当前位置： SCI文献检索 > AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE期刊下所有文献 > Use of exhaled nitric oxide measurement to identify a reactive, at-risk phenotype among patients with asthma.

Use of exhaled nitric oxide measurement to identify a reactive, at-risk phenotype among patients with asthma.

Abstract：

RATIONALE:Exhaled nitric oxide (Fe(NO)) is a biomarker of airway inflammation in mild to moderate asthma. However, whether Fe(NO) levels are informative regarding airway inflammation in patients with severe asthma, who are refractory to conventional treatment, is unknown. Here, we hypothesized that classification of severe asthma based on airway inflammation as defined by Fe(NO) levels would identify a more reactive, at-risk asthma phenotype. METHODS:Fe(NO) and major features of asthma, including airway inflammation, airflow limitation, hyperinflation, hyperresponsiveness, and atopy, were determined in 446 individuals with various degrees of asthma severity (175 severe, 271 non-severe) and 49 healthy subjects enrolled in the Severe Asthma Research Program. MEASUREMENTS AND MAIN RESULTS:Fe(NO) levels were similar among patients with severe and non-severe asthma. The proportion of individuals with high Fe(NO) levels (>35 ppb) was the same (40%) among groups despite greater corticosteroid therapy in severe asthma. All patients with asthma and high Fe(NO) had more airway reactivity (maximal reversal in response to bronchodilator administration and by methacholine challenge), more evidence of allergic airway inflammation (sputum eosinophils), more evidence of atopy (positive skin tests, higher serum IgE and blood eosinophils), and more hyperinflation, but decreased awareness of their symptoms. High Fe(NO) identified those patients with severe asthma characterized by the greatest airflow obstruction and hyperinflation and most frequent use of emergency care. CONCLUSIONS:Grouping of asthma by Fe(NO) provides an independent classification of asthma severity, and among patients with severe asthma identifies the most reactive and worrisome asthma phenotype.

journal_name

Am J Respir Crit Care Med

journal_title

American journal of respiratory and critical care medicine

authors

Dweik RA,Sorkness RL,Wenzel S,Hammel J,Curran-Everett D,Comhair SA,Bleecker E,Busse W,Calhoun WJ,Castro M,Chung KF,Israel E,Jarjour N,Moore W,Peters S,Teague G,Gaston B,Erzurum SC,National Heart, Lung, and Blood Insti

doi

10.1164/rccm.200905-0695OC

subject

Has Abstract

pub_date

2010-05-15 00:00:00

pages

1033-41

issue

eissn

1073-449X

issn

1535-4970

pii

200905-0695OC

journal_volume

181

pub_type

杂志文章

在线工具

Use of exhaled nitric oxide measurement to identify a reactive, at-risk phenotype among patients with asthma.