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Cited by 71Asthma and respiratory diseasesChronic Obstructive Pulmonary Disease (COPD) ResearchOccupational exposure and asthma

Relationship among pulmonary function, bronchial reactivity, and exhaled nitric oxide in a large group of asthmatic patients

Langley, Stephen J., Goldthorpe, Sophie, Custovic, Adnan, Woodcock, Ashley·2003·Annals of Allergy, Asthma & Immunology
DOI 10.1016/s1081-1206(10)61688-2
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Abstract

Background Bronchial reactivity and exhaled nitric oxide (eNO) are not often used to monitor control and severity of asthma in clinical practice.Objective To evaluate the relationship among different physiologic measures (pulmonary function, nonspecific bronchial reactivity, and eNO) in asthmatic patients.Methods Cross-sectional, hospital-based study conducted in patients with varied asthma severity.Results A total of 392 patients participated in the study. There was no difference in eNO levels between patients taking inhaled corticosteroids (ICS group) and patients not receiving inhaled corticosteroids (NICS group). However, the percentage of predicted forced expiratory volume in 1 second (FEV1) and the provocative dose of methacholine causing a 20% decrease in FEV1 were significantly lower in the ICS group compared with the NICS group (mean, 83.2%; 95% confidence interval [CI], 80.4%-86.0%; vs mean, 94.1%; 95% CI, 91.1%-97.1%; P = .001; and geometric mean, 0.32 mg; 95% CI, 0.23-0.45 mg; vs geometric mean, 0.58 mg; 95% CI, 0.42-0.81 mg; P = .01; respectively). Patients with more severe bronchial hyperresponsiveness had a lower percentage of predicted FEV1 values (P < .001) and levels of eNO were significantly increased with increasing bronchial hyperresponsiveness (P < .001). There was no relationship between the percentage of predicted FEV1 and eNO. Atopic patients had significantly higher eNO levels than nonatopic patients (geometric mean, 11.21 ppb; 95% CI, 10.07-12.49 ppb; vs geometric mean, 7.76 ppb; 95% CI, 6.11-9.85 ppb; P = .006; respectively).Conclusions eNO values are not related to the degree of airway obstruction but are related to airway reactivity and atopic status independent of inhaled corticosteroid use. Higher values of eNO are seen with increased airway reactivity.

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Crossref · 10.1016/s1081-1206(10)61688-2

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  • Despite interventions and treatments aimed at addressing modifiable factors and comorbidities, some children with difficult asthma and Asthma plus may not improve because of continued poor adherence with medications or ongoing high exposure to allergens, in which case they should be considered as having refractory difficult asthma or refractory Asthma plus.

    “However, despite interventions and treatments aimed at addressing modifiable factors and comorbidities, some children with DA and Asthma plus may not improve [e.g., because of the continued poor adherence with medications (50, 68), or ongoing high exposure to allergens (69–71)], in which case they should be considered as having refractory DA or refractory Asthma plus (46, 72).”

    From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [71]

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Authors
Langley, S. J., Goldthorpe, S., Custovic, A., & Woodcock, A.
Affiliations
Wythenshawe Hospital (GB)
ORCID
Woodcock, Ashley
Venue
Annals of Allergy, Asthma & Immunology
Publisher
Elsevier BV
Published
2003-10
Volume
91
Issue
4
Pages
398-404
ISSN
1081-1206 (ISSN-L)
DOI
10.1016/s1081-1206(10)61688-2
OpenAlex
W2124370503
Cited by
71
References
37
Citations by year
2025: 1 · 2021: 1 · 2019: 3 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 5 · 2013: 6 · 2012: 9
FWCI
2.49
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Annals of Allergy Asthma & Immunology (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
Keywords
asthma, exhaled nitric oxide, airway hyperresponsiveness, lung function, FEV1, methacholine challenge, inhaled corticosteroids, atopy, airway inflammation, asthma severity, airway obstruction, allergic asthma, non-allergic asthma, eosinophilic asthma
MeSH terms
Adolescent, Adult, Aged, Asthma, Breath Tests, Bronchial Provocation Tests, Child, Child, Preschool, Cross-Sectional Studies, Female, Forced Expiratory Volume, Hospitalization, Humans, Hypersensitivity, Immediate, Male, Middle Aged, Nitric Oxide, Respiratory Function Tests, Severity of Illness Index, Bronchial Hyperreactivity

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