Tuberc Respir Dis.  2011 Aug;71(2):106-113. 10.4046/trd.2011.71.2.106.

Relationship between Exhaled Nitric Oxide and Levels of Asthma Control in Asthma Patients Treated with Inhaled Corticosteroid

• Han CH
• Park YI
• Kwak HJ
• Kim SI
• Kim TH
• Sohn JW
• Yoon HJ
• Shin DH
• Park SS
• Kim SH

• KMID: 1846417
• DOI: http://doi.org/10.4046/trd.2011.71.2.106

Abstract

BACKGROUND
While asthma control is defined as the extent to which the various manifestations of asthma are reduced by treatment, current guidelines of asthma recommend assessment of asthma control without consideration of airway inflammation. Our aim was to investigate the relationships between fractional exhaled nitric oxide (FeNO), a reliable marker of airway inflammation, and levels of asthma control in patients treated with inhaled corticosteroids (ICS).
METHODS
We enrolled 71 adult patients with asthma who had been treated with ICS for more than four months. FeNO was measured and spirometry was performed at the time of enrollment. Asthma control was assessed (a) by the physician based on the Global Initiative for Asthma guidelines, (b) by the patients, and (c) by using the Asthma Control Test (ACT). Statistical analyses were done to analyze the relationships between (i) FeNO and (ii) measures of asthma control and clinical indices for asthma manifestations.
RESULTS
There was no significant difference in FeNO levels between the three groups according to levels of asthma control (controlled, partly controlled and uncontrolled) as determined by the physician (p=0.81), or by the patients (p=0.81). In addition, FeNO values were not significantly correlated with the ACT scores (r=0.031, p=0.807), while FeNO showed a correlation with peripheral blood eosinophil counts (p<0.001).
CONCLUSION
These findings demonstrate that FeNO levels are not associated with measures of asthma control in patients treated with ICS. Information on airway inflammation from FeNO concentrations seems to be unrelated to levels of asthma control.

Keyword

Nitric Oxide; Asthma; Corticosteroids

MeSH Terms

Adrenal Cortex Hormones
Adult
Asthma
Eosinophils
Humans
Inflammation
Nitric Oxide
Spirometry
Adrenal Cortex Hormones
Nitric Oxide

Figure

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  Figure 1 FeNO concentrations according to the level of asthma control. (A) Physician-assessed asthma control based on GINA guideline. (B) Self assessment of asthma control by the patients with asthma. FeNO: fractional exhaled nitric oxide; GINA: global initiative for asthma.

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  Figure 2 Correlation between ACT score and FeNO. ACT: asthma control test; FeNO: fractional exhaled nitric oxide.

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  Figure 3 Correlation between FeNO and various markers of asthma manifestations. (A) FeNO and FEV1. (B) FeNO and peripheral blood eosinophil count. FeNO: fractional exhaled nitric oxide; FEV1; forced expiratory volume in one second.

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