TY - JOUR
TI - Exhaled NO and exhaled breath condensate pH in the evaluation of asthma
control
AU - Kostikas, Konstantinos
AU - Papaioannou, Andriana I.
AU - Tanou, Kalliopi
AU - and Giouleka, Paschalina
AU - Koutsokera, Angela
AU - Minas, Markos and
AU - Papiris, Spyros
AU - Gourgoulianis, Konstantinos I.
AU - Taylor, D. Robin
AU - and Loukides, Stelios
JO - Advances in Respiratory Medicine
PY - 2011
VL - 105
TODO - 4
SP - 526-532
PB - W B SAUNDERS CO LTD
SN - null
TODO - 10.1016/j.rmed.2010.10.015
TODO - Asthma control; Exhaled NO; Exhaled breath condensate pH; Inhaled
corticosteroids; Smoking
TODO - Background: Asthma is a chronic inflammatory airways disorder. However,
no biomarker of airways inflammation has been included in the assessment
of asthma control.
Objective: To evaluate exhaled NO (FeNO) and exhaled breath condensate
(EBC) pH in patients with asthma according to the level of control, and
their performance in the identification of not well-controlled patients.
Methods: FeNO and EBC pH after Argon deaeration were measured in 274
consecutive patients. Asthma control was evaluated by two asthma
specialists blinded to FeNO and pH measurements according to GINA
guidelines, as well as by asthma control test (ACT) and asthma control
questionnaire (ACQ).
Results: FeNO was higher and EBC pH was lower in patients with not
well-controlled compared to controlled asthma. In ROC analysis, FeNO
presented an AUC of 0.790 for the identification of not well-controlled
asthma performing better in non-smokers; EBC pH presented an AUC of
0.791 for the identification of not well-controlled asthma, performing
better in smokers. The performance of both biomarkers was inferior to
that of ACT and ACQ. FeNO values > 30 ppb presented positive predictive
values (PPV) > 0.85 with the exception of smokers treated with inhaled
corticosteroids. EBC pH values <= 7.20 presented PPV > 0.80 in all
groups. The presence of FeNO > 30 ppb and/or EBC pH <= 7.20 was
indicative of not well-uncontrolled asthma in 88.3% of the patients.
Conclusion: FeNO and EBC pH levels may identify patients with not
well-controlled asthma. However, their performance was inferior to
clinical judgment and may be limited to selected subgroups of asthmatic
patients. (c) 2010 Elsevier Ltd. All rights reserved.
ER -