Nasal ventilation is an important factor in evaluating the diagnostic value of nasal nitric oxide in allergic rhinitis

Hou, Jingbo; Lou, Hongfei; Wang, Yan; He, Fei; Cao, Feifei; Zhang, Luo

doi:10.1002/alr.22087

Cited by 21 publications

(36 citation statements)

References 32 publications

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“…According to the above results, nNO can objectively reflect inflammation in AR patients. For the insignificant results of the other studies, we should further look into the correlations between nNO, nasal resistance and sinus obstruction 48…”

Section: Discussionmentioning

confidence: 99%

Nasal Nitric Oxide Is Correlated With Nasal Patency and Nasal Symptoms

Ren

Zhang

et al. 2019

Allergy Asthma Immunol Res

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Purpose Nitric oxide (NO) is an important endogenous mediator in both upper and lower respiratory systems. The purpose of the present study was to extract nasal NO (nNO) normal range of Chinese adults and the internal influencing factors. The differences in nNO levels between rhinitis and asymptomatic atopic subjects, and the diagnostic value of nNO in allergic rhinitis (AR) were further investigated. Methods One thousand adults were recruited from the general public. Participants were divided into different subgroups according to the questionnaires and skin prick tests. In all of these subjects, nNO, fractional exhaled NO (FeNO) and nasal airflow resistance were measured. The normal ranges of nNO and FeNO, the differences between subgroups, and the correlations between NO (nNO and FeNO) and other internal factors were analyzed. Results Both nNO and FeNO levels were significantly higher in AR patients than in healthy and asymptomatic atopic subjects. The nNO levels were significantly lower in asymptomatic atopic subjects than in normal adults. FeNO levels were significantly higher in non-AR patients than in the healthy and asymptomatic atopic adults. The cutoff value of nNO for the diagnosis of AR was 117.5 ppb (sensitivity, 50.9%; specificity, 63.9%). The nNO levels were correlated with FeNO levels, total nasal resistance measured at 75Pa, nasal volume within 0–7 cm from the anterior nares (V 0–7cm ) and nasal symptom visual analogue scale (VAS) scores, while the FeNO levels were correlated with age, height, weight, body surface area, nasal volume of V 0–7cm and the nasal symptom VAS score. Conclusions The nNO level can be significantly different between healthy and AR patients and may be significantly correlated with nasal symptoms and nasal patency of rhinitis patients. However, the clinical value of nNO is still in the exploration stage.

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Section: Discussionmentioning

confidence: 99%

Nasal Nitric Oxide Is Correlated With Nasal Patency and Nasal Symptoms

Ren

Zhang

et al. 2019

Allergy Asthma Immunol Res

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“…This is in line with our meta-regression analyses, indicating that an increasing nasal CT score relates to a higher difference in nNO levels between CRSsNP and healthy subjects. However, the low nNO levels found in patients with chronic rhinosinusitis can also be explained through other mechanisms, such as the nasal obstruction resulting from mucosal swelling and presence or absence of nasal secretions [44] or the damage of the NO-producing sinus mucosa by an increased synthesis of cytotoxic agents in chronic inflammation [4]. Moreover, reduced expression of the inducible isoform of NO synthase (iNO-synthase) caused by some inflammatory cytokines (IL-4, IL-6, and TGF-β) has been found in the sinus mucosa of chronic rhinosinusitis patients [4].…”

Section: Discussionmentioning

confidence: 99%

Nasal Nitric Oxide in Chronic Rhinosinusitis with or without Nasal Polyps: A Systematic Review with Meta-Analysis

Ambrosino

Molino

Spedicato³

et al. 2020

JCM

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Background and Aims: There has been a recent growing interest in the role of nasal nitric oxide (nNO) as a biomarker for osteomeatal complex obstruction in paranasal sinus diseases. By using meta-analysis, we systematically reviewed the literature to establish the possible link between nNO concentration and chronic rhinosinusitis with nasal polyps (CRSwNP) or without (CRSsNP). Methods: We systematically searched the EMBASE, PubMed, Scopus, and Web of Science databases for related studies. Differences between controls and cases were reported as standardized mean difference (SMD), with 95% confidence intervals (95% CI), using the random-effects method. Results: We selected 23 articles for the final analysis: 15 with data on 461 CRSwNP patients and 384 healthy controls, 10 with data on 183 CRSsNP patients and 260 controls, and 14 studies on 372 CRSwNP and 297 CRSsNP patients. CRSwNP patients showed significantly lower nNO values when compared to both healthy controls (SMD: −1.495; 95% CI: −2.135, −0.854; p < 0.0001) and CRSsNP patients (SMD: −1.448; 95% CI: −2.046, −0.850; p < 0.0001). Sensitivity and subgroup analyses confirmed the results, which were further refined by regression models. They showed that an increasing aspiration flow is related to a greater difference in nNO levels between cases and control subjects. We also documented lower nNO levels in CRSsNP patients with respect to controls (SMD: −0.696; 95% CI: −1.189, −0.202; p = 0.006), being this result no longer significant when excluding patients in therapy with intranasal corticosteroids. As shown by regression models, the increased Lund–Mackay score indicates a high effect size. Conclusions: nNO levels are significantly lower in CRSwNP, especially when using higher aspiration flows. Additional studies are needed to define one single standardized method and normal reference values for nNO.

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“…Previous publications have reported that AR is very heterogeneous with a wide degree of severity; meanwhile, there is no novel objective indication or biological marker that is speci c for its disease activity [7][8]. Current monitoring the severity of this clinical disorder relies primarily on subjective clinical symptom score which is relatively insensitive, particularly in children [9][10].…”

Section: Introductionmentioning

confidence: 99%

Serum Metabolomic Signatures Associated with Disease Severity in Allergic Rhinitis

Xie

Zhang

Xie

et al. 2020

Preprint

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Abstract Background: Allergic rhinitis (AR) is a global healthcare problem with obscure pathogenesis, and few studies have evaluated the association between AR and metabolomics. The aim of this study was to identify differences in serum metabolomics profiling of AR patients compared to healthy controls and to explore novel biomarkers reflecting disease severity.Methods: Serum samples were collected form 29 healthy controls and 72 AR patients, including 30 mild AR patients (MAR) and 42 moderate to severe AR patients (MSAR). Metabolomic profiling was performed by ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) in serum samples. Orthogonal partial least square-discriminate analysis (OPLS-DA) was applied to assess the differences between AR patients and controls and for subgroups based on disease severity. Results: These analysis results successfully revealed distinct metabolite signatures which distinguished MAR patients and MSAR patients from health controls. In addition, MSAR patients also could be discriminated from MAR patients basing on their metabolic fingerprints. Most observed metabolite changes were related to pathways associated with glycine, serine and threonine metabolism, pyrimidine metabolism, sphingolipid metabolism, arginine and proline metabolism and fatty acid metabolism. Among these metabolites from dysregulated metabolic pathways, levels of sarcosine, sphingosine-1-phosphate (S1P), cytidine and linoleic acid significantly correlated with AR total nasal symptom score (TNSS) and visual analogue scale (VAS).Conclusions: MSAR patients have a distinctive serum metabolomics profile compared to MAR and health controls. These results suggest that metabolomic profiling may provide novel insights into pathophysiological mechanisms of AR and contribute to its evaluation of disease severity.

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Nasal ventilation is an important factor in evaluating the diagnostic value of nasal nitric oxide in allergic rhinitis

Abstract: Nasal patency affects nasal NO level significantly, and may reflect the severity of nasal inflammation in AR patients with mild-to-moderate nasal obstruction, but not in patients with severe nasal obstruction.

Cited by 21 publications

References 32 publications

Nasal Nitric Oxide Is Correlated With Nasal Patency and Nasal Symptoms

Nasal Nitric Oxide Is Correlated With Nasal Patency and Nasal Symptoms

Nasal Nitric Oxide in Chronic Rhinosinusitis with or without Nasal Polyps: A Systematic Review with Meta-Analysis

Serum Metabolomic Signatures Associated with Disease Severity in Allergic Rhinitis

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