Makinen Tarja, Lehtimäki Lauri, Kinnunen Hannele, Nieminen Riina, Kankaanranta Hannu, Moilanen Eeva
Department of Respiratory Medicine, Medical School, University of Tampere, Tampere University Hospital, Tampere, Finland.
Int Arch Allergy Immunol. 2009;148(2):154-60. doi: 10.1159/000155746. Epub 2008 Sep 19.
Exhaled nitric oxide (NO) measurement at multiple exhalation flow rates allows calculation of flow-independent NO parameters: alveolar NO concentration, bronchial NO flux, bronchial diffusing capacity of NO and bronchial wall NO concentration.
In the present study, we measured the flow-independent NO parameters and inflammatory markers in exhaled breath condensate (EBC) and in serum in 14 patients with seasonal allergic rhinitis (AR) without asthma, and in 14 age- and sex-matched healthy volunteers.
At symptomatic stage before the treatment, patients with AR had higher bronchial wall diffusing capacity of NO than healthy volunteers (p = 0.024), but there were no differences in bronchial wall NO concentration or alveolar NO concentration. Patients with AR had also increased 8-isoprostane levels in the EBC (p = 0.040), and increased serum levels of IgE (p = 0.002) and eosinophil cationic protein (ECP; p = 0.027). Two-week treatment with nasal glucocorticoid mometasone decreased symptom scores and serum ECP levels but had no effect on NO parameters or 8-isoprostane levels in EBC.
Noninvasive markers of airway inflammation showed subclinical lower airway inflammation in patients with AR without asthma, but short-term treatment with nasal glucocorticoids did not affect most of the markers of lower airway inflammation.
在多个呼气流量下测量呼出一氧化氮(NO)可计算与流量无关的NO参数:肺泡NO浓度、支气管NO通量、支气管NO扩散能力和支气管壁NO浓度。
在本研究中,我们测量了14例无哮喘的季节性变应性鼻炎(AR)患者和14例年龄及性别匹配的健康志愿者呼出呼出气冷凝物(EBC)和血清中与流量无关的NO参数及炎症标志物。
在治疗前的症状期,AR患者的支气管壁NO扩散能力高于健康志愿者(p = 0.024),但支气管壁NO浓度或肺泡NO浓度无差异。AR患者EBC中的8-异前列腺素水平也升高(p = 0.040),血清IgE(p = 0.002)和嗜酸性粒细胞阳离子蛋白(ECP;p = 0.027)水平升高。用鼻用糖皮质激素莫米松治疗两周可降低症状评分和血清ECP水平,但对EBC中的NO参数或8-异前列腺素水平无影响。
气道炎症的无创标志物显示无哮喘的AR患者存在亚临床下气道炎症,但鼻用糖皮质激素短期治疗并未影响大多数下气道炎症标志物。