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Association of extended nitric oxide parameters with bronchial hyperresponsiveness and bronchodilator response in children with asthma

 Yoon Hee Kim  ;  In Suk Sol  ;  Seo Hee Yoon  ;  Min Jung Kim  ;  Kyung Won Kim  ;  Myung Hyun Sohn  ;  Kyu-Earn Kim 
 Journal of Breath Research, Vol.11(4) : 46003, 2017 
Journal Title
 Journal of Breath Research 
Issue Date
Asthma/diagnosis ; Asthma/drug therapy* ; Asthma/physiopathology* ; Bronchial Hyperreactivity/physiopathology* ; Bronchodilator Agents/pharmacology ; Bronchodilator Agents/therapeutic use* ; Child ; Female ; Humans ; Lung/metabolism ; Male ; Nitric Oxide/analysis* ; Regression Analysis
Theoretical non-linear modeling of exhaled nitric oxide has revealed extended flow-independent parameters that could explain where or how nitric oxide is produced in the lung and transferred to the airway gas stream. We aimed to evaluate the associations of bronchial hyperresponsiveness and bronchodilator response with extended flow-independent nitric oxide parameters. Nitric oxide (30, 50, 100, 200 ml s-1) was measured in 432 children with asthma on the same day with either a methacholine challenge test (n = 156) or spirometry with bronchodilator (n = 276; 96 previously diagnosed with asthma and treated with inhaled corticosteroid, 37 with acute exacerbation treated with systemic corticosteroid). We additionally included 107 healthy controls for evaluation of the suitability of the non-linear model of exhaled nitric oxide. In asthmatic children, the response-dose ratio of the methacholine challenge test was correlated positively with bronchial nitric oxide (JawNO) and airway tissue nitric oxide (CawNO) (r = 0.367 and r = 0.299, respectively; both p < 0.001), while the change in forced expiratory volume in 1 s, representing bronchodilator response, was associated positively with only JawNO (r = 0. 216, p < 0.001). On multiple regression, JawNO, CawNO, and the diffusing capacity of NO (DawNO) were significantly associated with the response-dose ratio. JawNO was significantly associated with change in forced expiratory volume in children with stable asthma but not those with acute exacerbation. Our findings suggest that bronchial hyperresponsiveness is associated with CawNO while factors other than airway tissue inflammation could affect bronchodilator response in children with mild asthma. Systemic corticosteroid use during asthma exacerbation could affect the association of bronchodilator response with extended nitric oxide parameters.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Kyu Earn(김규언)
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Sol, In Suk(설인숙) ORCID logo https://orcid.org/0000-0003-2470-9682
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
Yoon, Seo Hee(윤서희) ORCID logo https://orcid.org/0000-0002-8361-9815
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