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HIGHLIGHTED TOPICS
Airway Hyperresponsiveness: From Molecules to Bedside

SELECTED CONTRIBUTION

Temporal association of nitric oxide levels and airflow in asthma after whole lung allergen challenge

¹Pulmonary and Critical Care Medicine, ²Biostatistics, and ³Cancer Biology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195

Submitted 6 December 2002 ; accepted in final form 4 February 2003

Exhaled nitric oxide (NO) levels are high in asthmatic subjects and increase with exacerbations. We hypothesized that higher levels of NO observed during asthma exacerbations are due to increased synthesis of NO. Exhaled NO and peak flows were measured in 11 asthmatic and 9 healthy control subjects before and after experimental asthmatic response induced by whole lung allergen challenge. Baseline peak flows of asthmatics were significantly lower than controls and decreased significantly immediately after challenge (P = 0.004). NO was measured by collecting exhaled breaths without breath hold (NO₀) and after a 15-s breath hold (NO₁₅). The rate of NO accumulation over time [parts/billion per second (ppb/s)] was calculated by NO/t = (NO₁₅ - NO₀)/15, where denotes a change and t is time. The NO accumulation rates in asthmatic and control subjects were similar at baseline; however, NO accumulation at 24 h increased threefold from baseline in asthmatic compared with control subjects (asthmatic subjects, 0.6 ± 0.2 ppb/s; control subjects, 0.2 ± 0.1 ppb/s; P = 0.01). Our study suggests that increased NO during an asthma exacerbation is due to increased synthesis, perhaps by increased expression of NO synthases.

allergy; peak flows; spirometry; whole lung aerosolized allergen challenge

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