Nasal nitric oxide in a random sample of adults and its relationship to sensitization, cat allergen, rhinitis, and ambient nitric oxide (original) (raw)
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Exhaled and nasal nitric oxide is increased in laboratory animal allergy
Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 1998
Background Allergens from rats, mice, guinea pigs or rabbits cause up to 30% of exposed persons to develop specific immunoglobulin E (IgE) responses. Laboratory animal allergy (LAA) is among the highest occupational risks for asthma in the UK. Elevated levels of nitric oxide (NO) are found in exhaled breath in asthma. In LAA symptoms may progress from conjunctivitis, rhinitis to asthma. Health surveillance aims to detect early sensitization. Objective To assess whether an association exists between LAA and exhaled NO. Methods A cross-sectional study was performed in 39 laboratory workers undergoing LAA health surveillance. Volunteers completed two health questionnaires, had skin-prick tests, spirometry, total IgE and RAST tests. Exhaled and nasal NO was measured by chemiluminescence analyser (LR2000, Logan Research, Rochester, UK). Results There were 23 asymptomatic subjects (mean age 29.53 yearss) and 16 symptomatic subjects (29.63 yearss, P ¼ 0.95); 9 early LAA, seven LAA asthma. Exhaled NO was raised in those with LAA symptoms 17.97 ppb Ϯ 1.24 (mean Ϯ SEM) compared with asymptomatics 6.08 ppb Ϯ 1.15, P < 0.05. A trend of increased NO by allergic status was observed; asymptomatic, to early LAA, to asthma. One-way analysis of variance compared differences between groups (F ratio 13.93, P < 0.001). Symptomatic subjects also had raised nasal NO, vs asymptomatic subjects (mean difference 378 ppb, P < 0.05). A trend was again observed by allergic status (F ratio 5.28, P ¼ 0.01). Conclusion Raised NO levels in LAA increasing with symptom severity suggest NO may prove a useful additional tool in monitoring for LAA, and possibly the response to exposure reduction or allergy due to other respiratory sensitizers.
Allergy, 2007
Allergic rhinitis (AR) is an IgE-triggered chronic inflammatory disorder of the upper airways with pathophysiological and immunological links to allergic asthma (1). Recent studies providing evidence of systemic cross-talk between upper and lower airway compartments, have resulted in the concepts of Ôallergic airway diseaseÕ or Ôcombined allergic rhinitis and asthma syndromeÕ (CARAS) (2). The hallmark of CARAS is chronic airway inflammation, mainly characterized by mast cells, eosinophils, and their pro-inflammatory products (3). Historically, airway biopsies have been regarded as the gold standard for the sampling of the allergic airway inflammation. However, the applicability of invasive methods is limited for repeated sampling, such as in clinical monitoring or intervention trials. In addition, biopsies are limited to a very small part of the airways. Therefore, several less or noninvasive methodologies are being developed, some of which have been validated (4). Nitric oxide (NO) is a gaseous molecule synthesized in the respiratory compartment by NO-synthases (NOS) and can be detected in exhaled air of various species
Nasal nitric oxide and nasal allergy
Allergy, 2006
Nitric oxide (NO) was initially described as a an endothelium-derived relaxing factor due to its action as a vasodilator (1, 2). We now know that NO has a regulatory role in a wide variety of cellular functions and tissues. Gustafsson et al. (3) first demonstrated that NO is present in exhaled air. Alving et al. (4) observed the presence of NO in the nasal cavity in even much higher concentrations compared with the lower airways. In addition, it was demonstrated that nasal NO (nNO) is affected by inflammation of the upper airways (5-8). These findings lead to the question whether nNO can be used in a clinical setting as a diagnostic tool of airway inflammation, or more specific of allergic rhinitis. This is mainly the result of the lack of consensus on measurement techniques, consequently leading to different findings of nNO concentrations in different airway illnesses as sinusitis, polyposis nasi and (allergic) rhinitis. Exceptions are primary cilliary dyskinesia (9) and cystic fibrosis (10, 11). It is well known that nNO levels in these diseases are quite low, independent of measurement method, and can be used as a noninvasive screening tool. In this review, we try to answer the question whether nNO is helpful in the diagnosis and management of patients with allergic rhinitis.
Exhaled nitric oxide: relation to sensitization and respiratory symptoms
Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 2004
Background Conflicting data have been presented as to whether nitric oxide (NO) in exhaled air is merely reflecting atopy rather than airway inflammation. Objective To investigate the relationship between exhaled NO (eNO) and nasal NO (nNO), respiratory symptoms, and atopy, in the context of a cross-sectional study of the respiratory health of bleachery workers. Methods Two hundred and forty-six non-smoking bleachery and paper-mill workers answered a questionnaire and were examined by measurements of eNO and nNO and spirometry, outside the pollen season. Blood samples were collected and analysed for specific IgE against common aeroallergens (birch, timothy, cat and house dust mite). Atopy was defined as a positive Phadiatop TM test. Results The atopic and the non-atopic subjects without asthma or rhinitis had similar levels of eNO. Subjects reporting asthma or rhinitis who were also sensitized to perennial allergens had higher levels of eNO, whereas those sensitized to only seasonal allergens had similar eNO levels as nonatopic subjects with asthma or rhinitis. In multiple linear regression models adjusted for nNO, eNO was associated with asthma and sensitization to perennial allergens. Conclusion The results indicate that only atopic subjects who have recently been exposed to the relevant allergen have elevated levels of eNO. Atopic subjects who are not being exposed to a relevant allergen or have never experienced symptoms of asthma or rhinitis show normal eNO. These data indicate that eNO relates to airway inflammation in atopic subjects.
Nasal nitric oxide measurements in the assessment of nasal allergen challenge
Journal of investigational allergology & clinical immunology, 2012
Several objective methods are used to assess the result of nasal allergen challenge. The aim of this study was to compare the diagnostic value of nasal nitric oxide (nNO) measurements with that of peak nasal inspiratory flow (PNIF), nasal lavage fluid beta-tryptase levels, and changes in cell count after nasal challenge with grass pollen. The study population comprised 24 patients allergic to grass pollen and 24 healthy controls. All participants underwent grass allergen challenge preceded by administration of placebo. A visual analog scale was administered. nNO and PNIF were determined, and nasal lavage fluid was collected before and 30 minutes after administration of placebo and allergen. The study was performed outside the pollen season. Significant changes in nNO, PNIF, nasal lavage fluid beta-tryptase level, and cell count were observed only in allergic patients after administration of the allergen. Receiver operating characteristic (ROC) curves were drawn for each determinatio...
Lung India, 2014
standardized for supporting the diagnosis in cases of eosinophilic inflammation of airways, bronchial hyperreactivity and asthma. FE NO levels have been higher in atopic than non-atopic bronchial asthma patients and some studies also reported that healthy atopic subjects without symptoms or signs of airway disorders have higher FE NO levels than non-atopic subjects. Similarly the effect of clinical atopy, with atopic cases having higher levels as compared to non-atopic cases. To the best of our knowledge, the literature on exhaled breath and nasal nitric oxide from India is lacking. Hence, this study was undertaken to answer the question about the relationship between the noninvasive methods of nitric oxide measurements in bronchial asthma and allergic rhinitis and their correlation with atopic profile of Indian population.
European annals of allergy and clinical immunology, 2018
Sensitization to cat allergens is common worldwide. Currently, there is a trend towards costly and often unavailable diagnostic analysis. The aim is to assess the reliability of skin prick test (SPT) and serum specific IgE (ssIgE) to cat sensitization, by performing nasal challenge test (NCT) in a community with low cat ownership but common presence of stray cats. Forty-one pa-tients with perennial allergic rhinitis (AR) who were mono or polysensitized (including cat) were included. We had 31 cat non-owners and 10 present cat owners. SPT (> 5 mm / diameter), ssIgE (≥ 0.70 IU/ml), nasal smear for eosinophil (Eo) and NCT were compared between groups. Outcomes included nasal challenge score, nasal Eo positivity, peak inspiratory and expiratory flow (PIF and PEF) 2 and 8 hours after the NCT, and were compared to baseline. Baseline SPT wheal size and ssIgE level were similar in both groups. NCT positivity was more frequent in cat owners. The strongest nasal reaction was on the top con...
The increase in exhaled NO following allergen challenge is not associated with airway acidification
European journal of clinical investigation, 2011
Background Exhaled nitric oxide (NO), commonly accepted marker of airways inflammation, may be generated both by specific enzymes, NO synthases, as well as by nonenzymatic reduction in its metabolites. During asthma exacerbations, owing to lower airways pH, it has been reported that nitrite reduction may contribute to the increase in exhaled NO. Allergen exposure, an important cause of asthma exacerbations, is also known to increase exhaled NO.