Exhaled nitric oxide and carbon monoxide in lung transplanted patients. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Cameli, P.; Bargagli, E.; Fossi, A.; Bennett, D.; Voltolini, L.; Refini, R.M.; Gotti, G.; Rottoli, P.
• Is Part Of: Respiratory medicine. Volume 109:Issue 9(2015)
• Page Start: 1224
• Page End: 1229
• Publication Date: 2015-09
• Subjects: Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2015.07.005
• Languages: English
• ISSNs: 0954-6111

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">Exhaled nitric oxide (eNO) and carbon monoxide (eCO) are markers of pulmonary inflammation associated with acute graft rejection and lung infections in lung transplant (LTX) recipients. Regarding eNO and eCO levels in LTX patients affected by bronchiolitis obliterans syndrome (BOS), published data are discordant.</p> </sec> <sec> <title id="sectitle0020">Objectives</title> <p id="abspara0015">We aim to evaluate eNO at multiple flows, alveolar concentration of nitric oxide (Calv<sub>NO</sub>), maximum conducting airway wall flux (J'aw<sub>NO</sub>) and eCO levels in LTX patients to assess the potential role of these parameters in BOS evaluation.</p> </sec> <sec> <title id="sectitle0025">Methods</title> <p id="abspara0020">Fractional exhaled nitric oxide (FeNO), Calv<sub>NO</sub> and J'aw<sub>NO</sub> were analysed in 30 healthy subjects and 27 stable LTX patients (12 BOS patients). Pulmonary function tests were performed after eNO and eCO assessment. Receiver operating characteristic (ROC) curves were conducted to evaluate diagnostic accuracy for BOS of eNO parameters.</p> </sec> <sec> <title id="sectitle0030">Results</title> <p id="abspara0025">LTX patients reported higher values of FeNO at flow rates of 50 (p < 0.01), 150 (p < 0.05), 350 ml/s (p < 0.001), and Calv<sub>NO</sub> (p < 0.0001) than healthy controls. BOS patients showed higher FeNO at flow rates of 150 (p < 0.05) and 350 ml/s (p < 0.01) and Calv<sub>NO</sub> (p < 0.001) than non-BOS patients. Calv<sub>NO</sub> reported a remarkable diagnostic accuracy for BOS (AUC: 0.82). There were no significant differences of eCO levels between LTX patients and healthy controls.</p> </sec> <sec> <title id="sectitle0035">Conclusion</title> <p id="abspara0030">LTX patients affected by BOS showed higher levels of FeNO 150 and 350, and Calv<sub>NO</sub> than non-BOS LTX patients, probably due to chronic airway inflammation and fibrotic remodelling. Calv<sub>NO</sub> may be a potential biomarker of BOS in LTX patients.</p> </sec> </abstract>