Background Nitric oxide can be measured at multiple flow rates to

Background Nitric oxide can be measured at multiple flow rates to determine proximal (maximum airway nitric oxide flux; JawNO) and distal inflammation (alveolar nitric oxide concentration; CANO). their correlation with height were studied. The correlation among the fraction of exhaled NO at 50?ml/s (FENO50), CANO, JawNO, forced expiratory volume in 1?second (FEV1) and the CAN questionnaire was measured and the degree of agreement regarding asthma control assessment was studied using Cohens kappa. Results We studied 162 children; 49 healthy (group 1), 23 asthmatic participants without treatment (group 2) and 80 asthmatic patients treated with inhaled corticosteroids (group 3). CANO (ppb) was 2.2 (0.1-4.5), 3 (0.2-9.2) and 2.45 (0.1-24), respectively. JawNO (pl/s) was 516 (98.3-1470), 2356.67 (120C6110) and 1426 (156C11805), respectively. There was a strong association (r?=?0.97) between FENO50 and JawNO and the degree of agreement was very good in group 2 and was good in group 3. There was no agreement or only slight agreement between the measures used to monitor asthma 1208315-24-5 IC50 control (FEV1, CAN questionnaire, CANO and JawNO). 1208315-24-5 IC50 Conclusions The results for CANO and JawNO in controls were similar to those found in other reports. There was no agreement or only slight agreement among the three measure instruments analyzed to assess asthma control. In our sample, no additional information was provided by CANO and JawNO. Background Asthma is a chronic inflammatory disease characterised by recurrent symptoms of cough, wheezing and/or respiratory distress, associated with variable airway obstruction and bronchial hyperresponsiveness [1]. The Global Initiative for Asthma (GINA) [2] indicates that the severity of asthma should be determined on the basis of the degree of control in the corresponding treatment step, which is achieved by assessing the frequency of symptoms, the need for rescue bronchodilators, and pulmonary function [3]. To assess deterioration, questionnaires can be used that evaluate patients perceptions of their disease control. The only questionnaire developed and validated in the Spanish pediatric population is the CAN questionnaire [4]. Our group recently studied the association among symptoms, pulmonary function, and fraction of exhaled nitric oxide (FENO) for the management of asthma in children [5] and, like other authors [6], we found that the associationCdespite being significantCwas weak. The growing interest in modelling exhaled nitric oxide is understandable because only an extended NO analysis can reveal where in the lung the NO production is altered. FENO is inherently nonspecific regarding the origin of NO in the lungs and the recommended exhalation flow of 50?ml/s (FENO,50) identifies inflammatory activity mainly in the proximal airway or bronchi but the distal contributions are effectively ignored. However, applying mathematical models, the NO signal con be partitioned into proximal [maximum airway NO flux (JawNO)] and distal (CANO) airway which could indirectly reflect inflammatory activity in more distal areas (alveolar-capillary interface) [7]. There is a lack of standardization in the technique to determine CANO and JawNO. In this study, the two-compartment model and Tsoukias and Georges equation was applied [8], however, other, more complex models have been developed [9-11]. Several authors have reported an association between elevated CANO values and poor asthma control [12,13], persistent nocturnal symptoms, severe treatment-refractory asthma, and the risk of exacerbations [14]. The main aim of the present study was to study the association and correlation among symptoms, pulmonary function, proximal [maximum airway NO flux (JawNO)] and distal (CANO) airway inflammation with a view to aiding the management of asthma in daily clinical practice. The second objective was to determine alveolar NO in a healthy population. Methods Design of the study A cross-sectional study with prospective data collection was carried out in 1208315-24-5 IC50 a consecutive sample of girls and boys aged between 6 and 16?years with a medical diagnosis of asthma according to GINA 2012 criteria [2], recruited in the outpatient clinic of the Pediatric Pneumology Section of Donostia Hospital between January and August 2012. Study population Untreated asthmatic patients and asthmatic patients receiving inhaled glucocorticoid therapy as part of their standard care were included. Patients were excluded if they had asthma exacerbations or acute respiratory infection at the consultation. A control group was consecutively recruited during the same time period consisting of healthy girls and boys aged between 6 and 16?years. In this group, care was taken to ensure the absence of asthma, allergic rhinitis, food 1208315-24-5 IC50 allergy or atopic dermatitis in the clinical history and on physical examination. Primary exclusion Rabbit Polyclonal to TBC1D3 criteria consisted of patients not meeting the inclusion criteria, those with associated diseases, those who were incapable of collaborating and/or children, parents and/or guardians who refused to participate. Definitions Asthma severity and control.

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