The Journal of asthma : official journal of the Association for the Care of Asthma · 2025
Comparison of airway inflammation characteristics detected by lower exhaled nitric oxide in cough variant asthma, non-asthmatic eosinophilic bronchitis, and classic asthma.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Zhang Li, Aierken Alimire, Dong Ran, Zhang Mengru, Chen Qiang, Qiu Zhongmin
Аннотация
OBJECTIVE: To investigate the inflammatory profiles of non-asthmatic eosinophilic bronchitis (NAEB), cough variant asthma (CVA), and classic asthma (CA) using fractional exhaled nitric oxide (FeNO) analysis to identify their unique inflammatory phenotypes.
METHODS: This study involved cough patients newly diagnosed, corticosteroid-naïve with CVA (n = 68), NAEB (n = 53), and CA (n = 49). FeNO measurements at exhalation flow rates of 50 mL/s (FeNO50) and 200 mL/s (FeNO200) were conducted. The concentration of alveolar nitric oxide (CaNO) was calculated using a two-compartment model. Inflammatory mediators in induced sputum were also analyzed across the groups.
RESULTS: Significant differences in FeNO50, FeNO200, and CaNO levels were observed among the three groups (all p < 0.001). Compared to NAEB, CVA patients demonstrated significantly higher FeNO50 levels (27.5 [interquartile range, IQR: 12.0-33.0] ppb vs. 16.0 [IQR: 12.5-22.0] ppb; p = 0.008) but lower CaNO levels (2.6 [IQR: 1.0-4.3] ppb vs. 3.7 [IQR: 2.3-6.1] ppb; p = 0.009). CA exhibited the highest levels of FeNO50, FeNO200, and CaNO compared to both NAEB and CVA (all p < 0.01). In CVA, FeNO50 positively correlated with sputum eosinophils, IL-4, and LTC4, whereas NAEB showed elevated CaNO levels with higher sputum eosinophils, IL-5, and PGE2 (all p < 0.05).
CONCLUSIONS: Inflammation predominantly affects the central airways in CVA and the peripheral airways in NAEB, with a more uniform distribution across the airway in CA. These discrepancies in airway inflammation may suggest distinct cough mechanisms in CVA, NAEB, and CA.
METHODS: This study involved cough patients newly diagnosed, corticosteroid-naïve with CVA (n = 68), NAEB (n = 53), and CA (n = 49). FeNO measurements at exhalation flow rates of 50 mL/s (FeNO50) and 200 mL/s (FeNO200) were conducted. The concentration of alveolar nitric oxide (CaNO) was calculated using a two-compartment model. Inflammatory mediators in induced sputum were also analyzed across the groups.
RESULTS: Significant differences in FeNO50, FeNO200, and CaNO levels were observed among the three groups (all p < 0.001). Compared to NAEB, CVA patients demonstrated significantly higher FeNO50 levels (27.5 [interquartile range, IQR: 12.0-33.0] ppb vs. 16.0 [IQR: 12.5-22.0] ppb; p = 0.008) but lower CaNO levels (2.6 [IQR: 1.0-4.3] ppb vs. 3.7 [IQR: 2.3-6.1] ppb; p = 0.009). CA exhibited the highest levels of FeNO50, FeNO200, and CaNO compared to both NAEB and CVA (all p < 0.01). In CVA, FeNO50 positively correlated with sputum eosinophils, IL-4, and LTC4, whereas NAEB showed elevated CaNO levels with higher sputum eosinophils, IL-5, and PGE2 (all p < 0.05).
CONCLUSIONS: Inflammation predominantly affects the central airways in CVA and the peripheral airways in NAEB, with a more uniform distribution across the airway in CA. These discrepancies in airway inflammation may suggest distinct cough mechanisms in CVA, NAEB, and CA.