FENO and AHR mannitol in patients referred to an out-of-hospital asthma clinic: a real-life study
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FENO and AHR mannitol in patients referred to an out-of-hospital asthma clinic : a real-life study. / Backer, Vibeke; Sverrild, Asger; Porsbjerg, Celeste.
In: Journal of Asthma, Vol. 51, No. 4, 2014, p. 411-416.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - FENO and AHR mannitol in patients referred to an out-of-hospital asthma clinic
T2 - a real-life study
AU - Backer, Vibeke
AU - Sverrild, Asger
AU - Porsbjerg, Celeste
PY - 2014
Y1 - 2014
N2 - OBJECTIVE: Ongoing airway inflammation measured by fractional exhaled nitric oxide (FENO) and airway hyperresponsiveness (AHR) to mannitol are associated in selected asthma patients, but no evidence exists of this association in unselected asthma patients. The aim was to investigate the association between FENO and AHR to mannitol in unselected individuals with possible asthma.METHODS: A real-life study on patients with possible asthma referred to a specialized asthma clinic. Data on asthma history, FEV(1), FENO, atopy, smoking, treatment and AHR to mannitol were collected.RESULTS: In 217 unselected patients with symptoms suggestive of asthma, FENO and response to mannitol were tested. Of the 141 who underwent both tests, 32 (23%) had FENO > 25 ppb, and 58 (41%) had AHR to mannitol. A significant association between high FENO and AHR was found (p < 0.001); 26% responded to mannitol despite a normal NO, and 8% had a high FENO but no AHR. Additionally, a weak association was found between log FENO and log response to mannitol (r = 0.32, p < 0.01). The area under the ROC curve for FENO as a predictor of AHR was 0.66 (95% CI 0.6-0.8) and for mannitol for having high FENO was 0.73 (95%CI 0.6-0.9).CONCLUSION: In a large sample of patients referred to an asthma clinic, an association was found between FENO and AHR to mannitol. However, a significant proportion of asthma patients had a normal FENO despite having AHR, suggesting that in some patients, AHR to mannitol is not driven by eosinophilic airway inflammation.
AB - OBJECTIVE: Ongoing airway inflammation measured by fractional exhaled nitric oxide (FENO) and airway hyperresponsiveness (AHR) to mannitol are associated in selected asthma patients, but no evidence exists of this association in unselected asthma patients. The aim was to investigate the association between FENO and AHR to mannitol in unselected individuals with possible asthma.METHODS: A real-life study on patients with possible asthma referred to a specialized asthma clinic. Data on asthma history, FEV(1), FENO, atopy, smoking, treatment and AHR to mannitol were collected.RESULTS: In 217 unselected patients with symptoms suggestive of asthma, FENO and response to mannitol were tested. Of the 141 who underwent both tests, 32 (23%) had FENO > 25 ppb, and 58 (41%) had AHR to mannitol. A significant association between high FENO and AHR was found (p < 0.001); 26% responded to mannitol despite a normal NO, and 8% had a high FENO but no AHR. Additionally, a weak association was found between log FENO and log response to mannitol (r = 0.32, p < 0.01). The area under the ROC curve for FENO as a predictor of AHR was 0.66 (95% CI 0.6-0.8) and for mannitol for having high FENO was 0.73 (95%CI 0.6-0.9).CONCLUSION: In a large sample of patients referred to an asthma clinic, an association was found between FENO and AHR to mannitol. However, a significant proportion of asthma patients had a normal FENO despite having AHR, suggesting that in some patients, AHR to mannitol is not driven by eosinophilic airway inflammation.
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Ambulatory Care
KW - Ambulatory Care Facilities
KW - Analysis of Variance
KW - Asthma
KW - Bronchial Hyperreactivity
KW - Bronchial Provocation Tests
KW - Child
KW - Cohort Studies
KW - Exhalation
KW - Female
KW - Forced Expiratory Flow Rates
KW - Humans
KW - Male
KW - Mannitol
KW - Middle Aged
KW - Nitric Oxide
KW - Prognosis
KW - Respiratory Function Tests
KW - Risk Assessment
KW - Severity of Illness Index
KW - Skin Tests
U2 - 10.3109/02770903.2013.878953
DO - 10.3109/02770903.2013.878953
M3 - Journal article
C2 - 24450977
VL - 51
SP - 411
EP - 416
JO - Journal of Asthma
JF - Journal of Asthma
SN - 0277-0903
IS - 4
ER -
ID: 138146208