of NO2 air concentration monitored by atmospheric remote sensors showed that three of the ultra-high-prevalence districts were located in the concentrated chemical industry emission area; h-SLE patient prevalence was positively correlated with the excessive levels of nitrogen in drinking water; The positive ratio of pericarditis and proteinuria was positively correlated with the prevalence of h-SLE patients and pollution not only induced a high h-SLE patient prevalence but also a higher mortality rate, which might be attributed to NOx pollution in the air and drinking water. In summary, our data suggested that NOx in air and drinking water may be one of the important predispositions of SLE, especially for patients with renal involvement.

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Malar rash is a predictor of subclinical airway inflammation in patients with systemic lupus erythematosus: a pilot study

et al. 2019

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Exhaled nitric oxide, pulmonary function, and disease activity in children with systemic lupus erythematosus

Abstract: Decreased TLC and high FENO were common in SLE children who had no respiratory symptoms and correlated with disease activity. FENO should be considered as an additional pulmonary function to evaluate disease activity in children with SLE.

Cited by 4 publications

References 23 publications

Fractional exhaled nitric oxide in idiopathic pulmonary arterial hypertension and mixed connective tissue disease complicating pulmonary hypertension

Fractional exhaled nitric oxide in idiopathic pulmonary arterial hypertension and mixed connective tissue disease complicating pulmonary hypertension

The relationship of polluted air and drinking water sources with the prevalence of systemic lupus erythematosus: a provincial population-based study

Malar rash is a predictor of subclinical airway inflammation in patients with systemic lupus erythematosus: a pilot study

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