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Different Relationships between FENO and COPD Characteristics in Smokers and Ex-Smokers
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.ORCID iD: 0000-0001-5093-6980
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2019 (English)In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 16, no 3-4, p. 227-233Article in journal (Refereed) Published
Abstract [en]

Exhaled nitric oxide (FENO) is a marker of type-2 inflammation in asthma and is used in its management. However, smokers and ex-smokers have lower FENO values, and the clinical use of FENO values in COPD patients is unclear. Therefore, we investigated if FENO had a relationship to different COPD characteristics in smoking and ex-smoking subjects. Patients with COPD (n = 533, 58% females) were investigated while in stable condition. Measurements of FENO50, blood cell counts, IgE sensitisation and lung function were performed. Medication reconciliation was used to establish medication usage. Smokers (n = 150) had lower FENO50 9 (8, 10) ppb (geometric mean, 95% confidence interval) than ex-smokers did (n = 383) 15 (14, 16) ppb, p < 0.001. FENO50 was not associated with blood eosinophil or neutrophil levels in smokers, but in ex-smokers significant associations were found (r = 0.23, p < 0.001) and (r = -0.18, p = 0.001), respectively. Lower FENO values were associated with lower FEV1% predicted in both smokers (r = 0.17, p = 0.040) and ex-smokers (r = 0.20, p < 0.001). Neither the smokers nor ex-smokers with reported asthma or IgE sensitisation were linked to an increase in FENO50. Ex-smokers treated with inhaled corticosteroids (ICS) had lower FENO50 14 (13, 15) ppb than non-treated ex-smokers 17 (15, 19) ppb, p = 0.024. This was not found in smokers (p = 0.325). FENO is associated with eosinophil inflammation and the use of ICS in ex-smoking COPD subjects, but not in smoking subjects suggesting that the value of FENO as an inflammatory marker is more limited in smoking subjects. The association found between low FENO values and low lung function requires further investigation.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019. Vol. 16, no 3-4, p. 227-233
Keywords [en]
Exhaled NO, asthma and COPD, inflammatory mediators, lung function
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-398705DOI: 10.1080/15412555.2019.1638355ISI: 000479665900001PubMedID: 31357875OAI: oai:DiVA.org:uu-398705DiVA, id: diva2:1377670
Funder
Swedish Heart Lung FoundationSwedish Heart Lung FoundationAvailable from: 2019-12-12 Created: 2019-12-12 Last updated: 2019-12-12Bibliographically approved

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Högman, MarieannThornadtsson, AlexandraBröms, KristinaJansson, ChristerLisspers, KarinStällberg, BjörnHedenström, HansMalinovschi, Andrei
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Lung- allergy- and sleep researchCentre for Research and Development, GävleborgFamily Medicine and Preventive MedicineCenter for Clinical Research DalarnaClinical Physiology
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