Source: Annual Congress 2011 - Role of the biomarkers in airway diseases
Disease area: Airway diseases

Abstract

Background and objectives: Fractional exhaled nitric oxide (F_ENO) is considered a potentially useful biomarker to detect airway inflammation. Two-compartment model (2CM) of pulmonary NO dynamics has been used for the evaluation of bronchial NO flux (J‘aw_NO) and peripheral airway/alveolar NO concentration (CA_NO) in asthmatic patients. Recently, the trumpet shape of airway tree and axial diffusion model (TMAD) has been reported as the correction of 2CM. This study was designed to determine the validity of measurement of CA_NO using the TMAD model for the assessment of small airways obstruction in asthma
Methods: A total of 52 asthmatic patients and 12 normal controls were included in this study. Methacholine inhalation challenge testing, pulmonary function tests, sputum induction, and exhaled NO measurements at several flow rates were performed. And then J‘aw_NO and CA_NO were calculated using both the 2CM (CA_{NO 2CM}, J‘aw_{NO 2CM}) and the TMAD model (CA_{NO TMAD}, J‘aw_{NO TMAD}) respectively.
Results: Both J‘aw_NO and CA_NO were significantly higher in asthmatic patients than normal controls. CA_{NO 2CM} was significantly correlated with FEV₁/FVC (r=-0.35, p=0.01), FEF_25-75 (r=-0.45, p<0.001), and sputum eosinophils (r=0.32, p=0.02). In contrast, CA_{NO TMAD} was significantly correlated with FEF_25-75 alone (r=-0.42, p=0.002), and not with FEV₁/FVC or sputum eosinophils.
Conclusions: CA_{NO TMAD} is more selective as an indicator of small airways obstruction than CA_{NO 2CM}. Assessment of small airways obstruction using the TMAD model may reveal the role of the small airways in the pathogenesis of asthma.

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D. Kobayashi, Y. Tochino, H. Kanazawa, Y. Ichimaru, K. Shigenori, K. Asai, K. Hirata (Osaka City, Japan). Comparison of alveolar nitric oxide concentrations using two different methods for the assessment of small airways inflammation in asthma. Eur Respir J 2011; 38: Suppl. 55, 4783

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