Two variants of occupational asthma separable by exhaled breath nitric oxide level

Respiratory Medicine
Vicky C MooreP Sherwood Burge

Abstract

Exhaled nitric oxide (FE(NO)) has been used as a marker of asthmatic inflammation in non-occupational asthma, but some asthmatics have a normal FE(NO). In this study we investigated whether, normal FE(NO) variants have less reactivity in methacholine challenge and smaller peak expiratory flow (PEF) responses than high FE(NO) variants in a group of occupational asthmatics. We measured FE(NO) and PD(20) in methacholine challenge in 60 workers currently exposed to occupational agents, who were referred consecutively to a specialist occupational lung disease clinic and whose serial PEF records confirmed occupational asthma. Bronchial responsiveness (PD(20) in methacholine challenge) and the degree of PEF change to occupational exposures, (measured by calculating diurnal variation and the area between curves score of the serial PEF record in Oasys), were compared between those with normal and raised FE(NO). Potential confounding factors such as smoking, atopy and inhaled corticosteroid use were adjusted for. There was a significant correlation between FE(NO) and bronchial hyper-responsiveness in methacholine challenge (p = 0.011), after controlling for confounders. Reactivity to methacholine was significantly lower in the normal FE(...Continue Reading

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Citations

Jul 25, 2012·Occupational Medicine·G I WaltersP S Burge
Jun 2, 2015·European Respiratory Review : an Official Journal of the European Respiratory Society·Alice M TurnerNeil Barnes
May 12, 2018·The European Respiratory Journal·P Sherwood BurgeGareth I Walters
Dec 14, 2012·Expert Review of Respiratory Medicine·Sherwood Burge, Jennifer Hoyle
Oct 16, 2015·Journal of Occupational and Environmental Medicine·Athena T JollyPhilip Harber
Oct 17, 2020·Occupational Medicine·G I Walters, C C Huntley

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