Source: Annual Congress 2010 - COPD: treatment and monitoring
Disease area: Airway diseases

Abstract

Although there is widespread interest in non-invasive biomarkers such as fractional exhaled nitric oxide (FeNO) for assessing airway inflammation in chronic obstructive pulmonary disease (COPD), its usefulness is still controversial.
We examined whether FeNO levels differed between clinically meaningful subgroups of COPD in a group of 91 COPD patients with FEV₁ 17-77% of predicted. Multiple flow rates FeNO at 10, 30, 50, 100 and 200 mL/s were measured and two compartment nonlinear modelling was used for calculation of diffusion Capacity (D), alveolar NO concentration (Calv) and airway wall NO concentration (Caw). All patients had spirometri, assessment of symptoms with questionnaires and low dose CT scan as well as assessment of weight and body composition. We examined the following subgroups of COPD: Patients with 1) Mild emphysema, 2) Severe emphysema, 3) Chronic bronchitis, 4) Frequent exacerbations, 5) Loss of lean body mass and 6) Low fat-free mass index. We used advanced non-linear mixed model adjusted for age and gender.
Smoking affected Caw. Effect of Gender on D and Calv was also significant. However, there were no differences in D, Calv or Caw among COPD subgroups. The results were the same if the advanced non-linear mixed model was substituted by more standard analysis techniques.
This study questions the relevance of using FeNO as a non-invasive biomarker to evaluate local inflammation in COPD and points to a need for developing novel biomarkers that may assist us both in the research laboratory and daily clinical practice.

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Citations should be made in the following way:
N. Bazeghi, T. Gerds, E. Budtz-Joergensen, J. Hove, J. Vestbo (Copenhagen, Denmark; , United Kingdom). Exhaled nitric oxide measures using multiple flows in clinically relevant subgroups of COPD. Eur Respir J 2010; 36: Suppl. 54, 1337

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