Exhaled nitric oxide correlates with airway eosinophils in childhood asthma

Warke, T. J.; Fitch, P. S.; Brown, V.; Taylor, R.; Lyons, J. D. M.; Ennis, M.; Shields, M. D.
May 2002
Thorax;May2002, Vol. 57 Issue 5, p383
Academic Journal
Background: Exhaled nitric oxide has been proposed as a marker for airway inflammation in asthma. The aim of this study was to compare exhaled nitric oxide levels with inflammatory cells and mediators in bronchoalveolar lavage fluid from asthmatic and normal children. Methods: Children were recruited from elective surgical lists and a non-bronchoscopic bronchoalveolar lavage (BAL) was performed after induction of anaesthesia. Exhaled nitric oxide (parts per billion) was measured by two techniques: tidal breathing and restricted breath. Results: Median (interquartile range) exhaled nitric oxide measured by restricted breath was increased in asthmatics compared with normal children (24.3 (10.5-66.5) v 9.7 (6.5-16.5), difference between medians 14.6 (95% CI 5.1 to 29.9), p=0.001). In asthmatic children exhaled nitric oxide correlated significantly with percentage eosinophils (r=0.78, p&ly;0.001 (tidal breathing) and r=0.78, p<0.001 (restricted breath)) and with eosinophilic cationic protein (r=0.53, p<0.01 (restricted breath)), but not with other inflammatory cells in the BAL fluid. The area under the receiver operator characteristic curves for the prediction of the presence of eosinophilic airways inflammation by exhaled nitric oxide (tidal and restricted) was 0.80 and 0.87, respectively. Conclusions: Exhaled nitric oxide correlates closely with percentage eosinophils in BAL fluid in asthmatic children and is therefore likely to be a useful non-invasive marker of airway inflammation.


Related Articles

  • S�ndromes pulmonares eosinof�licos. Jim�nez, Abraham Emilio Reyes; Guti�rrez, Jorge Gonz�lez; G�mez, Ixchel Landgrave; D'Franchis, Luis Javier Castro; Galv�n, Alma Cristina P�rez; L�pez, Fernando Rogelio Espinosa // Medicina Interna de Mexico;nov/dic2009, Vol. 25 Issue 6, p461 

    Although the eosinophiles are normal lung components, several lung eosinophilic syndromes are characterized by an increased number of eosinophiles in peripheral blood, pulmonary tissue, sputum, or bronchoalveolar lavage. These lung eosinophilic syndromes are generally characterized by...

  • Expression of nitric oxide synthase, aquaporin 1 and aquaporin 5 in rat after bleomycin inhalation. An-Soo Jang; Jong-Un Lee; Inseon-S Choi; Kyung-Ok Park; June Hyuk Lee; Sung-Woo Park; Choon-Sik Park // Intensive Care Medicine;Mar2004, Vol. 30 Issue 3, p489 

    Objective. Nitric oxide (NO) and aquaporins (AQPs) are believed to play an important role in the pathogenesis of pulmonary inflammation and edema. The aim of this study was to investigate the role of NO synthase (NOS) and AQP in acute lung injury (ALI) lung following bleomycin inhalation in...

  • Problematic, severe asthma in children: a new concept and how to manage it. Bush, Andrew // Acta Medica Lituanica;2010, Vol. 17 Issue 1/2, p51 

    Most children with asthma respond to low doses of inhaled corticosteroids, but a few remain symptomatic despite being prescribed the routine usual asthma medications. The first steps are to ensure that the diagnosis is correct and that the inhaled medications are being given regularly with an...

  • ARCHIVIST: Endobronchial biopsy.  // Archives of Disease in Childhood;May2004, Vol. 89 Issue 5, p465 

    The article focuses on endobronchial biopsy and its impact on young children. Endobronchial biopsy appears to be fairly safe in young children, adding little to the risk of bronchoscopy and bronchoalveolar lavage. The London workers envisage it as a research tool for investigating young children...

  • bronchopulmonary lavage.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p322 

    An encyclopedia entry for "bronchopulmonary lavage, " which refers to the bronchoalveolar lavage, is presented.

  • Bronchoalveolar Lavage: Role in the Pathogenesis, Diagnosis, and Management of Interstitial Lung Disease. Daniele, Ronald P.; Elias, Jack A.; Epstein, Paul E.; Rossman, Milton D. // Annals of Internal Medicine;Jan85, Vol. 102 Issue 1, p93 

    Discusses the status of bronchoalveolar lavage as an investigative tool and assesses its advantages and limitations in the clinical setting. Assessment of interstitial lung diseases by lavage; Information on the lavage procedure; Constituents of normal airways.

  • The Calcareous Lung. Krishnakurup, Jayakrishnan; Abdelsayed, George // Mayo Clinic Proceedings;Feb2011, Vol. 86 Issue 2, p85 

    The article presents a case study of an 84-year-old woman who was admitted for aortic valve replacement and was diagnosed for a pulmonary alveolar microlithiasis (PAM) due to the presence of microliths in the bronchoalveolar lavage sample.

  • ROLE OF QUANTITATIVE ENDOTRACHEAL ASPIRATE AND CULTURES AS A SURVEILLANCE AND DIAGNOSTIC TOOL FOR VENTILATOR ASSOCIATED PNEUMONIA: A PILOT STUDY. Nair, Shalini; Sen, Nagamani; Peter, John Victor; Raj, John Prakash; Brahmadathan, K. N. // Indian Journal of Medical Sciences;Aug2008, Vol. 62 Issue 8, p304 

    BACKGROUND: Accurate diagnosis and appropriate treatment of ventilator associated pneumonia (VAP) is crucial for good outcomes. Endotracheal suctioning is performed in ventilated patients as part of routine care and for tracheal toileting. AIM: We evaluated if quantitative endotracheal aspirate...

  • Therapeutic limited bronchoalveolar lavage with fiberoptic bronchoscopy as a bridging procedure prior to total lung lavage in a patient with pulmonary alveolar proteinosis: a case report. Rodrigo, Damith; Rathnapala, Amila; Senaratne, Wijitha // Journal of Medical Case Reports;2015, Vol. 9 Issue 1, p1 

    Introduction: Therapeutic total lung lavage under general anesthesia is the current mainstay of treatment for pulmonary alveolar proteinosis, which is a rare lung disease characterized by alveolar accumulation of surfactant. Therapeutic limited bronchoalveolar lavage is considered an alternative...


Read the Article


Sign out of this library

Other Topics