Machado Roberto F, Stoller James K, Laskowski Daniel, Zheng Shuo, Lupica Joseph A, Dweik Raed A, Erzurum Serpil C
Department of Pulmonary and Critical Care Medicine, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
J Appl Physiol (1985). 2002 Dec;93(6):2038-43. doi: 10.1152/japplphysiol.00659.2002. Epub 2002 Aug 30.
Quantitations of exhaled nitric oxide (NO) and carbon monoxide (CO) have been proposed as noninvasive markers of airway inflammation. We hypothesized that exhaled CO is increased in individuals with alpha(1)-antitrypsin (AT) deficiency, who have lung inflammation and injury related to oxidative and proteolytic processes. Nineteen individuals with alpha(1)-AT deficiency, 22 healthy controls, and 12 patients with non-alpha(1)-AT-deficient chronic obstructive pulmonary disease (COPD) had NO, CO, CO(2), and O(2) measured in exhaled breath. Individuals with alpha(1)-AT deficiency had lower levels of NO and CO than control or COPD individuals. Alpha(1)-AT-deficient and COPD patients had lower exhaled CO(2) than controls, although only alpha(1)-AT-deficient patients had higher exhaled O(2) than healthy controls. NO was correlated inversely with exhaled O(2) and directly with exhaled CO(2), supporting a role for NO in regulation of gas exchange. Exhaled gases were not significantly related to corticosteroid use or lung function. Demonstration of lower than normal CO and NO levels may be useful as an additional noninvasive method to evaluate alpha(1)-AT deficiency in individuals with a severe, early onset of obstructive lung disease.
呼出一氧化氮(NO)和一氧化碳(CO)的定量分析已被提议作为气道炎症的非侵入性标志物。我们推测,在患有α1抗胰蛋白酶(AT)缺乏症的个体中,呼出的CO会增加,这些个体存在与氧化和蛋白水解过程相关的肺部炎症和损伤。对19名α1-AT缺乏症患者、22名健康对照者以及12名非α1-AT缺乏的慢性阻塞性肺疾病(COPD)患者的呼出气体进行了NO、CO、CO2和O2的测量。α1-AT缺乏症患者的NO和CO水平低于对照组或COPD患者。α1-AT缺乏症患者和COPD患者呼出的CO2低于对照组,尽管只有α1-AT缺乏症患者呼出的O2高于健康对照组。NO与呼出的O2呈负相关,与呼出的CO2呈正相关,这支持了NO在气体交换调节中的作用。呼出气体与皮质类固醇的使用或肺功能无显著相关性。证明低于正常水平的CO和NO可能是评估患有严重早发性阻塞性肺病个体中α1-AT缺乏症的一种额外的非侵入性方法。