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Zaigham S, Bertelsen RJ, Dharmage SC, Schlünssen V, Jögi NO, Gomez LP, Holm M, Oudin A, Abramson MJ, Sigsgaard T, Jõgi R, Svanes C, Olin AC, Forsberg B, Janson C, Nerpin E, Johannessen A, Malinovschi A. An observational analysis on the influence of parental allergic rhinitis, asthma and smoking on exhaled nitric oxide in offspring. Nitric Oxide 2024; 149:60-66. [PMID: 38876398 DOI: 10.1016/j.niox.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/31/2024] [Accepted: 06/12/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Parental allergic diseases and smoking influence respiratory disease in the offspring but it is not known whether they influence fractional exhaled nitric oxide (FeNO) in the offspring. We investigated whether parental allergic diseases, parental smoking and FeNO levels in parents were associated with FeNO levels in their offspring. METHODS We studied 609 offspring aged 16-47 years from the Respiratory Health in Northern Europe, Spain and Australia generation (RHINESSA) study with parental information from the Respiratory Health in Northern Europe (RHINE) III study and the European Community Respiratory Health Survey (ECRHS) III. Linear regression models were used to assess the association between offspring FeNO and parental FeNO, allergic rhinitis, asthma and smoking, while adjusting for potential confounding factors. RESULTS Parental allergic rhinitis was significantly associated with higher FeNO in the offspring, both on the paternal and maternal side (percent change: 20.3 % [95%CI 5.0-37.7], p = 0.008, and 13.8 % [0.4-28.9], p = 0.043, respectively). Parental allergic rhinitis with asthma in any parent was also significantly associated with higher offspring FeNO (16.2 % [0.9-33.9], p = 0.037). However, parental asthma alone and smoking were not associated with offspring FeNO. Parental FeNO was not associated with offspring FeNO after full adjustments for offspring and parental factors. CONCLUSIONS Parental allergic rhinitis but not parental asthma was associated with higher levels of FeNO in offspring. These findings suggest that parental allergic rhinitis status should be considered when interpreting FeNO levels in offspring beyond childhood.
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Affiliation(s)
- S Zaigham
- Department of Clinical Sciences, Cardiovascular Epidemiology, Lund University, Malmo, Sweden; Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
| | - R J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - S C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - V Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - N O Jögi
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - L Palacios Gomez
- El Torrejón Health Centre. Huelva, Andalusian Health Service, Huelva, Spain
| | - M Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - A Oudin
- Division for Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umea, Sweden
| | - M J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - T Sigsgaard
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - R Jõgi
- Lung Clinic, Tartu University Clinics, Tartu, Estonia
| | - C Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A C Olin
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - B Forsberg
- Division for Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umea, Sweden
| | - C Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala University, Uppsala, Sweden
| | - E Nerpin
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala University, Uppsala, Sweden; School of Health and Welfare, Dalarna University, Falun, Sweden
| | - A Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
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2
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Sasiene ZJ, LeBrun ES, Schaller E, Mach PM, Taylor R, Candelaria L, Glaros TG, Baca J, McBride EM. Real-time breath analysis towards a healthy human breath profile. J Breath Res 2024; 18:026003. [PMID: 38198707 DOI: 10.1088/1752-7163/ad1cf1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/10/2024] [Indexed: 01/12/2024]
Abstract
The direct analysis of molecules contained within human breath has had significant implications for clinical and diagnostic applications in recent decades. However, attempts to compare one study to another or to reproduce previous work are hampered by: variability between sampling methodologies, human phenotypic variability, complex interactions between compounds within breath, and confounding signals from comorbidities. Towards this end, we have endeavored to create an averaged healthy human 'profile' against which follow-on studies might be compared. Through the use of direct secondary electrospray ionization combined with a high-resolution mass spectrometry and in-house bioinformatics pipeline, we seek to curate an average healthy human profile for breath and use this model to distinguish differences inter- and intra-day for human volunteers. Breath samples were significantly different in PERMANOVA analysis and ANOSIM analysis based on Time of Day, Participant ID, Date of Sample, Sex of Participant, and Age of Participant (p< 0.001). Optimal binning analysis identify strong associations between specific features and variables. These include 227 breath features identified as unique identifiers for 28 of the 31 participants. Four signals were identified to be strongly associated with female participants and one with male participants. A total of 37 signals were identified to be strongly associated with the time-of-day samples were taken. Threshold indicator taxa analysis indicated a shift in significant breath features across the age gradient of participants with peak disruption of breath metabolites occurring at around age 32. Forty-eight features were identified after filtering from which a healthy human breath profile for all participants was created.
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Affiliation(s)
- Zachary Joseph Sasiene
- Biochemistry and Biotechnology Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM 87545, United States of America
| | - Erick Scott LeBrun
- Biochemistry and Biotechnology Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM 87545, United States of America
| | - Eric Schaller
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131, United States of America
| | - Phillip Michael Mach
- Biochemistry and Biotechnology Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM 87545, United States of America
| | - Robert Taylor
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131, United States of America
| | - Lionel Candelaria
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131, United States of America
| | - Trevor Griffiths Glaros
- Biochemistry and Biotechnology Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM 87545, United States of America
| | - Justin Baca
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131, United States of America
| | - Ethan Matthew McBride
- Biochemistry and Biotechnology Group, Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM 87545, United States of America
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3
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Baranauskas MN, Freemas JA, Tan R, Carter SJ. Moving beyond inclusion: Methodological considerations for the menstrual cycle and menopause in research evaluating effects of dietary nitrate on vascular function. Nitric Oxide 2021; 118:39-48. [PMID: 34774755 DOI: 10.1016/j.niox.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/18/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022]
Abstract
Recent reports have acknowledged the underrepresentation of women in the field of dietary nitrate (NO3-) research. Undoubtedly, greater participation from women is warranted to clarify potential sex differences in the responses to dietary NO3- interventions. However, careful consideration for the effects of sex hormones - principally 17β-estradiol - on endogenous nitric oxide (NO) synthesis and dietary NO3- reductase capacity is necessary for improved interpretation and reproducibility of such investigations. From available literature, we present a narrative review describing how hormonal variations across the menstrual cycle, as well as with menopause, may impact NO biosynthesis catalyzed by NO synthase enzymes and NO3- reduction via the enterosalivary pathway. In doing so, we address methodological considerations related to the menstrual cycle and hormonal contraceptive use relevant for the inclusion of premenopausal women along with factors to consider when testing postmenopausal women. Adherence to such methodological practices may explicate the utility of dietary NO3- supplementation as a means to improve vascular function among women across the lifespan.
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Affiliation(s)
- Marissa N Baranauskas
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA.
| | - Jessica A Freemas
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA
| | - Rachel Tan
- Department of Natural Science, Seaver College, Pepperdine University, 90263, USA
| | - Stephen J Carter
- Department of Kinesiology, School of Public Health - Bloomington, Bloomington, Indiana University, 47405, USA; Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, 46202, USA
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4
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Using FeNO Measurement in Clinical Asthma Management. Chest 2021; 161:906-917. [PMID: 34673021 DOI: 10.1016/j.chest.2021.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/30/2021] [Accepted: 10/10/2021] [Indexed: 11/24/2022] Open
Abstract
Asthma is a common and heterogeneous disease, characterised by lower airway inflammation and airflow limitation. Critical factors in asthma management include establishing an accurate diagnosis and ensuring appropriate selection and dosage of anti-inflammatory therapies. The majority of asthma patients exhibit type 2 (T2) inflammation, with increased interleukin (IL)-4, IL-5, and IL-13 signalling, often with associated eosinophilia. Identifying lower airway eosinophilia with sputum induction improves asthma outcomes, but is time consuming and costly. Increased T2-inflammation leads to upregulation of nitric oxide (NO) release into the airway, with increasing fractional exhaled NO (FeNO) reflecting greater T2-inflammation. FeNO can be easily and quickly measured in the clinic, offering a point of care surrogate measure of the degree of lower airway inflammation. FeNO testing can be used to help confirm an asthma diagnosis, to guide inhaled corticosteroid therapy, to assess adherence to treatment, and to aid selection of appropriate biologic therapy. However, FeNO levels may also be influenced by a variety of intrinsic and extrinsic factors other than asthma, including nasal polyposis and cigarette smoking, and must be interpreted in the broader clinical context rather than viewed in isolation. This review discusses the clinical application of FeNO measurement in asthma care, from diagnosis to treatment selection, and describes its place in current international expert guidelines.
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5
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Importance of type and degree of IgE sensitisation for defining fractional exhaled nitric oxide reference values. Respir Med 2021; 188:106621. [PMID: 34564049 DOI: 10.1016/j.rmed.2021.106621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/10/2021] [Accepted: 09/19/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FENO) is a marker of type 2 airway inflammation used in clinical practice in asthma. However, reference values are needed to broaden the clinical use of FENO and this is within the scope of a newly started Global Lung Function Initiative task force. We aim to study FENO levels with special emphasis on the upper limit of normal (ULN) in relation to the type and degree of IgE sensitisation. METHODS FENO was measured in 1855 non-smoking, respiratory healthy subjects from the Swedish CArdioPulmonary bioImage Study (SCAPIS). Atopic subjects (n = 424), defined as being IgE-sensitised to aeroallergens (ImmunoCAP Phadiatop™, ≥0.35 PAU/l) were compared to non-atopic subjects (<0.35 PAU/l, n = 1431). Atopic subjects were further characterised according to their grade of IgE sensitisation (IgE antibody tertiles: (T1<1.16, T2 1.16-3.72 and T3 >3.72 PAU/l) and sensitisation to perennial (cat or mite) or seasonal (birch) allergens. RESULTS Subjects IgE-sensitised to cat or mite had higher FENO compared to non-atopic subjects (FENO (ppb): median 20.0 vs. 15.0, and ULN 50.4 vs. 33.0, p < 0.001). This was seen to a lesser extent for subjects IgE-sensitised to birch only (median 18.0 vs. 15.0, and ULN 38.0 vs. 33.0, p = 0.048). Atopic subjects with a high degree of IgE sensitisation (Phadiatop: >3.72 PAU/l) had the highest FENO compared to non-atopic subjects (median 20.0 vs. 15.0, and ULN 56.0 vs. 33.0, p < 0.001). CONCLUSIONS The type and degree of IgE sensitisation should be considered in generating FENO reference values.
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6
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Gonzalez AM, Accetta MR, Spitz RW, Mangine GT, Ghigiarelli JJ, Sell KM. Red Spinach Extract Supplementation Improves Cycle Time Trial Performance in Recreationally Active Men and Women. J Strength Cond Res 2021; 35:2541-2545. [PMID: 31136549 DOI: 10.1519/jsc.0000000000003173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Adam M Gonzalez
- Department of Health Professions, Hofstra University, Hempstead, New York; and
| | - Matthew R Accetta
- Department of Health Professions, Hofstra University, Hempstead, New York; and
| | - Robert W Spitz
- Department of Health Professions, Hofstra University, Hempstead, New York; and
| | - Gerald T Mangine
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, Georgia
| | - Jamie J Ghigiarelli
- Department of Health Professions, Hofstra University, Hempstead, New York; and
| | - Katie M Sell
- Department of Health Professions, Hofstra University, Hempstead, New York; and
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7
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Antosova M, Bencova A, Mokra D, Plevkova J, Pepucha L, Buday T. Exhaled and Nasal Nitric Oxide - Impact for Allergic Rhinitis. Physiol Res 2021; 69:S123-S130. [PMID: 32228017 DOI: 10.33549/physiolres.934393] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
FeNO measurement is a validated non-invasive technique, which is used for diagnosis and monitoring of asthma. It would be desirable to find a reliable method to monitor allergic rhinitis (AR) via measurement of FeNO, and/or nasal nitric oxide (nNO). The aim of our study was the assessment of the efficacy of FeNO and nNO as markers in AR treatment. FeNO and nNO were measured with the portable NO analyser (NIOX MINO®) in healthy participants and in patients with AR. The patients were examined during the pollen season and out of it. The effect of local corticosteroids and antihistamine therapy was observed in patients with AR during pollen season after three weeks of therapy. There are significant differences between FeNO and nNO in patients with AR compared to healthy controls at all set points of measurements. While FeNO responded well to the treatment with both antihistamines and combined therapy, nNO decreased only after combined therapy with antihistamines and nasal corticosteroids. nNO monitoring alone is not a suitable method to monitor inflammation of the upper airways in AR and its suppression by anti-allergic treatment and should be correlated with other markers as FeNO or symptom scores.
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Affiliation(s)
- M Antosova
- BioMed Martin, Division of Respirology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Slovak
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8
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Mohammad MA, Didelija IC, Marini JC. Arginase II Plays a Central Role in the Sexual Dimorphism of Arginine Metabolism in C57BL/6 Mice. J Nutr 2020; 150:3133-3140. [PMID: 33188387 PMCID: PMC7726119 DOI: 10.1093/jn/nxaa318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sex differences in plasma concentration of arginine and arginase activity of different tissues have been reported in mice. In addition, male but not female C57BL/6 mice have a dietary arginine requirement for growth. OBJECTIVE The goal of this research was to test the hypothesis that arginase II is a key factor in the sexual dimorphism of arginine metabolism. METHODS Young adult male and female wild type (WT), and heterozygous and arginase II knockout mice on a C57BL/6 background mice were infused with labeled citrulline, arginine, ornithine, phenylalanine, and tyrosine to determine the rates of appearance and interconversion of these amino acids. Tissue arginase activity was measured in the liver, heart, jejunum, kidney, pancreas, and spleen with an arginine radioisotope. The effect of genotype, sex, and their interaction was tested. RESULTS Female mice produced ∼36% more citrulline than their male littermates, which translated into a greater arginine endogenous synthesis, flux, and plasma concentration (42, 6, and 27%, respectively; P < 0.001). Female mice also had a greater phenylalanine flux (10%) indicating a greater rate of whole protein breakdown; however, they had a lower protein synthesis rate than males (18%; P < 0.001). The ablation of arginase II reduced the production of citrulline and the de novo synthesis of arginine in females and increased the rate of appearance of arginine and plasma arginine concentration in male mice (16 and 22%, respectively; P < 0.001). No effect of arginase II deletion, however, was observed for whole-body protein kinetics. Arginase II activity was present in the pancreas, kidney, jejunum, and spleen; WT females had a ∼2-fold greater renal arginase activity than their WT counterparts. CONCLUSIONS A clear sexual dimorphism exists in the endogenous synthesis of arginine and its disposal. Female mice have a greater arginine availability than their male littermates. The ablation of arginase II increases arginine availability in male mice.
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Affiliation(s)
- Mahmoud A Mohammad
- USDA/ARS (Agricultural Research Service) Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA,Food Science and Nutrition Department, National Research Centre, Dokki, Giza, Egypt
| | - Inka C Didelija
- USDA/ARS (Agricultural Research Service) Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Habib SS, Alzoghaibi MA, Habib SH, Al-Regaiey KA. Reference Ranges and Determinant Factors for Fractional Exhaled Nitric Oxide in a Healthy Saudi Adult Population. Med Sci Monit Basic Res 2020; 26:e926382. [PMID: 32830193 PMCID: PMC7466833 DOI: 10.12659/msmbr.926382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Fractional exhaled nitric oxide (FENO) has emerged as a promising marker in respiratory research. The aim of this study was to determine the reference range values of FENO for healthy Saudi adults and the factors associated with FENO levels. MATERIAL AND METHODS This cross-sectional study was conducted at the Department of Physiology, King Saud University, Riyadh, Saudi Arabia, from January 2016 to August 2017. A total of 429 healthy Saudi adults were initially recruited. The final selection included 412 participants, consisting of 307 men and 105 women. FENO measurements were performed according to the current recommendations of the American Thoracic Society. RESULTS We observed that the FENO levels of women were significantly lower than those of men (18.6 vs. 21.3, P=0.009). In women, the measured FENO ranged from 5.7 ppb to 42 ppb, and in men from 5.0 ppb to 55.0 ppb. The mean FENO level in the entire study population was 20.6, with a range of 5.0 ppb to 55.0 ppb. The difference became non-significant when we calculated the FENO after adjusting for body surface area by different percentile distributions. Multiple linear regression analysis showed that body surface area and weight were significant predictors of FENO levels. CONCLUSIONS In this study, FENO levels were significantly affected by demographic variables. Therefore, it is important to consider the factors influencing FENO values to make a valid clinical interpretation.
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Affiliation(s)
- Syed Shahid Habib
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad A Alzoghaibi
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Syed Hamid Habib
- Department of Physiology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Khalid A Al-Regaiey
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Nguyen VN, Chavannes NH. Correlation between fractional exhaled nitric oxide and Asthma Control Test score and spirometry parameters in on-treatment-asthmatics in Ho Chi Minh City. J Thorac Dis 2020; 12:2197-2209. [PMID: 32642125 PMCID: PMC7330382 DOI: 10.21037/jtd.2020.04.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Although fractional exhaled nitric oxide (FeNO) is a reliable and easily applied marker of airway inflammation in asthma, the relationship between FeNO and indicators of asthma control [Asthma Control Test (ACT) score] and/or severity (spirometry parameters) remains unclear. This study aims to determine possible correlations between FeNO and ACT score; and between FeNO and spirometry parameters. Methods A cross-sectional study with convenience sampling was conducted among ambulatory patients in the Asthma & COPD clinic at the University Medical Center, Ho Chi Minh City from March 2016 to March 2017. Using measurement of FeNO, the ACT questionnaire and a spirometry test, correlations were determined between FeNO and the ACT score and spirometry parameters. Results Four hundred and ten asthmatic patients (mean age 42 years; 65% female) were included and analyzed; their mean time since onset of asthma was 9.5 years. All patients were treated following step 2 to 4 of GINA guidelines. Mean (SD) FeNO was 29.5 (24.4) parts per billion (ppb) and mean (SD) ACT score was 20.5 (40). A significant difference in FeNO values was found among the three groups with different asthma control levels categorized according to the ACT score (P=0.001) but was not found among the three groups with different asthma treatment levels (P=0.425). FeNO was significantly inversely correlated with the ACT score (Spearman’s r =−0.224, P<0.001) and with spirometry parameters indicate airway obstruction such as predicted FEV1, FEV1/FVC, predicted PEF and predicted FEF25–75% with Spearman’s r were −0.187; −0.143; −0.091 and −0.195, respectively (all P<0.05), whereas no correlation between FeNO and FVC—an indicator of airway restriction—was found. Conclusions In these asthmatic patients in Vietnam, an inverse correlation was found between FeNO and the ACT score and between FeNO and spirometry indicators of airway obstruction. Therefore, FeNO may be a useful tool in asthma management.
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Affiliation(s)
- Vinh Nhu Nguyen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Department of Respiratory Functional Exploration, University Medical Center, Ho Chi Minh City, Vietnam
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Nerpin E, Olivieri M, Gislason T, Olin AC, Nielsen R, Johannessen A, Ferreira DS, Marcon A, Cazzoletti L, Accordini S, Pin I, Corsico A, Demoly P, Weyler J, Nowak D, Jõgi R, Forsberg B, Zock JP, Sigsgaard T, Heinric J, Bono R, Leynaert B, Jarvis D, Janson C, Malinovschi A. Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III. Clin Exp Allergy 2019; 49:969-979. [PMID: 30934155 DOI: 10.1111/cea.13394] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The fractional exhaled nitric oxide (FE NO) is a marker for type 2 inflammation used in diagnostics and management of asthma. In order to use FE NO as a reliable biomarker, it is important to investigate factors that influence FE NO in healthy individuals. Men have higher levels of FE NO than women, but it is unclear whether determinants of FE NO differ by sex. OBJECTIVE To identify determinants of FE NO in men and women without lung diseases. METHOD Fractional exhaled nitric oxide was validly measured in 3881 healthy subjects that had answered the main questionnaire of the European Community Respiratory Health Survey III without airways or lung disease. RESULTS Exhaled NO levels were 21.3% higher in men compared with women P < 0.001. Being in the upper age quartile (60.3-67.6 years), men had 19.2 ppb (95% CI: 18.3, 20.2) higher FE NO than subjects in the lowest age quartile (39.7-48.3 years) P = 0.02. Women in the two highest age quartiles (54.6-60.2 and 60.3-67.6 years) had 15.4 ppb (14.7, 16.2), P = 0.03 and 16.4 ppb (15.6, 17.1), P = <0.001 higher FE NO, compared with the lowest age quartile. Height was related to 8% higher FE NO level in men (P < 0.001) and 5% higher FE NO levels in women (P = 0.008). Men who smoked had 37% lower FE NO levels and women had 30% lower levels compared with never-smokers (P < 0.001 for both). Men and women sensitized to both grass and perennial allergens had higher FE NO levels compared with non-sensitized subjects 26% and 29%, P < 0.001 for both. CONCLUSION AND CLINICAL RELEVANCE Fractional exhaled nitric oxide levels were higher in men than women. Similar effects of current smoking, height, and IgE sensitization were found in both sexes. FE NO started increasing at lower age in women than in men, suggesting that interpretation of FE NO levels in adults aged over 50 years should take into account age and sex.
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Affiliation(s)
- Elisabet Nerpin
- Department of Medical Sciences, Respiratory Medicine, Allergy and Sleep, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden.,Department of Medicine, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Mario Olivieri
- Unit of Occupational Medicine, University of Verona, Verona, Italy
| | - Thorainn Gislason
- Department of Sleep, Landspítali University Hospital, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Anna C Olin
- Section of Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Rune Nielsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Diogenes S Ferreira
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isabelle Pin
- Department of Pediatrics, CHU Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences, Inserm, Grenoble, France.,Université Grenoble Alpes, Grenoble, France
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Pascal Demoly
- Département de Pneumologie et Addictologie, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud-de-Villeneuve, univ Montpellier, Montpellier, France.,Institut Pierre-Louis D'épidémiologie et de Santé Publique, Équipe EPAR, Sorbonne Université, INSERM, Paris, France
| | - Joost Weyler
- Epidemiology and Social Medicine, University of Antwerp StatUA Statistics Center, University of Antwerp, Antwerp, Belgium
| | - Dennis Nowak
- Hospital of the Ludwig-Maximilian University Munich, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Jan P Zock
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Joachim Heinric
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximilians University Munich, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Bénédicte Leynaert
- INSERM, UMR1152, Paris, France.,DHU FIRE, Université Paris-Diderot, Paris, France
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College, London, UK
| | - Christer Janson
- Department of Medical Sciences, Respiratory Medicine, Allergy and Sleep, Uppsala University, Uppsala, Sweden
| | - Anderi Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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12
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Bahadoran Z, Mirmiran P, Jeddi S, Carlström M, Azizi F, Ghasemi A. Circulating markers of nitric oxide homeostasis and cardiometabolic diseases: insights from population-based studies. Free Radic Res 2019; 53:359-376. [PMID: 30821533 DOI: 10.1080/10715762.2019.1587168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Emerging data suggest that impaired nitric oxide (NO) homeostasis has a key role in development of cardiometabolic disorders. The association between circulating levels of NO metabolites, i.e. nitrate and nitrite (NOx), and risk of chronic diseases has not yet been fully clarified. This work aims to address epidemiologic aspects of NO metabolism and discusses different physiologic and pathophysiologic conditions influencing circulating NOx. Further, cross-sectional associations of serum NOx with metabolic disorders are described and along the way, potential short-term and long-term power of serum NOx for predicting cardiometabolic outcomes are reviewed. Results from population-based studies show that circulating NOx is affected by aging, smoking habits, pregnancy, menopause status, thyroid hormones, and various pathologic conditions including type 2 diabetes, insulin resistance, hypertension, and renal dysfunction. Lifestyle factors, especially dietary habits, but also smoking habits and the degree of physical activity influence NO homeostasis and the circulating levels of NOx. Elevated serum NOx, due to increased iNOS activity, is associated with increased incidence of metabolic syndrome, different obesity phenotypes, and cardiovascular events.
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Affiliation(s)
- Zahra Bahadoran
- a Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Parvin Mirmiran
- b Department of Clinical Nutrition and Diet Therapy, Faculty of Nutrition Sciences and Food Technology , National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Sajad Jeddi
- c Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Mattias Carlström
- d Department of Physiology and Pharmacology , Karolinska Institutet , Stockholm , Sweden
| | - Fereidoun Azizi
- e Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Asghar Ghasemi
- c Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
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13
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Coggan AR, Broadstreet SR, Mikhalkova D, Bole I, Leibowitz JL, Kadkhodayan A, Park S, Thomas DP, Thies D, Peterson LR. Dietary nitrate-induced increases in human muscle power: high versus low responders. Physiol Rep 2019; 6. [PMID: 29368802 PMCID: PMC5789728 DOI: 10.14814/phy2.13575] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 01/26/2023] Open
Abstract
Maximal neuromuscular power is an important determinant of athletic performance and also quality of life, independence, and perhaps even mortality in patient populations. We have shown that dietary nitrate (NO3−), a source of nitric oxide (NO), improves muscle power in some, but not all, subjects. The present investigation was designed to identify factors contributing to this interindividual variability. Healthy men (n = 13) and women (n = 7) 22–79 year of age and weighing 52.1–114.9 kg were studied using a randomized, double‐blind, placebo‐controlled, crossover design. Subjects were tested 2 h after ingesting beetroot juice (BRJ) either containing or devoid of 12.3 ± 0.8 mmol of NO3−. Plasma NO3− and nitrite (NO2−) were measured as indicators of NO bioavailability and maximal knee extensor speed (Vmax), power (Pmax), and fatigability were determined via isokinetic dynamometry. On average, dietary NO3− increased (P < 0.05) Pmax by 4.4 ± 8.1%. Individual changes, however, ranged from −9.6 to +26.8%. This interindividual variability was not significantly correlated with age, body mass (inverse of NO3− dose per kg), body mass index (surrogate for body composition) or placebo trial Vmax or fatigue index (in vivo indicators of muscle fiber type distribution). In contrast, the relative increase in Pmax was significantly correlated (r = 0.60; P < 0.01) with the relative increase in plasma NO2− concentration. In multivariable analysis female sex also tended (P = 0.08) to be associated with a greater increase in Pmax. We conclude that the magnitude of the dietary NO3−‐induced increase in muscle power is dependent upon the magnitude of the resulting increase in plasma NO2− and possibly female sex.
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Affiliation(s)
- Andrew R Coggan
- Departments of Kinesiology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana.,Cellular and Integrative Physiology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana.,Departments of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Seth R Broadstreet
- Departments of Kinesiology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana
| | - Deana Mikhalkova
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Indra Bole
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Joshua L Leibowitz
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Ana Kadkhodayan
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Soo Park
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Deepak P Thomas
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Dakkota Thies
- Departments of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Linda R Peterson
- Departments of Radiology, Washington University School of Medicine, St. Louis, Missouri.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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14
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Studying allergic inflammation and spirometry over menstrual cycles in well-controlled asthmatic women: Changes in progesterone and estradiol affect neither FENO levels nor lung function. Nitric Oxide 2018; 75:95-100. [PMID: 29486305 DOI: 10.1016/j.niox.2018.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/17/2018] [Accepted: 02/21/2018] [Indexed: 11/22/2022]
Abstract
It has been reported that female sex hormones influence on allergic inflammation and ventilation parameters in asthma but conclusions drawn by different researchers are divergent. The aim of our study was to assess the impact of progesterone (Pg) and estradiol (E) on the dynamics of allergic inflammation and spirometry test results in regularly menstruating women with stable allergic asthma. 13 women (28 days menstrual cycle), aged 18-45, taking no hormonal contraceptives, with mild and moderate asthma, without reported exacerbations at the near-ovulation and/or menstruation time, were monitored during two consecutive menstrual cycles. They had 4 visits per cycle (the first day of menstruation was assumed to be day 1 of the cycle; visits were carried out on days: 3-4, 10-11, 13-14 and 23-24). At each visit asthma symptoms, asthma control test (ACT) results, asthma treatment, fractioned nitric oxide (FENO) levels, spirometry test results, Pg and E, levels were analyzed. As a result of the study, no essential variability in FENO values and ventilation parameters' values in the course of menstruation cycle were observed. Negative correlation between FENO values and Pg concentrations was demonstrated (r = 0.27), but no correlation between FENO values and E levels was shown. No relationship between the ACT values and ventilation parameters and the levels of the sex hormones under investigation was detected. We conclude that changing levels of estradiol and progesterone (regardless of the negative correlation of progesterone and FENO values) affect neither the dynamics of allergic inflammation nor pulmonary function in women with stable allergic mild/moderate asthma.
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15
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Franconi F, Rosano G, Basili S, Montella A, Campesi I. Human cells involved in atherosclerosis have a sex. Int J Cardiol 2016; 228:983-1001. [PMID: 27915217 DOI: 10.1016/j.ijcard.2016.11.118] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/06/2016] [Indexed: 12/30/2022]
Abstract
The influence of sex has been largely described in cardiovascular diseases. Atherosclerosis is a complex process that involves many cell types such as vessel cells, immune cells and endothelial progenitor cells; however, many, if not all, studies do not report the sex of the cells. This review focuses on sex differences in human cells involved in the atherosclerotic process, emphasizing the role of sex hormones. Furthermore, we report sex differences and issues related to the processes that determine the fate of the cells such as apoptotic and autophagic mechanisms. The analysis of the data reveals that there are still many gaps in our knowledge regarding sex influences in atherosclerosis, largely for the cell types that have not been well studied, stressing the urgent need for a clear definition of experimental conditions and the inclusion of both sexes in preclinical studies.
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Affiliation(s)
- Flavia Franconi
- Assessorato alle Politiche per la Persona of Basilicata Region, Potenza, Italy; Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giuseppe Rosano
- Cardiovascular and Cell Sciences Research Institute, St. George's University of London, United Kingdom
| | - Stefania Basili
- Department of Internal Medicine and Medical Specialties - Research Center on Gender and Evaluation and Promotion of Quality in Medicine (CEQUAM), Sapienza University of Rome, Italy
| | - Andrea Montella
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ilaria Campesi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, Osilo, Italy.
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16
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Sheppard SV, Gibbs RV, Smith DC. Does the use of leucocyte depletion during cardiopulmonary bypass affect exhaled nitric oxide production? Perfusion 2016; 19:7-10. [PMID: 15072249 DOI: 10.1191/0267659104pf703oa] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Fifty patients undergoing elective coronary revascularisation were prospectively randomised to receive either a leucocyte-depleting or a control filter inserted into the arterial line of the cardiopulmonary bypass (CPB) circuit. The concentration of exhaled nitric oxide (NO) was measured 15 min before and 30 min after CPB using a real-time chemiluminescence analyser (Logan Research, Northampton, UK). The baseline rate of exhaled NO production was 2.14±0.83 ppb/s in the control group, and 2.58±0.53 ppb/s in leucocyte-depleted group ( p = 0.17). Following CPB, the mean rate of exhaled NO production in the control group had increased by 1.51±0.45 ppb/s to 3.65±0.81 ppb/s and in the leucocyte-depletion group had increased by 1.05±0.45 ppb/s to 3.64±0.62 ppb/s. The increase in exhaled NO production was significantly lower in the leucocyte depleted group ( p = 0.002), indicating that leucocyte depletion suppressed the increase in exhaled NO production seen following CPB.
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Affiliation(s)
- S V Sheppard
- Cardiothoracic Centre, Southampton University Hospitals Trust, Southampton, Hampshire, UK.
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17
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Al-Shamkhi N, Alving K, Dahlen SE, Hedlin G, Middelveld R, Bjerg A, Ekerljung L, Olin AC, Sommar J, Forsberg B, Janson C, Malinovschi A. Important non-disease-related determinants of exhaled nitric oxide levels in mild asthma - results from the Swedish GA(2) LEN study. Clin Exp Allergy 2016; 46:1185-93. [PMID: 27138350 DOI: 10.1111/cea.12749] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 04/17/2016] [Accepted: 04/23/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FeNO) has a potential clinical role in asthma management. Constitutive factors such as age, height and gender, as well as individual characteristics, such as IgE sensitization and smoking, affect the levels of FeNO in population-based studies. However, their effect on FeNO in subjects with asthma has been scarcely studied. OBJECTIVE To study the effects on FeNO of these commonly regarded determinants, as demonstrated in healthy subjects, as well as menarche age and parental smoking, in a population of asthmatics. MATERIAL AND METHODS Fractional exhaled nitric oxide was measured in 557 subjects with asthma from the Swedish GA(2) LEN study. Allergic sensitization was assessed by skin prick tests to most common aeroallergens. Upper airway comorbidities, smoking habits, smoking exposure during childhood and hormonal status (for women) were questionnaire-assessed. RESULTS Male gender (P < 0.001), greater height (P < 0.001) and sensitization to both perennial allergens and pollen (P < 0.001) are related to higher FeNO levels. Current smoking (P < 0.001) and having both parents smoking during childhood, vs. having neither (P < 0.001) or only one parent smoking (P = 0.002), are related to lower FeNO. Women with menarche between 9 and 11 years of age had lower FeNO than those with menarche between 12 and 14 years of age (P = 0.03) or 15 and 17 years of age (P = 0.003). CONCLUSIONS AND CLINICAL RELEVANCE Interpreting FeNO levels in clinical practice is complex, and constitutional determinants, as well as smoking and IgE sensitisation, are of importance in asthmatic subjects and should be accounted for when interpreting FeNO levels. Furthermore, menarche age and parental smoking during childhood and their effects on lowering FeNO deserve further studies.
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Affiliation(s)
- N Al-Shamkhi
- Department of Medical Sciences: Lung- allergy- and sleep research, Uppsala University, Uppsala, Sweden
| | - K Alving
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - S E Dahlen
- Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - G Hedlin
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - R Middelveld
- Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - A Bjerg
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - L Ekerljung
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - A C Olin
- Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - J Sommar
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umeå, Umeå, Sweden
| | - B Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umeå, Umeå, Sweden
| | - C Janson
- Department of Medical Sciences: Lung- allergy- and sleep research, Uppsala University, Uppsala, Sweden
| | - A Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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18
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Malerba M, Damiani G, Carpagnano GE, Olivini A, Radaeli A, Ragnoli B, Foschino MP, Olivieri M. Values in Elderly People for Exhaled Nitric Oxide Study. Rejuvenation Res 2016; 19:233-8. [PMID: 26414479 DOI: 10.1089/rej.2015.1706] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Ageing population is constantly increasing due to rising life expectancy; consequently, the percentage of the elderly patients with asthma is increasing, as well. Fractional exhaled nitric oxide (FeNO) is a biomarker of lung inflammation, and currently it is widely used in clinical practice for asthma diagnosis and monitoring. Yet, there are no data about normal values of FeNO in patients of more than 65 years of age with normal lung function. The aim of this study was to establish adult FeNO reference values for subjects older than 65 years, according to the international guidelines. FeNO was measured in 303 healthy, nonsmoking adults more than 65 years of age, with normal spirometry values measured using the online single-breath technique. The results were analyzed by chemiluminescent detection. The FeNO levels obtained range from 5.00 to 29.9 ppb, with a mean value of 12.48 ± 2.80 ppb. A significant association of FeNO levels with age (p < 0.05) was observed. There was no difference in FeNO values between men and women unlike what was observed in younger patients. FeNO levels in healthy controls over 65 years of age are influenced by age as in younger adults. However, there is no difference in FeNO values in male and female seniors, in contrast with what was found in younger adults in other studies. These data can be useful for the clinician to interpret the values of FeNO assessed during clinical practice.
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Affiliation(s)
- Mario Malerba
- 1 Department of Internal Medicine, University of Brescia and ASST Spedali Civili , Brescia, Italy
| | - Giovanni Damiani
- 1 Department of Internal Medicine, University of Brescia and ASST Spedali Civili , Brescia, Italy
| | - Giovanna E Carpagnano
- 2 Department of Medical and Surgical Sciences, Institute of Respiratory Disease, University of Foggia , Foggia, Italy
| | - Alessia Olivini
- 1 Department of Internal Medicine, University of Brescia and ASST Spedali Civili , Brescia, Italy
| | | | | | - Maria Pia Foschino
- 2 Department of Medical and Surgical Sciences, Institute of Respiratory Disease, University of Foggia , Foggia, Italy
| | - Mario Olivieri
- 4 Unit of Occupational Medicine, University Hospital of Verona , Verona, Italy
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19
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Low alveolar and bronchial nitric oxide in severe uncomplicated obesity. Obes Res Clin Pract 2015; 9:603-8. [PMID: 25863983 DOI: 10.1016/j.orcp.2015.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 02/18/2015] [Accepted: 03/19/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Fractional concentration of exhaled nitric oxide (FeNO) is a recognized biomarker of the lower respiratory tract, where it is produced by the proximal conducting airways and the expansible peripheral bronchoalveolar compartment. We have previously shown that large increase in body mass decreases FeNO. Here we evaluated bronchial and alveolar components of the NO output of the lower respiratory tract in subjects with severe uncomplicated obesity (OB). METHODS Fifteen OB subjects (BMI 45.3 ± 5.6 kg/m(2)), 15 healthy controls (HC) (BMI 22.4 ± 2.4 kg/m(2)) and 10 obese subjects who experienced weight loss after bariatric surgery (OBS) (BMI 31.2 ± 3.4 kg/m(2)), were examined. Anthropometry and respiratory lung tests were performed. Exhaled NO was assessed using multiple single-breath NO analysis at different constant expiratory flow rates. From the fractional NO concentration measured at each flow-rate, the total NO flux between tissue and gas phase in the bronchial lumen (J'awNO), and the alveolar NO concentration (CANO) were extrapolated. RESULTS Measured FeNO levels at 50 mL/s were lower in OB compared with HC and OBS (11.6 ± 2.8 ppb, 18.0 ± 4.1 ppb and 17.6 ± 2.9 ppb, respectively, p < 0.05). In OB, both J'awNO and CANO resulted significantly lower than OBS and HC values. CONCLUSIONS Respiratory NO output is decreased in severe uncomplicated obesity for the reduction of both large/central airway maximal NO flux and alveolar NO concentration. The pathophysiological relevance of airway NO abnormalities in severe obese phenotype remains to be investigated.
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20
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Fractional Exhaled Nitric Oxide: Indications and Interpretation. DIAGNOSTIC TESTS IN PEDIATRIC PULMONOLOGY 2015. [DOI: 10.1007/978-1-4939-1801-0_14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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21
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Tehrani FR, Behboudi-Gandevani S, Ghasemi A, Azizi F. Menopause status as the main factor explaining the gender differences of serum nitric oxide concentrations in middle-aged population. Arch Gynecol Obstet 2014; 291:159-63. [DOI: 10.1007/s00404-014-3338-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 06/24/2014] [Indexed: 01/24/2023]
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22
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Exhaled nitric oxide is associated with cyclic changes in sexual hormones. Pulm Pharmacol Ther 2013; 26:644-8. [DOI: 10.1016/j.pupt.2013.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/24/2013] [Accepted: 04/25/2013] [Indexed: 11/19/2022]
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23
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Rouatbi S, Alqodwa A, Ben Mdella S, Ben Saad H. Fraction of exhaled nitric oxide (FeNO ) norms in healthy North African children 5-16 years old. Pediatr Pulmonol 2013; 48:981-95. [PMID: 23169683 DOI: 10.1002/ppul.22721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 10/03/2012] [Indexed: 12/18/2022]
Abstract
AIMS (i) To identify factors that influence the FeNO values in healthy North African, Arab children aged 6-16 years; (ii) to test the applicability and reliability of the previously published FeNO norms; and (iii) if needed, to establish FeNO norms in this population, and to prospectively assess its reliability. POPULATION AND METHODS This was a cross-sectional analytical study. A convenience sample of healthy Tunisian children, aged 6-16 years was recruited. First subjects have responded to two questionnaires, and then FeNO levels were measured by an online method with electrochemical analyzer (Medisoft, Sorinnes [Dinant], Belgium). Anthropometric and spirometric data were collected. Simple and a multiple linear regressions were determined. The 95% confidence interval (95% CI) and upper limit of normal (ULN) were defined. RESULTS Two hundred eleven children (107 boys) were retained. Anthropometric data, gender, socioeconomic level, obesity or puberty status, and sports activity were not independent influencing variables. Total sample FeNO data appeared to be influenced only by maximum mid expiratory flow (l sec(-1) ; r(2) = 0.0236, P = 0.0516). For boys, only 1st second forced expiratory volume (l) explains a slight (r(2) = 0.0451) but significant FeNO variability (P = 0.0281). For girls, FeNO was not significantly correlated with any children determined data. For North African/Arab children, FeNO values were significantly lower than in other populations and the available published FeNO norms did not reliably predict FeNO in our population. The mean ± SD (95% CI ULN, minimum-maximum) of FeNO (ppb) for the total sample was 5.0 ± 2.9 (5.4, 1.0-17.0). For North African, Arab children of any age, any FeNO value greater than 17.0 ppb may be considered abnormal. Finally, in an additional group of children prospectively assessed, we found no child with a FeNO higher than 17.0 ppb. CONCLUSION Our FeNO norms enrich the global repository of FeNO norms the pediatrician can use to choose the most appropriate norms based on children's location or ethnicity.
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Affiliation(s)
- Sonia Rouatbi
- Service of Physiology and Functional Explorations, Farhat HACHED Hospital, Sousse, Tunisia; Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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24
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Leon de la Barra S, Smith AD, Cowan JO, Peter Herbison G, Robin Taylor D. Predicted versus absolute values in the application of exhaled nitric oxide measurements. Respir Med 2011; 105:1629-34. [PMID: 21689913 DOI: 10.1016/j.rmed.2011.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 05/28/2011] [Accepted: 06/02/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Constitutional factors such as age, sex and height, and acquired factors such as atopy and smoking, influence exhaled nitric oxide (F(E)NO) levels. The utility of predicted values based on reference equations which account for these factors has not been evaluated. AIM To compare the performance characteristics of absolute versus % predicted values for F(E)NO as predictors of diagnosed asthma and steroid response. METHODS We compared the sensitivities, specificities and likelihood ratios using F(E)NO (% predicted) with absolute values for F(E)NO (ppb) in 52 steroid-naive subjects with non-specific respiratory symptoms. The reference equations of Olin et al. (Chest, 2007) and Dressel et al. (Resp. Med., 2008) were used to derive predicted values. Receiver operating curve analyses were performed and the areas under the curve (AUC) were calculated for two outcomes: diagnosed asthma (yes/no), and steroid response after fluticasone for 4 weeks (defined as ≥ 12% increase in FEV(1); increase in mean morning PEF ≥ 15%; reduction in symptoms ≥ 1 point; increase in PC(20)AMP of ≥ 2 doubling doses). RESULTS The AUCs for diagnosed asthma were: F(E)NO (absolute) 0.770; F(E)NO (% pred.): 0.758 (Olin) and 0.775 (Dressel) (NS). The AUCs for F(E)NO (abs.) and F(E)NO (% pred.) with respect to the four indices of steroid response were likewise not significantly different. CONCLUSION Correcting F(E)NO for combinations of age, sex, height, smoking and atopy using reference equations did not enhance the performance characteristics of F(E)NO as a predictor of either the diagnosis of asthma or steroid responsiveness in patients with chronic airways-related symptoms.
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Affiliation(s)
- Sophia Leon de la Barra
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, New Zealand
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25
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Santmyire BR, Venkat V, Beinder E, Baylis C. Impact of the estrus cycle and reduction in estrogen levels with aromatase inhibition, on renal function and nitric oxide activity in female rats. Steroids 2010; 75:1011-5. [PMID: 20619284 PMCID: PMC2926238 DOI: 10.1016/j.steroids.2010.06.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 06/24/2010] [Accepted: 06/25/2010] [Indexed: 11/20/2022]
Abstract
Estradiol increases mRNA and/or protein expression of the nitric oxide synthase (NOS) isoforms in a variety of tissues including kidney. In this study we determined the relationship between cyclical variations in estradiol levels and renal function and total NO production in the virgin female rat. In addition, we used an aromatase inhibitor (Anastrozole), to inhibit synthesis of estradiol from testosterone. Estradiol levels were higher in proestrus vs. diestrus, and were markedly suppressed by 7 days treatment with aromatase inhibitor. There was no difference in total NO production (from urinary and plasma nitrate+nitrite=NO(X)) between proestrus and diestrus but aromatase inhibition resulted in increases in total NO production. The renal cortical NOS activity and protein abundance also increased in aromatase-inhibited female rats. There were no differences in blood pressure (BP) in any group but the renal vascular resistance (RVR) was low in proestrus, increased in diestrus and did not change further after aromatase inhibition. In summary, the cyclical changes in renal function correlate with estradiol but not NO levels. Pharmacologic castration with aromatase inhibition leads to a marked increase in total and renal NOS. This contrasts to earlier work where surgical castration causes decreased NOS.
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Affiliation(s)
| | - Vasuki Venkat
- Department of Physiology, West Virginia University, Morgantown, WV
| | - Ernst Beinder
- Department of Obstetrics, University Hospital, Zurich, Switzerland
| | - Chris Baylis
- Department of Physiology and Functional Genomics and Department of Medicine, University of Florida, Gainesville, Fl
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Ghasemi A, Syedmoradi L, Momenan AA, Zahediasl S, Azizi F. The influence of cigarette and qalyan (hookah) smoking on serum nitric oxide metabolite concentration. Scandinavian Journal of Clinical and Laboratory Investigation 2010; 70:116-21. [PMID: 20156035 DOI: 10.3109/00365511003611282] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the effect of exposure to cigarette and qalyan (hookah) smoking on serum nitric oxide (NO) metabolites (NO(x)) concentration. MATERIAL AND METHODS Fasting serum NO(x) was measured by the Griess method in 333 men free of diabetes, hypertension and cardiovascular disease selected from participants of the Tehran Lipid and Glucose Study. Subjects were classified into active and passive cigarette smokers and they were age-matched with the non-smoker groups (n = 93/group). Twenty-seven qalyan smokers were also included in the study with their age-matched controls. RESULTS Multivariable-adjustment serum NO(x) values were compared between groups by analysis of covariance. Serum NO(x) was significantly higher (p < 0.05) in the active smokers [28.9 micromol/L (95% CI 26.2-32.0)] compared to nonsmokers [24.1 micromol/L (95% CI 21.8-26.7)]. A positive correlation was found between serum NO(x) and the number of cigarettes smoked per day (r = 0.222, p < 0.05). Qalyan smokers had higher serum NO(x) levels compared to the non-smoker controls [34.3 micromol/L (95% CI 27.8-42.3) vs. 22.5 micromol/L (95% CI 18.4-27.6), p < 0.01]. CONCLUSION Active cigarette and qalyan smoking are associated with high serum NO(x) levels.
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Affiliation(s)
- Asghar Ghasemi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Antosova M, Bencova A, Psenkova A, Herle D, Rozborilova E. Exhaled nitric oxide - circadian variations in healthy subjects. Eur J Med Res 2009; 14 Suppl 4:6-8. [PMID: 20156715 PMCID: PMC3521365 DOI: 10.1186/2047-783x-14-s4-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Exhaled nitric oxide (eNO) has been suggested as a marker of airway inflammatory diseases. The level of eNO is influenced by many various factor including age, sex, menstrual cycle, exercise, food, drugs, etc. The aim of our study was to investigate a potential influence of circadian variation on eNO level in healthy subjects. METHODS Measurements were performed in 44 women and 10 men, non-smokers, without respiratory tract infection in last 2 weeks. The eNO was detected at 4-hour intervals from 6 a.m. to 10 p.m. using an NIOX analyzer. We followed the ATS/ERS guidelines for eNO measurement and analysis. RESULTS Peak of eNO levels were observed at 10 a.m. (11.1 +/- 7.2 ppb), the lowest value was detected at 10 p.m. (10.0 +/- 5.8 ppb). The difference was statistically significant (paired t-test, P<0.001). CONCLUSIONS The daily variations in eNO, with the peak in the morning hours, could be of importance in clinical practice regarding the choice of optimal time for monitoring eNO in patients with respiratory disease.
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Affiliation(s)
- M Antosova
- Institute of Pharmacology, Jessenius Faculty of Medicine, Sklabinska 26, Martin 03601, Slovakia.
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Sandrini A, Taylor DR, Thomas PS, Yates DH. Fractional exhaled nitric oxide in asthma: an update. Respirology 2009; 15:57-70. [PMID: 19761537 DOI: 10.1111/j.1440-1843.2009.01616.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In asthma, clinical symptoms and lung function are insensitive in reflecting the underlying airway inflammation, and monitoring of this process has only recently become available. Fractional exhaled nitric oxide (Fe(NO)) is now recognized as a reliable surrogate marker of eosinophilic airway inflammation and offers the advantage of being completely non-invasive and very easy to obtain. This review summarizes the clinical use of Fe(NO) in asthma. It covers the relationship between Fe(NO) and the underlying eosinophilic inflammation, the pathophysiology and production of Fe(NO), technical aspects of Fe(NO) measurement and potential confounding factors in interpreting levels. Fe(NO) reference values and the role of Fe(NO) in asthma assessment, diagnosis and management are also discussed.
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Affiliation(s)
- Alessandra Sandrini
- Department of Thoracic Medicine, St Vincent's Hospital, Sydney, NSW 2010, Australia
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Dinakar C, Lapuente M, Barnes C, Garg U. Real-Life Environmental Tobacco Exposure Does Not Affect Exhaled Nitric Oxide Levels in Asthmatic Children. J Asthma 2009. [DOI: 10.1081/jas-51317] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mandhane PJ, Hanna SE, Inman MD, Duncan JM, Greene JM, Wang HY, Sears MR. Changes in exhaled nitric oxide related to estrogen and progesterone during the menstrual cycle. Chest 2009; 136:1301-1307. [PMID: 19617403 DOI: 10.1378/chest.09-0604] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Significant changes in asthma and atopy occur throughout the menstrual cycle. We hypothesized that the characteristics of asthma (eg, symptoms, exhaled nitric oxide [eNO] levels as a marker of airway inflammation, pulmonary function, and atopy) vary throughout the menstrual cycle in relation to changes in the levels of estrogen or progesterone and that this variation is attenuated in women using oral contraception (OC). METHODS Seventeen women with asthma were studied over the course of their menstrual cycle through daily measurements of symptoms, eNO, spirometry, 17beta-estradiol, and progesterone levels, and through the performance of alternate-day allergy skin-prick tests (SPTs). RESULTS Of 534 potential daily visits, 526 (98.5%) were completed. Women not using OC (n = 8) had higher mean eNO levels (48.2 parts per billion [ppb]; 95% CI, 43.1 ppb to 53.3 ppb) than women using OC (27.0 ppb; 95% CI, 24.2 ppb to 29.7 ppb; p <or= 0.005). Among women not using OC, a 10 pmol/L increase in 17beta-estradiol levels was associated with a 15.2-ppm decrease in eNO levels (95% CI, -23.4 ppb to -7.0 ppm; p < 0.005). In contrast, an increase in progesterone level of 0.5 nmol/L was significantly associated with a 10.0-ppb increase in eNO (95% CI, 1.2 ppb to 18.7 ppb; p <or= 0.05). Consistent and significant results were found for 17beta-estradiol and progesterone levels and SPT. There were no significant associations between sex hormones and markers of asthma among women using OC. CONCLUSION During natural menstrual cycles, increases in estrogen levels were associated with decreased eNO levels, whereas increases in progesterone levels were associated with increased eNO levels and SPT wheal size. These effects were not observed among women using OC.
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Affiliation(s)
- Piush J Mandhane
- Department of Medicine, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada.
| | - Steven E Hanna
- Department of Clinical Epidemiology and Biostatistics, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Mark D Inman
- Department of Medicine, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Joanne M Duncan
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Medicine, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Justina M Greene
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Medicine, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Hong-Yu Wang
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Medicine, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Malcolm R Sears
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Medicine, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Reddel HK, Taylor DR, Bateman ED, Boulet LP, Boushey HA, Busse WW, Casale TB, Chanez P, Enright PL, Gibson PG, de Jongste JC, Kerstjens HAM, Lazarus SC, Levy ML, O'Byrne PM, Partridge MR, Pavord ID, Sears MR, Sterk PJ, Stoloff SW, Sullivan SD, Szefler SJ, Thomas MD, Wenzel SE. An Official American Thoracic Society/European Respiratory Society Statement: Asthma Control and Exacerbations. Am J Respir Crit Care Med 2009; 180:59-99. [DOI: 10.1164/rccm.200801-060st] [Citation(s) in RCA: 1321] [Impact Index Per Article: 88.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Saraiva-Romanholo BM, Machado FS, Almeida FM, Nunes MDPT, Martins MA, Vieira JE. Non-asthmatic patients show increased exhaled nitric oxide concentrations. Clinics (Sao Paulo) 2009; 64:5-10. [PMID: 19142544 PMCID: PMC2671975 DOI: 10.1590/s1807-59322009000100002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 08/25/2008] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluate whether exhaled nitric oxide may serve as a marker of intraoperative bronchospasm. INTRODUCTION Intraoperative bronchospasm remains a challenging event during anesthesia. Previous studies in asthmatic patients suggest that exhaled nitric oxide may represent a noninvasive measure of airway inflammation. METHODS A total of 146,358 anesthesia information forms, which were received during the period from 1999 to 2004, were reviewed. Bronchospasm was registered on 863 forms. From those, three groups were identified: 9 non-asthmatic patients (Bronchospasm group), 12 asthmatics (Asthma group) and 10 subjects with no previous airway disease or symptoms (Control group). All subjects were submitted to exhaled nitric oxide measurements (parts/billion), spirometry and the induced sputum test. The data was compared by ANOVA followed by the Tukey test and Kruskal-Wallis followed by Dunn's test. RESULTS The normal lung function test results for the Bronchospasm group were different from those of the asthma group (p <0.05). The median percentage of eosinophils in induced sputum was higher for the Asthma [2.46 (0.45-6.83)] compared with either the Bronchospasm [0.55 (0-1.26)] or the Control group [0.0 (0)] (p <0.05); exhaled nitric oxide followed a similar pattern for the Asthma [81.55 (57.6-86.85)], Bronchospasm [46.2 (42.0 -62.6] and Control group [18.7 (16.0-24.7)] (p< 0.05). CONCLUSIONS Non-asthmatic patients with intraoperative bronchospasm detected during anesthesia and endotracheal intubation showed increased expired nitric oxide.
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Ghasemi A, Zahedi Asl S, Mehrabi Y, Saadat N, Azizi F. Serum nitric oxide metabolite levels in a general healthy population: Relation to sex and age. Life Sci 2008; 83:326-31. [DOI: 10.1016/j.lfs.2008.06.010] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 06/08/2008] [Accepted: 06/16/2008] [Indexed: 11/26/2022]
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Taylor DR, Mandhane P, Greene JM, Hancox RJ, Filsell S, McLachlan CR, Williamson AJ, Cowan JO, Smith AD, Sears MR. Factors affecting exhaled nitric oxide measurements: the effect of sex. Respir Res 2007; 8:82. [PMID: 18005450 PMCID: PMC2231356 DOI: 10.1186/1465-9921-8-82] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2007] [Accepted: 11/15/2007] [Indexed: 11/29/2022] Open
Abstract
Background Exhaled nitric oxide (FENO) measurements are used as a surrogate marker for eosinophilic airway inflammation. However, many constitutional and environmental factors affect FENO, making it difficult to devise reference values. Our aim was to evaluate the relative importance of factors affecting FENO in a well characterised adult population. Methods Data were obtained from 895 members of the Dunedin Multidisciplinary Health and Development Study at age 32. The effects of sex, height, weight, lung function indices, smoking, atopy, asthma and rhinitis on FENO were explored by unadjusted and adjusted linear regression analyses. Results The effect of sex on FENO was both statistically and clinically significant, with FENO levels approximately 25% less in females. Overall, current smoking reduced FENO up to 50%, but this effect occurred predominantly in those who smoked on the day of the FENO measurement. Atopy increased FENO by 60%. The sex-related differences in FENO remained significant (p < 0.001) after controlling for all other significant factors affecting FENO. Conclusion Even after adjustment, FENO values are significantly different in males and females. The derivation of reference values and the interpretation of FENO in the clinical setting should be stratified by sex. Other common factors such as current smoking and atopy also require to be taken into account.
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Affiliation(s)
- D Robin Taylor
- Department of Respiratory Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
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Peinado MA, López-Ramos JC, Camacho MV, Molina FJ, Martínez-Romero R, Hernández R, Siles E, Martínez-Lara E, Del Moral ML, Pedrosa JA, Gásso M. Age and sex-related serum changes in nitric oxide: Correlations with serological markers. Int J Cardiol 2007; 121:88-90. [PMID: 17257694 DOI: 10.1016/j.ijcard.2006.08.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 08/03/2006] [Indexed: 11/17/2022]
Abstract
Serum nitric oxide levels, systematically determined in 200 men and women from 18 to 65 year-old, undergo age and sex changes that strongly correlate with serological markers such as those related with cardiovascular functions and lipid profile.
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Maniscalco M, de Laurentiis G, Zedda A, Faraone S, Giardiello C, Cristiano S, Sofia M. Exhaled nitric oxide in severe obesity: Effect of weight loss. Respir Physiol Neurobiol 2007; 156:370-3. [PMID: 17127108 DOI: 10.1016/j.resp.2006.10.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2006] [Revised: 09/10/2006] [Accepted: 10/18/2006] [Indexed: 11/16/2022]
Abstract
Exhaled nitric oxide (NO) is a recognized biomarker in the lower respiratory tract. The effect of large variation in body mass on exhaled NO in the same individuals is not well known. The aim of the study was to evaluate both the effect of severe obesity and the influence of weight reduction on exhaled NO. A consecutive series of 24 uncomplicated obese patients (OB), who had laparoscopic adjustable gastric banding (LAGB) and 15 healthy controls (HC) were studied. Body mass index (BMI), exhaled NO and respiratory function tests were assessed. Exhaled NO was lower in obese in comparison to HC (12.0+/-3.6ppb versus 15.8+/-4.0ppb, p=0.0035). A significant positive correlation was found between exhaled NO and BMI in HC, which was not evident in OB. Among the respiratory indexes, functional residual capacity was significantly associated to exhaled NO. After 1 year, 12 obese patients undergone to LAGB were re-evaluated. Mean BMI (kg/m(2)) decreased from 44.8 before surgery to 32.3 post-operatively. The exhaled NO increased from 11.8+/-3.2ppb before surgery to 14.9+/-3.1ppb 1 year post-operatively (p=0.0023, n=12). In conclusion exhaled NO is consistently reduced in severe obesity and it is restored after weight reduction. The relationship between exhaled NO, large body mass excess and decrease of resting lung volume in severe obesity deserves further studies.
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Affiliation(s)
- Mauro Maniscalco
- Section of Respiratory Medicine, Hospital S. Maria della Pietà Casoria, Naples, Italy.
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Olin AC, Rosengren A, Thelle DS, Lissner L, Bake B, Torén K. Height, age, and atopy are associated with fraction of exhaled nitric oxide in a large adult general population sample. Chest 2006; 130:1319-25. [PMID: 17099006 DOI: 10.1378/chest.130.5.1319] [Citation(s) in RCA: 219] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVES The fraction of exhaled nitric oxide (Feno) is elevated in subjects with asthma and atopy, and it has been proposed to be a noninvasive marker of airway inflammation. In addition to asthma and atopy, there is limited information about the determinants of Feno in a general population. DESIGN Cross-sectional. SETTING A random adult general population sample. PARTICIPANTS A total of 2,200 subjects, 1,111 women and 1,089 men, aged 25 to 75 years. INTERVENTIONS The subjects were examined with regard to Feno, pulmonary function, anthropometric variables, and blood samples for Ig E, and completed a respiratory questionnaire. The associations between different determinants and Feno were analyzed with multiple linear regression models. RESULTS The median value of Feno was 16.0 parts per billion (ppb), ranging from 2.4 to 199 ppb. Height, age, atopy, reporting of asthma symptoms in the last month, and reported use of inhaled steroids were positively associated with Feno. Current smokers had lower values of Feno. Gender was not associated with Feno. CONCLUSIONS In this random adult population sample, height, but not gender, was associated with Feno. Furthermore, asthma symptoms in the last month, reported use of inhaled steroids, and atopy were positively and independently associated with Feno, while there was a negative association with smoking.
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Affiliation(s)
- Anna-Carin Olin
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, SE 405 30 Göteborg, Sweden.
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Olivieri M, Talamini G, Corradi M, Perbellini L, Mutti A, Tantucci C, Malerba M. Reference values for exhaled nitric oxide (reveno) study. Respir Res 2006; 7:94. [PMID: 16813647 PMCID: PMC1534026 DOI: 10.1186/1465-9921-7-94] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Accepted: 06/30/2006] [Indexed: 11/10/2022] Open
Abstract
Background Despite the widespread use of fractional exhaled nitric oxide (FENO) as a biomarker of airways inflammation, there are no published papers describing normal FENO values in a large group of healthy adults. Objective The aim of this study was to establish adult FENO reference values according to the international guidelines. Methods FENO was measured in 204 healthy, non-smoking adults with normal spirometry values using the on-line single-breath technique, and the results were analysed chemiluminescently. Results The main result of the study was the significant difference in FENO values between men and women, thus indicating that gender-based reference FENO values are necessary. The FENO levels obtained at expiratory flows of 50 ml/s ranged from 2.6 to 28.8 ppb in men, and from 1.6 to 21.5 ppb in women. Conclusion We propose reference FENO values for healthy adult men and women that could be used for clinical and research purposes.
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Affiliation(s)
- Mario Olivieri
- Department of Medicine and Public Health, University of Verona, Italy
| | - Giorgio Talamini
- Department of Medicine and Public Health, University of Verona, Italy
| | - Massimo Corradi
- Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Italy
| | - Luigi Perbellini
- Department of Medicine and Public Health, University of Verona, Italy
| | - Antonio Mutti
- Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Italy
| | | | - Mario Malerba
- Department of Internal Medicine, University of Brescia, Italy
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Metzger IF, Souza-Costa DC, Marroni AS, Nagassaki S, Desta Z, Flockhart DA, Tanus-Santos JE. Endothelial nitric oxide synthase gene haplotypes associated with circulating concentrations of nitric oxide products in healthy men. Pharmacogenet Genomics 2006; 15:565-70. [PMID: 16007000 DOI: 10.1097/01.fpc.0000167328.85163.44] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Controversy exists regarding the effects of polymorphisms in the endothelial nitric oxide synthase (eNOS) gene on nitrites/nitrates (NOx) plasma concentrations. In this study we compared the distribution of haplotypes involving three relevant eNOS polymorphisms (T-786C in the promoter region; b/a in intron 4, and Glu298Asp in exon 7) in healthy subjects with low and high circulating NOx levels. METHODS We studied 154 healthy subjects (fasting, white males, who were non-smokers, 18-60 years of age, and not taking any medication). Genomic DNA was isolated from blood samples and genotypes were determined by PCR and restriction fragment length digestion. Circulating NOx was determined by chemiluminescence. RESULTS Haplotype frequencies were compared in two groups of subjects: those with the 30 lowest NOx levels (group L) and those with the 30 highest NOx levels (group H). NOx levels in group L and H were 24.2+/-4.5 microM and 80.9+/-8.9 microM, respectively. Genotype frequencies for the three polymorphisms were not different when the two groups were compared (all P>0.05, chi-squared test). However, the haplotype including the alleles C (promoter), 4b (intron 4), and Glu (exon 7) was significantly more common in group L (16%) than in group H (4%) (P=0.0047). The frequencies of the remaining haplotypes were not different among group L and H. CONCLUSIONS While eNOS genotypes are not significantly associated with changes in the circulating NOx concentrations, the specific eNOS haplotype that includes the 'C', '4b', and 'Glu' alleles is associated with lower circulating NOx concentrations.
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Affiliation(s)
- Ingrid F Metzger
- Department of Pharmacology, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
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Nagassaki S, Metzger IF, Souza-Costa DC, Marroni AS, Uzuelli JA, Tanus-Santos JE. eNOS genotype is without effect on circulating nitrite/nitrate level in healthy male population. Thromb Res 2005; 115:375-9. [PMID: 15733970 DOI: 10.1016/j.thromres.2004.09.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2004] [Revised: 07/21/2004] [Accepted: 09/07/2004] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Nitric oxide (NO) plays an important role in the regulation of the cardiovascular system. It is produced by endothelial nitric oxide synthase (eNOS), which exhibits genetic polymorphisms. Although the clinically relevant polymorphism T(+IhI-786)C reduces eNOS-promoter activity, it is not clear whether circulating nitrite/nitrate (NOx) are affected by this polymorphism. MATERIALS AND METHODS We addressed this issue by studying a homogeneous group of 200 healthy subjects (males, Caucasians, nonsmokers, 18+IBM-56 years of age, and not taking any medication). Genotypes were determined by restriction fragment length polymorphism and circulating NOx were determined by chemiluminescence. RESULTS We found nonsignificant effects of the T(+IhI-786)C polymorphism on circulating NOx (mean+ALE-S.D.=52.2+ALE-21.4, 49.0+ALE-17.8, and 45.9+ALE-16.8 +A7w-mol/L for genotypes +IBw-TT,+IB0 +IBw-TC,+IB0 and +IBw-CC,+IB0 respectively) and on total plasma cholesterol concentrations (both P>.05). No correlation was found between circulating NOx and total plasma cholesterol concentrations (P>.05). CONCLUSIONS Our study provides strong evidence that the T(+IhI-786)C polymorphism does not affect plasma NOx concentrations, which are believed to reflect endogenous production of NO. Therefore, our results suggest that this polymorphism does not affect endogenous NO production.
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Affiliation(s)
- Sabrina Nagassaki
- Department of Pharmacology, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes, 3900, 14049-900 Ribeirao Preto, SP, Brazil
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ATS/ERS Recommendations for Standardized Procedures for the Online and Offline Measurement of Exhaled Lower Respiratory Nitric Oxide and Nasal Nitric Oxide, 2005. Am J Respir Crit Care Med 2005; 171:912-30. [PMID: 15817806 DOI: 10.1164/rccm.200406-710st] [Citation(s) in RCA: 2482] [Impact Index Per Article: 130.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Franklin PJ, Stick SM, Le Souëf PN, Ayres JG, Turner SW. Measuring exhaled nitric oxide levels in adults: the importance of atopy and airway responsiveness. Chest 2005; 126:1540-5. [PMID: 15539724 DOI: 10.1378/chest.126.5.1540] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Raised exhaled nitric oxide (Feno) levels have been associated with asthma. However, we have found that in children, Feno was increased in atopic children with increased airway responsiveness (AR), and this was independent of a diagnosis of asthma. STUDY OBJECTIVES The current study was designed to test the hypothesis that in adults there is no association between Feno and asthma after controlling for atopy and AR. MEASUREMENTS One hundred fifteen adults (77 women; mean age, 41 years) underwent an assessment that included Feno measurements, spirometry, skin-prick testing, blood eosinophil count, and inhaled histamine challenge (results are expressed as a dose-response slope [DRS]). RESULTS When only atopic individuals were considered (n = 73), Feno was positively associated with the DRS (p = 0.003), male gender (0.02), and negatively associated with current smoking (p = 0.09). Only male gender (p = 0.03) was associated with Feno among nonatopic individuals (n = 36). In multivariate analysis, there was no association between Feno and current asthma, current wheeze, or asthma ever. CONCLUSIONS We conclude that in adult subjects, elevated Feno measurements are associated with a phenotype characterized by atopy and increased AR regardless of the presence of asthma or asthma-like symptoms.
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Affiliation(s)
- Peter J Franklin
- School of Medicine, Department of Child Health, Royal Aberdeen Children's Hospital, Foresterhill, Aberdeen, AB, UK
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Pleiner J, Schaller G, Mittermayer F, Zorn S, Marsik C, Polterauer S, Kapiotis S, Wolzt M. Simvastatin prevents vascular hyporeactivity during inflammation. Circulation 2004; 110:3349-54. [PMID: 15520323 DOI: 10.1161/01.cir.0000147774.90396.ed] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is growing evidence that statins exert anti-inflammatory and antioxidative vascular actions that are independent of lipid lowering. We tested whether hyporeactivity to the endothelium-dependent vasodilator acetylcholine (ACh) and the vasoconstrictor norepinephrine (NE) during acute experimental inflammation could be prevented by simvastatin. METHODS AND RESULTS In a randomized, placebo-controlled, parallel group study, forearm blood flow (FBF) responses to NE, ACh, and the endothelium-independent vasodilator nitroglycerin (NTG) were assessed at baseline, after 4 days of simvastatin 80 mg PO or placebo treatment, and during Escherichia coli endotoxin (lipopolysaccharide [LPS])-induced inflammation in 20 healthy volunteers. Additionally, markers of inflammation and neutrophil oxidative burst were assessed. Simvastatin and placebo had no effect on FBF or oxidative/inflammatory markers. LPS administration decreased the responses of FBF to NE by 43% (P<0.05) and decreased responses to ACh by 48% (P<0.05) but did not decrease FBF responses to NTG. Simvastatin completely preserved responses to NE and to ACh. The LPS-induced increases in neutrophil oxidative burst and plasma tumor necrosis factor-alpha concentrations were mitigated by simvastatin (P<0.05 versus placebo). CONCLUSIONS This study demonstrates potent vasoprotective properties of high-dose simvastatin during endotoxemia that may be useful for patients with acute systemic inflammation and associated vascular hyporeactivity.
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Affiliation(s)
- Johannes Pleiner
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Lee TH, Wu MY, Chen MJ, Chao KH, Ho HN, Yang YS. Nitric oxide is associated with poor embryo quality and pregnancy outcome in in vitro fertilization cycles. Fertil Steril 2004; 82:126-31. [PMID: 15237000 DOI: 10.1016/j.fertnstert.2004.02.097] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2003] [Revised: 02/13/2004] [Accepted: 02/13/2004] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the association between follicular and serum nitric oxide (NO) levels and embryo development and outcome in IVF. DESIGN Prospective, case-control study. SETTING University hospital, tertiary medical center. PATIENT(S) Eighteen patients with tubal or peritoneal factor infertility and 18 female partners from couples with male factor infertility underwent controlled ovarian stimulation and IVF/intracytoplasmic sperm injection (ICSI). INTERVENTION(S) Controlled ovarian stimulation and oocyte retrieval followed by IVF/ICSI and embryo culture. MAIN OUTCOME MEASURE(S) Degree of fragmentation of embryos and pregnancy rate. RESULT(S) Higher follicular NO levels were associated with advanced fragmentation of embryos. Follicular soluble Fas could not prevent embryo fragmentation. Higher serum NO levels were found among nonpregnant patients with tubal or peritoneal factor infertility. No elevated serum NO levels were found in the female partners from couples with male factor infertility. CONCLUSION(S) Up-regulation of serum NO is associated with implantation failure in patients with tubal or peritoneal factor infertility.
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Affiliation(s)
- Tsung-Hsien Lee
- Department of Obstetrics and Gynecology, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan
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Esberg LB, Zhang X, Scott GI, Culver B, Ren J. Impact of gender on basal and insulin-like growth factor I-regulated nitric oxide synthase activity in adult rat left ventricular myocytes. Comp Biochem Physiol A Mol Integr Physiol 2004; 138:141-6. [PMID: 15275648 DOI: 10.1016/j.cbpb.2004.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2003] [Revised: 02/20/2004] [Accepted: 02/21/2004] [Indexed: 10/26/2022]
Abstract
Cardiovascular morbidity and mortality are far less in pre-menopausal women compared to age-matched men. Ovarian hormones are believed to be mainly responsible for this "female advantage" in cardiovascular function although the underlying mechanism has not been fully elucidated. A gender difference exists in vascular nitric oxide (NO) synthesis, which may play a key role in ventricular function and cardiac remodeling. This study was designed to compare NO production, basal NO synthase (NOS) expression and activity, as well as insulin-like growth factor I (IGF-1)-induced response on NOS activity in left ventricular myocytes from age-matched adult male and female Sprague-Dawley rats. NO production and protein expression of NOS, IGF-1 receptor (IGF-1R) and IGF binding protein-3 (IGFBP-3) were measured by Griess assay and Western blot analysis, respectively. NOS activity was evaluated by conversion of (3)H-arginine to (3)H-citrulline. Basal NO production, endothelial NOS expression and NOS activity were both significantly higher in female left ventricular myocytes than their male counterparts. However, protein expression of inducible and neuronal NOS as well as IGFBP-3 was comparable between the two genders. IGF-1R expression was less in female than male group. IGF-1 (10(-10)-10(-6) m) induced a concentration-dependent inhibition of NOS activity in male myocytes with a maximal inhibition of 22.2%. However, the IGF-1-induced inhibition in NOS activity was not present in left ventricular myocytes from female rats. These data revealed a gender difference in myocardial basal NO levels, endothelial NOS expression, basal NOS activity and IGF-1-induced inhibition on NOS activity, which may contribute to the gender-related difference of cardiac function.
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Affiliation(s)
- Lucy B Esberg
- Division of Pharmaceutical Sciences and Graduate Neuroscience Program, University of Wyoming College of Health Sciences, P.O. Box 3375, Laramie, WY 82071-3375, USA
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Cope KA, Watson MT, Foster WM, Sehnert SS, Risby TH. Effects of ventilation on the collection of exhaled breath in humans. J Appl Physiol (1985) 2004; 96:1371-9. [PMID: 14672964 DOI: 10.1152/japplphysiol.01034.2003] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A computerized system has been developed to monitor tidal volume, respiration rate, mouth pressure, and carbon dioxide during breath collection. This system was used to investigate variability in the production of breath biomarkers over an 8-h period. Hyperventilation occurred when breath was collected from spontaneously breathing study subjects ( n = 8). Therefore, breath samples were collected from study subjects whose breathing were paced at a respiration rate of 10 breaths/min and whose tidal volumes were gauged according to body mass. In this “paced breathing” group ( n = 16), end-tidal concentrations of isoprene and ethane correlated with end-tidal carbon dioxide levels [Spearman's rank correlation test ( rs) = 0.64, P = 0.008 and rs = 0.50, P = 0.05, respectively]. Ethane also correlated with heart rate ( rs = 0.52, P < 0.05). There was an inverse correlation between transcutaneous pulse oximetry and exhaled carbon monoxide ( rs = -0.64, P = 0.008). Significant differences were identified between men ( n = 8) and women ( n = 8) in the concentrations of carbon monoxide (4 parts per million in men vs. 3 parts per million in women; P = 0.01) and volatile sulfur-containing compounds (134 parts per billion in men vs. 95 parts per billion in women; P = 0.016). There was a peak in ethanol concentration directly after food consumption and a significant decrease in ethanol concentration 2 h later ( P = 0.01; n = 16). Sulfur-containing molecules increased linearly throughout the study period (β = 7.4, P < 0.003). Ventilation patterns strongly influence quantification of volatile analytes in exhaled breath and thus, accordingly, the breathing pattern should be controlled to ensure representative analyses.
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Affiliation(s)
- Keary A Cope
- Department of Environmental Health Sciences, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD 21205, USA
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Frey U, Kuehni C, Roiha H, Cernelc M, Reinmann B, Wildhaber JH, Hall GL. Maternal atopic disease modifies effects of prenatal risk factors on exhaled nitric oxide in infants. Am J Respir Crit Care Med 2004; 170:260-5. [PMID: 15059789 DOI: 10.1164/rccm.200307-1002oc] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In a prospective healthy birth cohort, we determined whether levels of exhaled nitric oxide (eNO) in healthy unselected infants at the age of 1 month were associated with maternal atopic disease and prenatal and early postnatal environmental exposures. Tidal eNO was measured in 98 healthy, unsedated infants (35 from mothers with atopy) (mean age +/- SD, 36.0 +/- 6.2 days) and was compared with histories taken in standardized interviews. eNO was higher in males compared with females (17.7 vs. 14.6 ppb, p = 0.042) and infants exposed to postnatal maternal smoking (+4.4 ppb, p = 0.027), adjusting for weight and tidal breathing parameters. Prenatal tobacco exposure was associated with higher eNO (+12.0 ppb, p = 0.01) in infants of mothers with asthma and lower eNO (-5.7 ppb) in infants of mothers without asthma (p for interaction < 0.0001). Coffee consumption in pregnancy decreased eNO (-6.0 ppb, p = 0.008) only in children of mothers with atopy (p for interaction = 0.015). Paternal atopy had no influence. In the early phase of immunologic development, before the onset of infections and allergic disease, the effect of prenatal or early postnatal environmental factors on eNO was modified by the presence of maternal atopic disease. This underlines the complex interaction of maternal and environmental factors in the development of airway disease.
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Affiliation(s)
- Urs Frey
- Swiss Pediatric Respiratory Research Group, Department of Pediatrics, University Hospital of Zurich, Switzerland.
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Avital A, Uwyyed K, Berkman N, Bar-Yishay E, Godfrey S, Springer C. Exhaled nitric oxide is age-dependent in asthma. Pediatr Pulmonol 2003; 36:433-8. [PMID: 14520727 DOI: 10.1002/ppul.10377] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We determined whether the exhaled nitric oxide (eNO) level in asthmatics is age-dependent. Eighty-seven asthmatic patients aged 2-41 years were studied. Hyperreactivity to adenosine 5'-monophosphate (AMP) was used to confirm asthma (</= 200 mg/ml). In the younger group of children (2-5 years), AMP challenge was performed by the provocation concentration causing wheeze (PCW) method, while in the older groups of patients (6-41 years), regular spirometry was used. Exhaled NO was measured in the younger group by the tidal breathing method (TBm) and in the older subjects by the slow vital capacity method (SVCm). TBm and SVCm were compared in 21 other subjects, and there was a significant correlation between the two values (r = 0.96, P < 0.0001). The equation of correlation between the two methods was eNOTBm = 0.78eNOSVCm - 0.51. Within asthmatic patients, we found a significant increase in eNO with age (P < 0.0001), while there was no significant difference in AMP reactivity (P = 0.35). We conclude that eNO in asthmatic patients is age-dependent, with lower values in young children.
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Affiliation(s)
- Avraham Avital
- Institute of Pulmonology, Hadassah University Hospital and Hadassah-Hebrew University Medical School, Jerusalem, Israel.
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Valenti S, Fazzuoli L, Giusti M. Circulating nitric oxide levels increase after anti-androgen treatment in male-to-female transsexuals. J Endocrinol Invest 2003; 26:522-6. [PMID: 12952365 DOI: 10.1007/bf03345214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Circulating nitric oxide is produced by the vascular endothelium under the influence of the sex steroid milieu and shows gender difference. Since data on hormonal manipulation in males are scant, the present study was designed to evaluate nitric oxide levels before and after anti-androgen treatment in young male-to-female (MF) transsexuals. Fifteen MF transsexuals aged 23.7 +/- 1.3 yr, with normal testicular volume and normal body mass index were studied. Twenty adult males aged 28.2 +/- 2.4 yr served as controls. A low nitrate diet was administered to all subjects throughout the study, starting 15 days before the beginning. Blood samples were drawn from all subjects on day 0; flutamide 750 mg/day was then administered to transsexuals for 30 days, and another sample was taken on day 30. In all subjects the concentration of nitrite plus nitrate (NOx), two stable compounds into which nitric oxide spontaneously decomposes, was determined; also total testosterone (T) and free testosterone (fT), 17(beta)estradiol (E2), SHBG, delta4-androstenedione (A), DHEAS, 17-hydroxy-progesterone (OHP), LH, FSH and PRL were assayed. All hormones determined in controls and transsexuals were comparable at the beginning of the study. NOx was also comparable in controls (11.0 +/- 1.0 microM/l) and transsexuals (11.1 +/- 1.2 microM/l) and did not significantly correlate with any of the hormones assayed. After 30 days of flutamide administration, LH, T, fT, A and E2 increased; DHEAS decreased, while FSH, SHBG and PRL were unchanged; NOx rose significantly (18.7 +/- 1.7 microM/l; p < 0.05), and its percentage increase with respect to pre-treatment levels correlated with that of E2 (R = 0.77; p < 0.01). Healthy males and MF transsexuals do not differ in terms of sex hormones and NOx levels. In neither group is NOx significantly correlated to any sex hormone assayed. Treatment with flutamide in MF transsexuals elicits an increase in androgens, which are not biologically active because of the androgen receptor blockade, and an increase in the estrogenic milieu, which correlates with the increase in NOx.
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Affiliation(s)
- S Valenti
- DiSEM, Chair of Endocrinology, University of Genoa, Genoa, Italy
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