Bronchial Responsiveness is Related to Increased Exhaled NO (FE(NO)) in Non-smokers and Decreased FE(NO) in Smokers

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2012 May 8

PMID 22563393

Citations 1

Authors

Andrei Malinovschi

Christer Janson

Marieann Hogman

Giovanni Rolla

Kjell Toren

Dan Norback

Anna-Carin Olin

Affiliations

Soon will be listed here.

Abstract

Rationale: Both atopy and smoking are known to be associated with increased bronchial responsiveness. Fraction of nitric oxide (NO) in the exhaled air (FE(NO)), a marker of airways inflammation, is decreased by smoking and increased by atopy. NO has also a physiological bronchodilating and bronchoprotective role.

Objectives: To investigate how the relation between FE(NO) and bronchial responsiveness is modulated by atopy and smoking habits.

Methods: Exhaled NO measurements and methacholine challenge were performed in 468 subjects from the random sample of three European Community Respiratory Health Survey II centers: Turin (Italy), Gothenburg and Uppsala (both Sweden). Atopy status was defined by using specific IgE measurements while smoking status was questionnaire-assessed.

Main Results: Increased bronchial responsiveness was associated with increased FE(NO) levels in non-smokers (p = 0.02) and decreased FE(NO) levels in current smokers (p = 0.03). The negative association between bronchial responsiveness and FE(NO) was seen only in the group smoking less <10 cigarettes/day (p = 0.008). Increased bronchial responsiveness was associated with increased FE(NO) in atopic subjects (p = 0.04) while no significant association was found in non-atopic participants. The reported interaction between FE(NO) and smoking and atopy, respectively were maintained after adjusting for possible confounders (p-values<0.05).

Conclusions: The present study highlights the interactions of the relationship between FE(NO) and bronchial responsiveness with smoking and atopy, suggesting different mechanisms behind atopy- and smoking-related increases of bronchial responsiveness.

Citing Articles

[Effects of type 2 inflammation on bronchodilator responsiveness of large and small airways in chronic obstructive pulmonary disease].

Xu G, Gong Z, Wang J, Ma Y, Xu M, Chen M Nan Fang Yi Ke Da Xue Xue Bao. 2024; 44(1):93-99.

PMID: 38293980 PMC: 10878905. DOI: 10.12122/j.issn.1673-4254.2024.01.11.

References

Laprise C, Laviolette M, Boutet M, Boulet L . Asymptomatic airway hyperresponsiveness: relationships with airway inflammation and remodelling. Eur Respir J. 1999; 14(1):63-73. DOI: 10.1034/j.1399-3003.1999.14a12.x. View

Emms J, Rogers D . Cigarette smoke-inhibition of neurogenic bronchoconstriction in guinea-pigs in vivo: involvement of exogenous and endogenous nitric oxide. Br J Pharmacol. 1998; 122(4):779-85. PMC: 1564994. DOI: 10.1038/sj.bjp.0701440. View

Hessel E, Cruikshank W, Van Ark I, De Bie J, Van Esch B, Hofman G . Involvement of IL-16 in the induction of airway hyper-responsiveness and up-regulation of IgE in a murine model of allergic asthma. J Immunol. 1998; 160(6):2998-3005. View

Chinn S, Burney P, Jarvis D, Luczynska C . Variation in bronchial responsiveness in the European Community Respiratory Health Survey (ECRHS). Eur Respir J. 1998; 10(11):2495-501. DOI: 10.1183/09031936.97.10112495. View

Malinovschi A, Janson C, Hogman M, Rolla G, Toren K, Norback D . Both allergic and nonallergic asthma are associated with increased FE(NO) levels, but only in never-smokers. Allergy. 2008; 64(1):55-61. DOI: 10.1111/j.1398-9995.2008.01835.x. View

Verbanck S, Schuermans D, Meysman M, Paiva M, Vincken W . Noninvasive assessment of airway alterations in smokers: the small airways revisited. Am J Respir Crit Care Med. 2004; 170(4):414-9. DOI: 10.1164/rccm.200401-037OC. View

Smith A, Cowan J, Brassett K, Herbison G, Taylor D . Use of exhaled nitric oxide measurements to guide treatment in chronic asthma. N Engl J Med. 2005; 352(21):2163-73. DOI: 10.1056/NEJMoa043596. View

Smith A, Cowan J, Filsell S, McLachlan C, Monti-Sheehan G, Jackson P . Diagnosing asthma: comparisons between exhaled nitric oxide measurements and conventional tests. Am J Respir Crit Care Med. 2003; 169(4):473-8. DOI: 10.1164/rccm.200310-1376OC. View

Deykin A, Massaro A, Drazen J, Israel E . Exhaled nitric oxide as a diagnostic test for asthma: online versus offline techniques and effect of flow rate. Am J Respir Crit Care Med. 2002; 165(12):1597-601. DOI: 10.1164/rccm.2201081. View

10.

Hoyt J, Robbins R, Habib M, Springall D, Buttery L, Polak J . Cigarette smoke decreases inducible nitric oxide synthase in lung epithelial cells. Exp Lung Res. 2003; 29(1):17-28. DOI: 10.1080/01902140303759. View

11.

Silvestri M, Spallarossa D, Frangova Yourukova V, Battistini E, Fregonese B, Rossi G . Orally exhaled nitric oxide levels are related to the degree of blood eosinophilia in atopic children with mild-intermittent asthma. Eur Respir J. 1999; 13(2):321-6. DOI: 10.1034/j.1399-3003.1999.13b17.x. View

12.

Wang H, Oei J, Lui K, Henry R . Interleukin-16 in tracheal aspirate fluids of newborn infants. Early Hum Dev. 2002; 67(1-2):79-86. DOI: 10.1016/s0378-3782(01)00257-2. View

13.

Chinn S, Jarvis D, Luczynska C, Ackermann-Liebrich U, Anto J, Cerveri I . An increase in bronchial responsiveness is associated with continuing or restarting smoking. Am J Respir Crit Care Med. 2005; 172(8):956-61. DOI: 10.1164/rccm.200503-323OC. View

14.

Rytila P, Rehn T, Ilumets H, Rouhos A, Sovijarvi A, Myllarniemi M . Increased oxidative stress in asymptomatic current chronic smokers and GOLD stage 0 COPD. Respir Res. 2006; 7:69. PMC: 1524947. DOI: 10.1186/1465-9921-7-69. View

15.

Taylor D, McGrath J, ORR L, Barnes P, OConnor B . Effect of endogenous nitric oxide inhibition on airway responsiveness to histamine and adenosine-5'-monophosphate in asthma. Thorax. 1998; 53(6):483-9. PMC: 1745235. DOI: 10.1136/thx.53.6.483. View

16.

Kharitonov S, Yates D, Robbins R, Shinebourne E, Barnes P . Increased nitric oxide in exhaled air of asthmatic patients. Lancet. 1994; 343(8890):133-5. DOI: 10.1016/s0140-6736(94)90931-8. View

17.

Riess A, Wiggs B, Verburgt L, Wright J, Hogg J, Pare P . Morphologic determinants of airway responsiveness in chronic smokers. Am J Respir Crit Care Med. 1996; 154(5):1444-9. DOI: 10.1164/ajrccm.154.5.8912762. View

18.

Djukanovic R, Lai C, Wilson J, Britten K, Wilson S, Roche W . Bronchial mucosal manifestations of atopy: a comparison of markers of inflammation between atopic asthmatics, atopic nonasthmatics and healthy controls. Eur Respir J. 1992; 5(5):538-44. View

19.

Brusselle G, Kips J, Joos G, Bluethmann H, Pauwels R . Allergen-induced airway inflammation and bronchial responsiveness in wild-type and interleukin-4-deficient mice. Am J Respir Cell Mol Biol. 1995; 12(3):254-9. DOI: 10.1165/ajrcmb.12.3.7873190. View

20.

Bryant D, Burns M . The relationship between bronchial histamine reactivity and atopic status. Clin Allergy. 1976; 6(4):373-81. DOI: 10.1111/j.1365-2222.1976.tb01919.x. View