Chest Dept, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Chest Dept, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
Eur Respir J. 2018 Feb 21;51(2). doi: 10.1183/13993003.01749-2017. Print 2018 Feb.
Abnormal airway reactivity and overproduction of nitric oxide (NO) occurring in small airways have been found in asthma. If the "one airway, one disease" concept is consistent, such dysfunctions should also be detected in the peripheral airways of patients suffering from allergic rhinitis.We investigated whether peripheral airway reactivity and NO overproduction could be documented in distal airways in patients with allergic rhinitis. Exhaled NO fraction () and the slope (S) of phase III of the single-breath washout test (SBWT) of helium (He) and sulfur hexafluoride (SF) were measured in 31 patients with allergic asthma, 23 allergic rhinitis patients and 24 controls, before and after sputum induction. SBWT is sensitive to airway calibre change occurring in the lung periphery.The decrease was more significant in asthma and rhinitis than in controls (-55.1% and -50.0%, respectively, -40.8%) (p=0.007 and p=0.029, respectively). S and S increased in all groups. Change in S (ΔS) > ΔS was observed in rhinitis (p=0.004) and asthma (p<0.001), whereas ΔS = ΔS in controls (p=0.431).This study provides evidence of peripheral airway dysfunction in patients with allergic rhinitis quite similar to that described in asthma. Furthermore, a large proportion of the increased NO production reported in allergic rhinitis appears to originate in the peripheral airways.
在哮喘中发现小气道存在异常气道反应性和一氧化氮（NO）过度产生。如果“一个气道，一种疾病”的概念成立，那么这种功能障碍也应该在患有过敏性鼻炎的患者的周围气道中检测到。我们研究了过敏性鼻炎患者的周围气道反应性和 NO 过度产生是否可以在远端气道中记录到。在痰诱导前后，测量了 31 例哮喘患者、23 例过敏性鼻炎患者和 24 例对照者的呼气一氧化氮分数（）和氦（He）和六氟化硫（SF）单呼吸洗脱试验（SBWT）的第三相斜率（S）。SBWT 对发生在肺外周的气道口径变化敏感。与对照组相比，哮喘和鼻炎患者的下降更为明显（分别为-55.1%和-50.0%，分别为-40.8%）（p=0.007 和 p=0.029）。所有组的 S 和 S 均增加。在鼻炎（p=0.004）和哮喘（p<0.001）中观察到 S 的变化（ΔS）>ΔS，而在对照组中ΔS=ΔS（p=0.431）。本研究为过敏性鼻炎患者的周围气道功能障碍提供了证据，与哮喘中描述的情况非常相似。此外，过敏性鼻炎中报道的大量增加的 NO 产生似乎起源于周围气道。
