RESUMEN
BACKGROUND: Asthma is characterised by chronic airway inflammation, a complex cascade of events, mostly sustained by eosinophil recruitment and activation. Fractional exhaled nitric oxide (FeNO) is a surrogate marker of airway inflammation closely associated with bronchial eosinophilia. FeNO is used to define asthma phenotype, to assess eosinophilic inflammatory severity and to predict corticosteroid responsiveness. OBJECTIVE: The aim of this study was to investigate whether FeNO may be associated with some clinical and functional factors in asthmatics evaluated in a real life setting. METHODS: Globally 363 patients (150 males, mean age 46.3 years) with asthma were consecutively evaluated. The following parameters were assessed: history, including comorbidities, physical examination, body mass index (BMI), lung function, asthma control grade, asthma control test (ACT), and FeNO. RESULTS: FeNO values were significantly higher in patients with poorly controlled asthma (p < 0.01), asthma symptoms (p = 0.015), wheezing (p < 0.001), rhinitis diagnosis, (p = 0.049) and rhinitis symptoms (p = 0.019), but lower in patients with GERD (p = 0.024) and pneumonia history (p = 0.048). FeNO values increased in patients with the lowest corticosteroid dose (p = 0.031). FeNO values > 25 ppb were associated with poorly controlled asthma (OR 3.71), asthma signs (OR 3.5) and symptoms (OR 1.79). A FeNO value cut-off of 29.9 ppb was fairly predictive of (AUC 0.7) poorly controlled asthma. CONCLUSIONS: FeNO assessment in clinical practice may be a useful tool for monitoring asthmatics as it is associated with several clinical factors, including asthma control
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Asma/diagnóstico , Asma/patología , Asma/fisiopatología , Óxido Nítrico/metabolismo , Óxido Nítrico/farmacología , Óxido Nítrico/uso terapéutico , Rinitis/diagnóstico , Rinitis/patología , Rinitis/terapia , Biomarcadores/análisis , Biomarcadores/metabolismo , Fenotipo , Eosinofilia/diagnóstico , Eosinofilia/patología , Rinitis Alérgica/patología , Corticoesteroides/administración & dosificación , Corticoesteroides/uso terapéutico , Infecciones del Sistema Respiratorio/patología , Enfermedades Bronquiales/patología , Prueba de Realidad , Encuestas de Atención de la SaludRESUMEN
BACKGROUND: Asthma is characterised by chronic airway inflammation, a complex cascade of events, mostly sustained by eosinophil recruitment and activation. Fractional exhaled nitric oxide (FeNO) is a surrogate marker of airway inflammation closely associated with bronchial eosinophilia. FeNO is used to define asthma phenotype, to assess eosinophilic inflammatory severity and to predict corticosteroid responsiveness. OBJECTIVE: The aim of this study was to investigate whether FeNO may be associated with some clinical and functional factors in asthmatics evaluated in a real life setting. METHODS: Globally 363 patients (150 males, mean age 46.3 years) with asthma were consecutively evaluated. The following parameters were assessed: history, including comorbidities, physical examination, body mass index (BMI), lung function, asthma control grade, asthma control test (ACT), and FeNO. RESULTS: FeNO values were significantly higher in patients with poorly controlled asthma (p<0.01), asthma symptoms (p=0.015), wheezing (p<0.001), rhinitis diagnosis, (p=0.049) and rhinitis symptoms (p=0.019), but lower in patients with GERD (p=0.024) and pneumonia history (p=0.048). FeNO values increased in patients with the lowest corticosteroid dose (p=0.031). FeNO values>25ppb were associated with poorly controlled asthma (OR 3.71), asthma signs (OR 3.5) and symptoms (OR 1.79). A FeNO value cut-off of 29.9ppb was fairly predictive of (AUC 0.7) poorly controlled asthma. CONCLUSIONS: FeNO assessment in clinical practice may be a useful tool for monitoring asthmatics as it is associated with several clinical factors, including asthma control.