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Assessment of nitric oxide in induced sputum of asthmatic patients and its prognostic significance in monitoring allergic inflammation
Scientific Journal of Al-Azhar Medical Faculty [Girls] [The]. 2001; 22 (3): 27-39
in English | IMEMR | ID: emr-104969
ABSTRACT
Nitric oxide [NO] plays an important role as an inflammatory mediator in the airways. However, because direct measurement of endogenous NO has been difficult in vivo, the exact pathologic role of NO in bronchial asthma has remained unclear. To study the levels of nitric oxide derivatives in induced sputum of asthmatic patients in order to assess their clinical utility as non-invasive prognostic indicator for monitoring the degree of airway inflammation in asthmatics. We examined the concentration of stable end products of NO, namely nitrite and nitrate in hypertonic saline-induced sputum in 25 patients with different grades of bronchial asthma among whom 12 patients were examined before and after anti-asthmatic medications including steroid preparations. Ten normal age and sex-matched subjects were included as controls. Patients were 14 males and 11 females aged 36.6 +/- 8.7 years. They included 11 patients with severe asthma, 7 with moderate asthma and 7 with mild asthma. Fresh expectorated sputum was treated with equal volume of dithiothreitol 0.1%, cytospinned for cell count, and the supernatant was collected for biochemical assay. Measurement of NO derivatives in induced sputum was carried out colorimetrically by using modified Griess reaction. We evaluated the relationship between levels of NO derivatives and percentages of eosinophils, epithelial shedding in induced sputum and the degree of airway obstruction measured by pulmonary functions [forced expiratory volume in one second [FEV1]/forced vital capacity [FVC]] in asthmatic patients. The concentration of NO derivatives in induced sputum was significantly higher in patients with asthma than in normal control subjects [1126 +/- 134.3 micro mol/L versus 567 +/- 98.4 micro mol/L; P <0.01]. According to asthma severity, severe and moderate asthmatic patients had higher levels of NO derivatives [1261 +/- 193.2 and 1037 +/- 156.3micro mol/L, respectively] in induced sputum as compared to mild asthmatic patients [786 +/- 89.5 micro mol/L] [P < 0.01]. Percentages of eosinophils in induced sputum were also significantly higher in asthmatic patients than controls [35.6 +/- 4.7% vs 1.3 +/- 0.2%, P<0.01]. There were significant positive correlations between NO derivatives levels and percentages of each of eosinophils and shedding epithelial cells in induced sputum in asthmatic patients [r[S]=0.58, P <0.01; r[S]=0.62, P<0.01, respectively]. A significant negative correlation was found between NO derivatives levels and the ratio of FEV1/FVC [r[S]= -0.63, P<0.01], that's to say NO derivatives levels correlated positively with the degree of airway obstruction in asthmatic patients. The levels of NO derivatives and percentages of eosinophils in induced sputum were reduced significantly in asthmatic patients following treatment with corticosteroids [P<0.05]. These findings confirmed that the level of NO derivatives was increased in the tracheobronchial secretion of asthmatic patients and was parallel with the severity of asthma. Hence, measurement of NO derivatives in induced sputum could be used as a non-invasive prognostic biochemical marker for assessing the degree of airway inflammation and monitoring the anti-inflammatory treatment response in asthmatic patients
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Index: IMEMR (Eastern Mediterranean) Main subject: Prognosis / Respiratory Function Tests / Sputum / Colorimetry / Hypersensitivity / Nitric Oxide Limits: Female / Humans / Male Language: English Journal: Sci. J. Al-Azhar Med. Fac. [Girls] Year: 2001

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Index: IMEMR (Eastern Mediterranean) Main subject: Prognosis / Respiratory Function Tests / Sputum / Colorimetry / Hypersensitivity / Nitric Oxide Limits: Female / Humans / Male Language: English Journal: Sci. J. Al-Azhar Med. Fac. [Girls] Year: 2001