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Longitudinal changes in sputum and blood inflammatory mediators during FeNO suppression testing.
- Source :
- Thorax; Sep2022, Vol. 77 Issue 9, p933-938, 6p
- Publication Year :
- 2022
-
Abstract
- To explore whether fractional exhaled nitric oxide (FeNO) non-suppression identifies corticosteroid resistance, we analysed inflammatory mediator changes during a FeNO suppression test with monitored high-intensity corticosteroid therapy. In linear mixed-effects models analysed over time, the 15 clinically distinct 'suppressors' (ie, ≥42% FeNO suppression) normalised Asthma Control Questionnaire scores (mean±SD, start to end of test: 2.8±1.4 to 1.4±0.9, p<0.0001) and sputum eosinophil counts (median (IQR), start to end of test: 29% (6%-41%) to 1% (1%-5%), p=0.0003) while significantly decreasing sputum prostaglandin D2 (254 (89-894) to 93 (49-209) pg/mL, p=0.004) and numerically decreasing other type-2 cytokine, chemokine and alarmin levels. In comparison, the 19 non-suppressors had persistent sputum eosinophilia (10% (1%-67%) despite high-intensity therapy) with raised end-test inflammatory mediator levels (1.9 (0.9-2.8)-fold greater than suppressors). FeNO non-suppression during monitored treatment implies biological corticosteroid resistance. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00406376
- Volume :
- 77
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Thorax
- Publication Type :
- Academic Journal
- Accession number :
- 159210400
- Full Text :
- https://doi.org/10.1136/thoraxjnl-2021-217994