HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Free Full Text (PDF) Free All Versions of this Article: 96/1/65    most recent 00575.2003v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (19) Citing Articles via Google Scholar Google Scholar Articles by Shin, H.-W. Articles by George, S. C. Search for Related Content PubMed PubMed Citation Articles by Shin, H.-W. Articles by George, S. C.

Airway diffusing capacity of nitric oxide and steroid therapy in asthma

Departments of ¹Biomedical Engineering, ²Chemical Engineering and Materials Science, and ⁴Pediatrics, ³General Clinical Research Center, and ⁵Center for Statistical Consulting, University of California, Irvine, California 92697-2575

Submitted 2 June 2003 ; accepted in final form 28 August 2003

Exhaled nitric oxide (NO) concentration is a noninvasive index for monitoring lung inflammation in diseases such as asthma. The plateau concentration at constant flow is highly dependent on the exhalation flow rate and the use of corticosteroids and cannot distinguish airway and alveolar sources. In subjects with steroid-naive asthma (n = 8) or steroid-treated asthma (n = 12) and in healthy controls (n = 24), we measured flow-independent NO exchange parameters that partition exhaled NO into airway and alveolar regions and correlated these with symptoms and lung function. The mean (±SD) maximum airway flux (pl/s) and airway tissue concentration [parts/billion (ppb)] of NO were lower in steroid-treated asthmatic subjects compared with steroid-naive asthmatic subjects (1,195 ± 836 pl/s and 143 ± 66 ppb compared with 2,693 ± 1,687 pl/s and 438 ± 312 ppb, respectively). In contrast, the airway diffusing capacity for NO (pl·s^-1·ppb^-1) was elevated in both asthmatic groups compared with healthy controls, independent of steroid therapy (11.8 ± 11.7, 8.71 ± 5.74, and 3.13 ± 1.57 pl·s^-1·ppb^-1 for steroid treated, steroid naive, and healthy controls, respectively). In addition, the airway diffusing capacity was inversely correlated with both forced expired volume in 1 s and forced vital capacity (%predicted), whereas the airway tissue concentration was positively correlated with forced vital capacity. Consistent with previously reported results from Silkoff et al. (Silkoff PE, Sylvester JT, Zamel N, and Permutt S, Am J Respir Crit Med 161: 1218-1228, 2000) that used an alternate technique, we conclude that the airway diffusing capacity for NO is elevated in asthma independent of steroid therapy and may reflect clinically relevant changes in airways.

model; airways; alveoli; inflammation

This article has been cited by other articles:

				V. Suresh, D. A. Shelley, H.-W. Shin, and S. C. George Effect of heterogeneous ventilation and nitric oxide production on exhaled nitric oxide profiles J Appl Physiol, June 1, 2008; 104(6): 1743 - 1752. [Abstract] [Full Text] [PDF]

				H. Lehtonen, P. Oksa, L. Lehtimaki, A. Sepponen, R. Nieminen, H. Kankaanranta, S. Saarelainen, R. Jarvenpaa, J. Uitti, and E. Moilanen Increased alveolar nitric oxide concentration and high levels of leukotriene B4 and 8-isoprostane in exhaled breath condensate in patients with asbestosis Thorax, July 1, 2007; 62(7): 602 - 607. [Abstract] [Full Text] [PDF]

				C. Brindicci, K. Ito, P. J. Barnes, and S. A. Kharitonov Differential Flow Analysis of Exhaled Nitric Oxide in Patients With Asthma of Differing Severity Chest, May 1, 2007; 131(5): 1353 - 1362. [Abstract] [Full Text] [PDF]

				K. Roy, Z. L. Borrill, C. Starkey, A. L. Hazel, J. Morris, J. Vestbo, and D. Singh Use of different exhaled nitric oxide multiple flow rate models in COPD Eur. Respir. J., April 1, 2007; 29(4): 651 - 659. [Abstract] [Full Text] [PDF]

				H.-W. Shin, D. A. Shelley, E. M. Henderson, A. Fitzpatrick, B. Gaston, and S. C. George Airway nitric oxide release is reduced after PBS inhalation in asthma J Appl Physiol, March 1, 2007; 102(3): 1028 - 1033. [Abstract] [Full Text] [PDF]

				P. Condorelli, H.-W. Shin, A. S. Aledia, P. E. Silkoff, and S. C. George A simple technique to characterize proximal and peripheral nitric oxide exchange using constant flow exhalations and an axial diffusion model J Appl Physiol, January 1, 2007; 102(1): 417 - 425. [Abstract] [Full Text] [PDF]

				H.-W. Shin, C. D. Schwindt, A. S. Aledia, C. M. Rose-Gottron, J. K. Larson, R. L. Newcomb, D. M. Cooper, and S. C. George Exercise-induced bronchoconstriction alters airway nitric oxide exchange in a pattern distinct from spirometry Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2006; 291(6): R1741 - R1748. [Abstract] [Full Text] [PDF]

				D R Taylor, M W Pijnenburg, A D Smith, and J C D Jongste Exhaled nitric oxide measurements: clinical application and interpretation Thorax, September 1, 2006; 61(9): 817 - 827. [Abstract] [Full Text] [PDF]

				E. Paraskakis, C. Brindicci, L. Fleming, R. Krol, S. A. Kharitonov, N. M. Wilson, P. J. Barnes, and A. Bush Measurement of Bronchial and Alveolar Nitric Oxide Production in Normal Children and Children with Asthma Am. J. Respir. Crit. Care Med., August 1, 2006; 174(3): 260 - 267. [Abstract] [Full Text] [PDF]

				H.-W. Shin, P. Condorelli, and S. C. George Examining axial diffusion of nitric oxide in the lungs using heliox and breath hold J Appl Physiol, February 1, 2006; 100(2): 623 - 630. [Abstract] [Full Text] [PDF]

				ATS Workshop Proceedings: Exhaled Nitric Oxide and Nitric Oxide Oxidative Metabolism in Exhaled Breath Condensate. Proceedings of the ATS, January 1, 2006; 3(2): 131 - 145. [Full Text] [PDF]

				C. Brindicci, K. Ito, O. Resta, N. B. Pride, P. J. Barnes, and S. A. Kharitonov Exhaled nitric oxide from lung periphery is increased in COPD Eur. Respir. J., July 1, 2005; 26(1): 52 - 59. [Abstract] [Full Text] [PDF]

				H.-W. Shin, P. Condorelli, and S. C. George A new and more accurate technique to characterize airway nitric oxide using different breath-hold times J Appl Physiol, May 1, 2005; 98(5): 1869 - 1877. [Abstract] [Full Text] [PDF]

				ATS/ERS Recommendations for Standardized Procedures for the Online and Offline Measurement of Exhaled Lower Respiratory Nitric Oxide and Nasal Nitric Oxide, 2005 Am. J. Respir. Crit. Care Med., April 15, 2005; 171(8): 912 - 930. [Full Text] [PDF]

				A. F. Gelb, C. F. Taylor, E. Nussbaum, C. Gutierrez, A. Schein, C. M. Shinar, M. J. Schein, J. D. Epstein, and N. Zamel Alveolar and Airway Sites of Nitric Oxide Inflammation in Treated Asthma Am. J. Respir. Crit. Care Med., October 1, 2004; 170(7): 737 - 741. [Abstract] [Full Text] [PDF]

				H.-W. Shin, P. Condorelli, C. M. Rose-Gottron, D. M. Cooper, and S. C. George Probing the impact of axial diffusion on nitric oxide exchange dynamics with heliox J Appl Physiol, September 1, 2004; 97(3): 874 - 882. [Abstract] [Full Text] [PDF]

				P. Condorelli, H.-W. Shin, and S. C. George Characterizing airway and alveolar nitric oxide exchange during tidal breathing using a three-compartment model J Appl Physiol, May 1, 2004; 96(5): 1832 - 1842. [Abstract] [Full Text] [PDF]

				S. C. George, M. Hogman, S. Permutt, and P. E. Silkoff Modeling pulmonary nitric oxide exchange J Appl Physiol, March 1, 2004; 96(3): 831 - 839. [Abstract] [Full Text] [PDF]