BACKGROUND: The role of the peripheral airways in asthma is increasingly being recognized as a potential target for the achievement of optimal control of the disease. We postulated that the inflammatory changes of the small airways are implicated in the lack of asthma control in mild asthma. OBJECTIVE: To test this hypothesis, we measured the alveolar fraction of exhaled NO (CalvNO) in patients with mild asthma with different levels of control of symptoms. METHODS: Seventy-eight patients with asthma (35 men, age, 37 +/- 15 years; FEV1 percentage of predicted, 100% +/- 9%) were studied. Asthma control was assessed by using the Asthma Control Test (ACT). Measurements of exhaled NO at multiple constant flows were performed. RESULTS: Bronchial NO concentrations were 27.1 +/- 20 ppb, and CalvNO levels were 5.7 +/- 3.4 ppb. The ACT score was 20 +/- 4.2. The level of asthma control was not associated with bronchial NO concentrations (rs = 0.16, P = .15). However, a significant correlation was found between the ACT score and CalvNO (rs = 0.25, P = .03). Moreover, CalvNO was significantly higher in patients with uncontrolled asthma than in patients with controlled/partially controlled asthma (6.7 +/- 2.6 ppb vs 4.9 +/- 2.6 ppb, respectively, P = .02). In the subgroup of patients with asthma who underwent extrafine inhaled corticosteroid treatment, the magnitude of the inhaled corticosteroid-induced improvement in asthma control positively correlated with baseline CalvNO at 1 month (rs = 0.39, P = .003) and at 3 months (rs = 0.49, P < .0001). CONCLUSIONS: The alveolar component of exhaled NO is associated with the lack of asthma control in patients with mild, untreated asthma. This observation supports the notion that abnormalities of the peripheral airways are implicated in the mildest forms of asthma.

Scichilone, N., Battaglia, S., Taormina, S., Modica, V., Pozzecco, E., & Bellia, V. (2013). Alveolar nitric oxide and asthma control in mild untreated asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 131(6), 1513-1517 [10.1016/j.jaci.2013.03.009].

Alveolar nitric oxide and asthma control in mild untreated asthma

SCICHILONE, Nicola Alessandro;BATTAGLIA, Salvatore;BELLIA, Vincenzo
2013

Abstract

BACKGROUND: The role of the peripheral airways in asthma is increasingly being recognized as a potential target for the achievement of optimal control of the disease. We postulated that the inflammatory changes of the small airways are implicated in the lack of asthma control in mild asthma. OBJECTIVE: To test this hypothesis, we measured the alveolar fraction of exhaled NO (CalvNO) in patients with mild asthma with different levels of control of symptoms. METHODS: Seventy-eight patients with asthma (35 men, age, 37 +/- 15 years; FEV1 percentage of predicted, 100% +/- 9%) were studied. Asthma control was assessed by using the Asthma Control Test (ACT). Measurements of exhaled NO at multiple constant flows were performed. RESULTS: Bronchial NO concentrations were 27.1 +/- 20 ppb, and CalvNO levels were 5.7 +/- 3.4 ppb. The ACT score was 20 +/- 4.2. The level of asthma control was not associated with bronchial NO concentrations (rs = 0.16, P = .15). However, a significant correlation was found between the ACT score and CalvNO (rs = 0.25, P = .03). Moreover, CalvNO was significantly higher in patients with uncontrolled asthma than in patients with controlled/partially controlled asthma (6.7 +/- 2.6 ppb vs 4.9 +/- 2.6 ppb, respectively, P = .02). In the subgroup of patients with asthma who underwent extrafine inhaled corticosteroid treatment, the magnitude of the inhaled corticosteroid-induced improvement in asthma control positively correlated with baseline CalvNO at 1 month (rs = 0.39, P = .003) and at 3 months (rs = 0.49, P < .0001). CONCLUSIONS: The alveolar component of exhaled NO is associated with the lack of asthma control in patients with mild, untreated asthma. This observation supports the notion that abnormalities of the peripheral airways are implicated in the mildest forms of asthma.
Settore MED/10 - Malattie Dell'Apparato Respiratorio
http://www.ncbi.nlm.nih.gov/pubmed/23639306
Scichilone, N., Battaglia, S., Taormina, S., Modica, V., Pozzecco, E., & Bellia, V. (2013). Alveolar nitric oxide and asthma control in mild untreated asthma. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 131(6), 1513-1517 [10.1016/j.jaci.2013.03.009].
File in questo prodotto:
File Dimensione Formato  
Scichilone 2013 - JACI original.pdf

Solo gestori archvio

Descrizione: Articolo principale
Dimensione 364.95 kB
Formato Adobe PDF
364.95 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Scichilone 2013 - JACI Correction.pdf

Solo gestori archvio

Descrizione: File contenente le correzioni
Dimensione 29.28 kB
Formato Adobe PDF
29.28 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10447/73800
Citazioni
  • ???jsp.display-item.citation.pmc??? 16
  • Scopus 53
  • ???jsp.display-item.citation.isi??? 52
social impact