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1 Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA; Department of Chemical Engineering and Materials Science, University of California, Irvine, Irvine, CA, USA
2 General Clinical Research Center, University of California, Irvine, Irvine, CA, USA
3 Department of Pediatrics, University of California, Irvine, Irvine, CA, USA; General Clinical Research Center, University of California, Irvine, Irvine, CA, USA
4 General Clinical Research Center, University of California, Irvine, Irvine, CA, USA; Center for Statistical Consulting, University of California, Irvine, Irvine, CA, USA
* To whom correspondence should be addressed. E-mail: scgeorge{at}uci.edu.
Exhaled nitric oxide (NO) concentration is a non-invasive 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) , steroid-treated asthma (n=12), and healthy controls (n=24), we measured flowindependent 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-1) and airway tissue concentration (ppb) of NO were lower in steroid-treated asthmatics compared with steroid-naive asthmatics (1195 (836) and 143 (66) compared to 2693 (1687) and 438 (312), respectively). In contrast, the airway diffusing capacity for NO (pl.s-1.ppb-1) was elevated in both asthmatic groups compared to healthy controls independent of steroid therapy (11.8 (11.7), 8.71 (5.74) and 3.13 (1.57) for steroid-treated and steroid-naive, and healthy controls, respectively). In addition, the airway diffusing capacity was inversely correlated with both FEV1 and FVC (% predicted), while the airway tissue concentration was positively correlated with FVC. Consistent with previously reported results from Silkoff et. al. (Am. J. Resp. Crit. Med., 161:1218, 2000) using 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.
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