TY - JOUR
T1 - Onset of action of inhaled glucocorticoids on bronchial and alveolar nitric oxide output
AU - Karvonen, Tuomas
AU - Sepponen-Lavikko, Anna
AU - Holm, Kati
AU - Schultz, Rüdiger
AU - Moilanen, Eeva
AU - Lehtimäki, Lauri
N1 - Funding Information:
The study was supported by Foundation of the Finnish Anti-Tuberculosis Association (https://tbfoundation.org/), The Research Foundation of the Pulmonary Diseases (https://hengitysliitto.fi/fi), Tampere Tuberculosis Foundation (http://tuber kuloosisaatio.fi/), Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, and Foundation for Tampere University Hospital (https://taystuki.fi/).
Publisher Copyright:
© 2020 IOP Publishing Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Fractional exhaled nitric oxide (FENO) is a marker of airway inflammation. Measuring FENO at multiple flow rates enables calculation of NO parameters: bronchial NO output (JawNO), bronchial wall (CawNO) and alveolar (CANO) NO concentrations, and bronchial diffusion factor of NO (DawNO). FENO is known to rapidly reduce after the commencement of inhaled corticosteroid (ICS) treatment. However, little is known on the effect of ICS on the other NO parameters. We assessed (1) the onset of action of ICS treatment on the NO parameters and (2) whether the changes in bronchial NO output are due to changes in bronchial wall NO concentration or diffusion factor. FENO and other NO parameters were measured at baseline and after 1, 3 and 7 d of treatment with inhaled fluticasone propionate 250 µg b.i.d. in 23 allergic children with a history of asthma-like symptoms. There was a decrease in JawNO (from 680 (244/1791) (median (1st/3rd quartile)) to 357 (165/753) pl s−1, p < 0.001) and FENO50 (from 13.8 (7.5/35) to 8.3 (5.36/17.0) ppb, p < 0.001) in 3 d from the first dose of ICS. Also, CawNO seemed to reduce after 3 d (from 171 (89/328) to 79 (54/157) ppb, p = 0.041), while DawNO remained unchanged. Furthermore, CANO reduced during the 7 d treatment (from 3.0 (2.0/5.0) to 2.3 (1.9/2.6) ppb, p = 0.004). ICS treatment reduced FENO50 and JawNO rapidly and the decline was caused by decreased bronchial wall NO concentration while bronchial NO diffusion factor remained unchanged. These findings suggest that CawNO could be a more specific marker of airway inflammation and treatment response than JawNO or FENO50, which are both determined also by DawNO that seems to be resistant to the treatment with ICS.
AB - Fractional exhaled nitric oxide (FENO) is a marker of airway inflammation. Measuring FENO at multiple flow rates enables calculation of NO parameters: bronchial NO output (JawNO), bronchial wall (CawNO) and alveolar (CANO) NO concentrations, and bronchial diffusion factor of NO (DawNO). FENO is known to rapidly reduce after the commencement of inhaled corticosteroid (ICS) treatment. However, little is known on the effect of ICS on the other NO parameters. We assessed (1) the onset of action of ICS treatment on the NO parameters and (2) whether the changes in bronchial NO output are due to changes in bronchial wall NO concentration or diffusion factor. FENO and other NO parameters were measured at baseline and after 1, 3 and 7 d of treatment with inhaled fluticasone propionate 250 µg b.i.d. in 23 allergic children with a history of asthma-like symptoms. There was a decrease in JawNO (from 680 (244/1791) (median (1st/3rd quartile)) to 357 (165/753) pl s−1, p < 0.001) and FENO50 (from 13.8 (7.5/35) to 8.3 (5.36/17.0) ppb, p < 0.001) in 3 d from the first dose of ICS. Also, CawNO seemed to reduce after 3 d (from 171 (89/328) to 79 (54/157) ppb, p = 0.041), while DawNO remained unchanged. Furthermore, CANO reduced during the 7 d treatment (from 3.0 (2.0/5.0) to 2.3 (1.9/2.6) ppb, p = 0.004). ICS treatment reduced FENO50 and JawNO rapidly and the decline was caused by decreased bronchial wall NO concentration while bronchial NO diffusion factor remained unchanged. These findings suggest that CawNO could be a more specific marker of airway inflammation and treatment response than JawNO or FENO50, which are both determined also by DawNO that seems to be resistant to the treatment with ICS.
KW - Asthma
KW - Breath tests
KW - Children
KW - Glucocorticoids
KW - Nitric oxide
KW - Two-compartment model
U2 - 10.1088/1752-7163/abc054
DO - 10.1088/1752-7163/abc054
M3 - Article
C2 - 33045700
AN - SCOPUS:85096076621
SN - 1752-7155
VL - 15
JO - JOURNAL OF BREATH RESEARCH
JF - JOURNAL OF BREATH RESEARCH
IS - 1
M1 - 016008
ER -