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The Role of Measuring Fractional Exhaled Nitric Oxide in Chronic Obstructive Pulmonary Disease Patients with Frequent Exacerbations
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A3126 - The Role of Measuring Fractional Exhaled Nitric Oxide in Chronic Obstructive Pulmonary Disease Patients with Frequent Exacerbations
Author Block: M. Howsare1, A. Bhatt2, R. Cavallazzi1, H. L. Rivas-Perez3; 1Pulmonary, Critical Care, and Sleep Medicine, University of Louisville, Louisville, KY, United States, 2Internal Medicine, University of Louisville, Louisville, KY, United States, 3Pulmonary, Critical Care, and Sleep Medicine, University Of Louisville, Louisville, KY, United States.
Introduction: Some patients with COPD tend to have frequent exacerbations. It is possible that those with predominantly neutrophilic inflammation are more prone to exacerbations in comparison to those with eosinophilic inflammation. Fractional exhaled nitric oxide (FENO) is a non-invasive measurement of airway inflammation, and increased FENO levels are found when there is increased amount of airway eosinophils. We hypothesized that lower FENO levels are associated with an increased number of exacerbations in patients with COPD. Methods: This is a retrospective cohort study. Patients with COPD were recruited in the outpatient clinic at the University of Louisville. Their demographic and clinical data were collected including results of pulmonary function tests, six minute walk test, modified medical research council score (MMRC), GOLD classification, and respiratory medications. Their FENO level was measured. We divided the patient population into 2 groups: those with 2 or more exacerbations, and those with 1 exacerbation. We compared the FENO level in these two groups. Results: A total of 26 patients were included (12 in the group with 2 or more exacerbations, and 14 in the group with 1 exacerbation). 50% of patients were female with the average age being 62.7 years (SD=8.77) Average six minute walk distance was 339.1 meters (SD= 90.1). On average patients had a 49.1 pack year smoking history and average MMRC of 2.1 (SD = 1.05). The mean FENO was 10.5 (standard deviation [SD] = 4.9]) in the group with 1 exacerbation versus 15.2 in the group with 2 or more exacerbations (SD = 8.2). The difference was -4.7 (P = 0.087). Conclusion: One of the possible uses of FENO in COPD patients is to characterize the type of inflammation and thus risk for exacerbation and responsiveness to inhaled steroid. In our study, there was no statistically significant difference in the FENO level between the 2 groups. This preliminary analysis does not support the role of FENO as a marker for exacerbation in patients with COPD.
Author Block: M. Howsare1, A. Bhatt2, R. Cavallazzi1, H. L. Rivas-Perez3; 1Pulmonary, Critical Care, and Sleep Medicine, University of Louisville, Louisville, KY, United States, 2Internal Medicine, University of Louisville, Louisville, KY, United States, 3Pulmonary, Critical Care, and Sleep Medicine, University Of Louisville, Louisville, KY, United States.
Introduction: Some patients with COPD tend to have frequent exacerbations. It is possible that those with predominantly neutrophilic inflammation are more prone to exacerbations in comparison to those with eosinophilic inflammation. Fractional exhaled nitric oxide (FENO) is a non-invasive measurement of airway inflammation, and increased FENO levels are found when there is increased amount of airway eosinophils. We hypothesized that lower FENO levels are associated with an increased number of exacerbations in patients with COPD. Methods: This is a retrospective cohort study. Patients with COPD were recruited in the outpatient clinic at the University of Louisville. Their demographic and clinical data were collected including results of pulmonary function tests, six minute walk test, modified medical research council score (MMRC), GOLD classification, and respiratory medications. Their FENO level was measured. We divided the patient population into 2 groups: those with 2 or more exacerbations, and those with 1 exacerbation. We compared the FENO level in these two groups. Results: A total of 26 patients were included (12 in the group with 2 or more exacerbations, and 14 in the group with 1 exacerbation). 50% of patients were female with the average age being 62.7 years (SD=8.77) Average six minute walk distance was 339.1 meters (SD= 90.1). On average patients had a 49.1 pack year smoking history and average MMRC of 2.1 (SD = 1.05). The mean FENO was 10.5 (standard deviation [SD] = 4.9]) in the group with 1 exacerbation versus 15.2 in the group with 2 or more exacerbations (SD = 8.2). The difference was -4.7 (P = 0.087). Conclusion: One of the possible uses of FENO in COPD patients is to characterize the type of inflammation and thus risk for exacerbation and responsiveness to inhaled steroid. In our study, there was no statistically significant difference in the FENO level between the 2 groups. This preliminary analysis does not support the role of FENO as a marker for exacerbation in patients with COPD.
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