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Exhaled nitric oxide, sensitization, and exposure to allergens in patients with asthma who are not taking inhaled steroids.
Simpson A, Custovic A, Pipis S, Adisesh A, Faragher B, Woodcock A
Am J Respir Crit Care Med. 1999;160( 1):45-9.
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Abstract
The level of exhaled nitric oxide (eNO) is elevated in patients with asthma and eNO may be involved in airway inflammation.Exposure to allergen in sensitized individuals may contribute to airwayinflammation. Our aim was to investigate the relationship between eNO,sensitization, and exposure to indoor allergen in nonsmoking adults withasthma who are not taking inhaled steroids. In subjects with a positivemethacholine challenge (PD20 < 4 mg) we measured eNO (LR 2000chemiluminesence analyzer); serum total and specific IgE; skin test tomite, cat, and dog; and allergen levels in domestic dust (Der p 1, Fel d1, and Can f 1). Subjects were classified as exposed or not exposed toallergen according to previously proposed significant levels (> 2micrograms/g Der p 1, > 8 micrograms/g Fel d 1, and > 10micrograms/g Can f 1). Of the 43 subjects (> 95% atopic) complete datawere available for 38, of whom 26 were both sensitized and exposed to oneor more allergen and 12 were sensitized but not exposed to any allergens.eNO was significantly higher in those subjects who were both sensitizedand exposed to indoor allergen than in those who were sensitized but notexposed (GM and 95% CI: 17. 69 [14.1- 22.15] versus 9.09 [6.5-12.7], p =0.001). Levels of eNO are significantly higher in patients with asthma whoare both sensitized and exposed to relevant allergen than in those whowere sensitized but not exposed. eNO may be a marker of the airwayinflammation induced by domestic exposure to allergen in sensitizedpatients with asthma.
Keyword(s)
Adolescent; Adult; Animals; Breath Tests; Bronchial Provocation Tests; Cats; Dogs; Female; Humans; Intradermal Tests; Male; Middle Aged; blood: Immunoglobulin E; diagnosis: Asthma; diagnosis: Respiratory Hypersensitivity; diagnosis: Sepsis Syndrome; diagnostic use: Allergens; diagnostic use: Methacholine Chloride; physiology: Airway Resistance; physiology: Nitric Oxide