Clinical utility of ultrahigh fractional exhaled nitric oxide in predicting bronchial hyperresponsiveness in patients with suspected asthma release_mzk767ma5fbrzf65f7qaasmbz4 [as of editgroup_dpiuydbf4ngcvdr3hareuad3mi]

by Jiaxing Liu, Rong Xu, Chen Zhan, Wei Luo, Kefang Lai, Nanshan Zhong, Wei Chen, Ruchong Chen


<jats:sec><jats:title>Background</jats:title>Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker for airway eosinophilic inflammation. However, the clinical value of ultrahigh FeNO (≥100 parts per billion (ppb)) in predicting asthma is never explored. We aimed to investigate the value of ultrahigh FeNO as a predictor of bronchial hyperresponsiveness (BHR), an important index for asthma diagnosis.</jats:sec><jats:sec><jats:title>Methods</jats:title>A retrospective cohort study was conducted on 259 patients with suspected asthma who received the examination of FeNO, spirometry, bronchial provocation test (BPT) and differential cell count of induced sputum. Patients were stratified by FeNO value: ultrahigh (group A:≥100 ppb), high (group B: 50–99 ppb), intermediate (group C: 26–49 ppb) and normal (group D:≤25 ppb). The positive rates of BPT and sputum eosinophils percentage (Eos%) were compared among four cohorts. The correlations between FeNO and sputum Eos% were measured.</jats:sec><jats:sec><jats:title>Results</jats:title>A significant higher positive rate of BPT was observed in group A (90.91%) than all others (B: 51.43%, C: 31.43%, D: 28.13%, all p&lt;0.01). Referring to group D, the ORs of positive BPT in groups A, B and C were 26.84, 2.84 and 1.05. Sputum Eos% in group A (19.75 (7.00, 46.25)) is higher than that in others (B: 3.50 (1.00, 12.75), C: 1.13 (0.06,3.50), D: 0.50 (0.00, 2.13)). FeNO correlates with sputum Eos% in groups A and B, but not group C or D.</jats:sec><jats:sec><jats:title>Conclusions</jats:title>Ultrahigh FeNO correlates with BHR and could serve as a practical alternative to methacholine challenge to support an asthma diagnosis in patients with suspected asthma in primary care.</jats:sec>
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Published in Postgraduate medical journal by BMJ
ISSN-L 0032-5473
Page(s) postgradmedj-2018-136333
Release Date 2019-07-11
Publisher BMJ
Primary Language en (lookup)
Type  article-journal
Stage   published
Date   2019-07-11
Container Metadata
Unknown OA Status
Not in DOAJ
ISSN-L:  0032-5473
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