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IgE sensitisation in relation to flow-independent nitric oxide exchange parameters
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology, Integrative Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology, Integrative Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
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2006 (English)In: Respiratory research (Online), ISSN 1465-993X, Vol. 7, 92- p.Article in journal (Refereed) Published
Abstract [en]

Background: A positive association between IgE sensitisation and exhaled NO levels has been found in several studies, but there are no reports on the compartment of the lung that is responsible for the increase in exhaled NO levels seen in IgE-sensitised subjects.

Methods: The present study comprised 288 adult subjects from the European Community Respiratory Health Survey II who were investigated in terms of lung function, IgE sensitisation ( sum of specific IgE), smoking history and presence of rhinitis and asthma. Mean airway tissue concentration of NO (Caw(NO)), airway transfer factor for NO (Daw(NO)), mean alveolar concentration of NO (Calv(NO)) and fractional exhaled concentration of NO at a flow rate of 50 mL s(-1) ( FENO0.05) were determined using the extended NO analysis.

Results: IgE-sensitised subjects had higher levels ( geometric mean) of FENO 0.05 (24.9 vs. 17.3 ppb) ( p < 0.001), Daw(NO) ( 10.5 vs. 8 mL s(-1)) ( p = 0.02) and Caw(NO) (124 vs. 107 ppb) ( p < 0.001) and positive correlations were found between the sum of specific IgE and FENO 0.05, Caw(NO) and Daw(NO) levels ( p < 0.001 for all correlations). Sensitisation to cat allergen was the major determinant of exhaled NO when adjusting for type of sensitisation. Rhinitis and asthma were not associated with the increase in exhaled NO variables after adjusting for the degree of IgE sensitisation.

Conclusion: The presence of IgE sensitisation and the degree of allergic sensitisation were related to the increase in airway NO transfer factor and the increase in NO concentration in the airway wall. Sensitisation to cat allergen was related to the highest increases in exhaled NO parameters. Our data suggest that exhaled NO is more a specific marker of allergic inflammation than a marker of asthma or rhinitis.

Place, publisher, year, edition, pages
2006. Vol. 7, 92- p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97884DOI: 10.1186/1465-9921-7-92ISI: 000240146300001PubMedID: 16787532OAI: oai:DiVA.org:uu-97884DiVA: diva2:172983
Available from: 2008-11-27 Created: 2008-11-27 Last updated: 2012-11-20Bibliographically approved
In thesis
1. Nitric Oxide Exchange in Central and Peripheral Airways: Determinants in Health and Respiratory Disease
Open this publication in new window or tab >>Nitric Oxide Exchange in Central and Peripheral Airways: Determinants in Health and Respiratory Disease
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Exhaled nitric oxide (NO) is a marker of eosinophilic steroid-sensitive inflammation in the airways of patients with respiratory disease. Moreover, information about the localization of inflammation in the respiratory tree is obtained by estimates of bronchial and alveolar contributions to exhaled NO.

Aims: The main aim of this thesis was to identify the determinants of exhaled NO, as well as determinants of bronchial and alveolar contributions to exhaled NO in health and disease. Smoking history, degree of IgE sensitization and effects of modulating the pharyngo-oral tract production of NO were specifically studied in this context. Other specific aims were to determine the association of exhaled NO with the presence of asthma and pulmonary hypertension (PH).

Methods: Both population-based studies and experimental studies have been performed within the frame of the thesis. The population-based studies are based on data from the European Community Respiratory Health Survey II. NO measurements at several exhalation flow rates were performed in order to estimate alveolar and bronchial contributions to exhaled NO.

Results: Both current and previous smoking were associated with decreased exhaled NO and bronchial NO flux levels. Alveolar NO concentrations were decreased in current smokers. The degree of IgE sensitization was positively related to the levels of exhaled NO and its bronchial contribution. Exhaled NO appeared to be a more specific marker of allergic inflammation than of rhinitis or asthma. Both allergic and non-allergic asthma were associated with increased exhaled NO levels, but only in never-smoking persons. The estimated alveolar NO increased after ingestion of nitrate in individuals with high nitrate turnover in the pharyngo-oral tract. Pulmonary arterial hypertension, but not other forms of PH, was associated with decreased bronchial NO flux, whereas PH of all etiologies was related to increased alveolar NO concentrations.

Conclusion: Smoking history and IgE sensitization, that are known determinants of exhaled NO, affected the bronchial and alveolar contributions to exhaled NO differently. The limitations of the simple NO pulmonary exchange models were highlighted by the paradoxical effects on estimated alveolar NO when modulating the NO production proximally, in the pharyngo-oral tract. Predominance of non-eosinophilic inflammation in ever-smoking patients with asthma could explain the poor association between the presence of asthma and exhaled NO in these patients. Different pathophysiological changes in terms of bronchial NO production and exchange were related to the etiology of pulmonary hypertension.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 64 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 403
Keyword
exhaled nitric oxide, alveolar NO, bronchial NO flux, extended NO analysis, asthma, smoking, snus, IgE-sensitization, pharyngo-oral tract, nitrate, nitrite, pulmonary hypertension
Identifiers
urn:nbn:se:uu:diva-9416 (URN)978-91-554-7363-1 (ISBN)
Public defence
2008-12-19, Robergsalen, Akademiska Sjukhuset, Ingång 40, 4 tr., Uppsala, 09:15
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Available from: 2008-11-27 Created: 2008-11-27Bibliographically approved

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Janson, ChristerHögman, Marieann

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