Περίληψη:
Background: Distinct inflammatory cellular phenotypes of severe
refractory asthma (SRA) have been reported. Fractional exhaled nitric
oxide (FENO) primarily is related to eosinophilic inflammation. Exhaled
breath condensate (EBC) pH has been suggested as a noninvasive tool in
the assessment of patients with asthma. We sought to determine whether
FENO and EBC pH could identify the presence and type of the underlying
cellular inflammation in patients with SRA.
Methods: Twenty-nine patients with SRA, 27 patients with moderate
asthma, and 17 healthy subjects underwent FENO measurement, EBC
collection for pH measurement, and sputum induction for cell count
identification.
Results: FENO was significantly higher and pH significantly lower in
patients with SRA than in the other groups. In SRA, FENO levels of >19
parts per billion were associated with a sensitivity of 0.78 and a
specificity of 0.73 for sputum eosinophilia, whereas FEND levels of <19
parts per billion were associated with a sensitivity of 0.63 and a
specificity of 0.9 for sputum neutrophilia irrespective of the presence
of eosinophils. The pH failed to predict the cellular profile in SRA,
but a cutoff value of <7.37 could predict sputum eosinophilia in
moderate asthma.
Conclusions: In patients with SRA, different FENO threshold values can
identify those with predominant eosinophilia as well as those with
neutrophilia. FENO levels were reduced in patients with predominant
neutrophilia regardless of the concomitant presence of eosinophilia.
Although pH could not identify the cellular profile in SRA, it seemed to
be a better index for predicting eosinophilia in moderate asthma. CHEST
2010; 138(1):107-113
Συγγραφείς:
Tseliou, Eleni
Bessa, Vasiliki
Hillas, Georgios
Delimpoura,
Vasiliki
Papadaki, Georgia
Roussos, Charis
Papiris, Spyros
and Bakakos, Petros
Loukides, Stelios
