European journal of medical research · 2026
Identifying optimal flow rates for airway eosinophilia detection in asthma.
СтатьяНазвание и аннотация: Перевод в очереди
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Wu Yiting, Lin Yanmei, Hao Huijuan, Lin Jingwang, Zhou Yan, Pan Yilin, Zhang Min, Bao Wuping
Аннотация
BACKGROUND: Fractional exhaled nitric oxide (FeNO) is a valuable biomarker for eosinophilic airway inflammation, with accuracy influenced by expiratory flow rates.
OBJECTIVE: To identify optimal FeNO flow rates for detecting airway inflammation in asthma.
METHODS: This prospective cohort study enrolled non-smoking adult (18 healthy controls, 61 asthmatics). FeNO (45, 50, 55, and 200 mL/s), complete blood counts, sputum cytology, and spirometry were performed. Correlations between FeNOs and sputum/peripheral eosinophils were analyzed. Receiver operating characteristic (ROC) curves assessed FeNOs' predictive value for identifying sputum eosinophilia, alone or in combination with peripheral eosinophils.
RESULTS: FeNO at 50 mL/s (FeNO50) exhibited the strongest correlation with peripheral eosinophils (r = 0.51, p < 0.001) and was superior to FeNO45/55 in predicting sputum eosinophilia (AUC = 0.694 for 2% eosinophilia, 0.726 for 3% eosinophilia; p < 0.05). FeNO200 demonstrated better predictive accuracy (AUC = 0.717 at 2%, 0.743 at 3%), with cutoffs of 9.6 ppb (2%) and 10.5 ppb (3%). Combining FeNO200 with elevated peripheral eosinophil counts further improved diagnostic accuracy (AUC = 0.806 at 2%, 0.763 at 3%; peripheral eosinophil cutoffs: 155 and 275 cells/μL, respectively). Moreover, FeNOs correlated more strongly with absolute sputum eosinophil counts compared to percentages. Asthmatics exhibiting both reduced small airway indices and FEV1 presented significantly elevated FeNO levels.
CONCLUSION: Precisely controlling expiratory flow rate at 50 mL/s improves the correlation between FeNO and eosinophil counts, while FeNO200 yields superior diagnostic performance. Combining FeNO200 with peripheral eosinophil counts offers a robust strategy for accurately detecting airway eosinophilic inflammation in asthma.
CLINICAL TRIAL REGISTRATION: ChiCTR2500104677 (Date of Registration: 2025-06-20).
OBJECTIVE: To identify optimal FeNO flow rates for detecting airway inflammation in asthma.
METHODS: This prospective cohort study enrolled non-smoking adult (18 healthy controls, 61 asthmatics). FeNO (45, 50, 55, and 200 mL/s), complete blood counts, sputum cytology, and spirometry were performed. Correlations between FeNOs and sputum/peripheral eosinophils were analyzed. Receiver operating characteristic (ROC) curves assessed FeNOs' predictive value for identifying sputum eosinophilia, alone or in combination with peripheral eosinophils.
RESULTS: FeNO at 50 mL/s (FeNO50) exhibited the strongest correlation with peripheral eosinophils (r = 0.51, p < 0.001) and was superior to FeNO45/55 in predicting sputum eosinophilia (AUC = 0.694 for 2% eosinophilia, 0.726 for 3% eosinophilia; p < 0.05). FeNO200 demonstrated better predictive accuracy (AUC = 0.717 at 2%, 0.743 at 3%), with cutoffs of 9.6 ppb (2%) and 10.5 ppb (3%). Combining FeNO200 with elevated peripheral eosinophil counts further improved diagnostic accuracy (AUC = 0.806 at 2%, 0.763 at 3%; peripheral eosinophil cutoffs: 155 and 275 cells/μL, respectively). Moreover, FeNOs correlated more strongly with absolute sputum eosinophil counts compared to percentages. Asthmatics exhibiting both reduced small airway indices and FEV1 presented significantly elevated FeNO levels.
CONCLUSION: Precisely controlling expiratory flow rate at 50 mL/s improves the correlation between FeNO and eosinophil counts, while FeNO200 yields superior diagnostic performance. Combining FeNO200 with peripheral eosinophil counts offers a robust strategy for accurately detecting airway eosinophilic inflammation in asthma.
CLINICAL TRIAL REGISTRATION: ChiCTR2500104677 (Date of Registration: 2025-06-20).