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Predicting Sputum Eosinophilia in Exacerbations of COPD Using Exhaled Nitric Oxide

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Abstract

Fractional exhaled nitric oxide (FENO) may be a pulmonary biomarker in chronic obstructive pulmonary disease (COPD). In this prospective study, the relationship between FENO and airway inflammation was assessed in COPD exacerbations. FENO and lung function were measured, and sputum was collected from 49 ex-smoking COPD patients, first at the time of hospital admission and again at discharge following treatment. There was a significant positive correlation between the percentage of sputum eosinophils and FENO concentrations, both at exacerbation (r = 0.593, p < 0.001) and discharge (r = 0.337, p = 0.044). The increase in forced expiratory volume in one second (FEV1) after treatment was greater in patients with sputum eosinophilia (ΔFEV1 0.35 ± 0.12 vs. 0.13 ± 0.04 L, p = 0.046), and FENO was a strong predictor of sputum eosinophilia (area under the receiver operating characteristic curve, 0.89). The optimum cut point was 19 parts per billion (sensitivity: 90 %; specificity: 74 %). Our data suggest that FENO is a good surrogate marker of eosinophilic inflammation in COPD patients with exacerbations.

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Acknowledgments

We thank M. Mikoss and J. Hernadi (National Koranyi Institute of TB and Pulmonology) for their technical assistance in sputum processing and FENO measurements. The study was supported by the Hungarian Respiratory Foundation and the Hungarian National Scientific Foundation (OTKA K83338). Dr. B. Antus is a recipient of Bolyai Janos Scholarship of the Hungarian Academy of Sciences.

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Authors and Affiliations

  1. Department of Pulmonology, National Koranyi Institute of TB and Pulmonology, Piheno ut 1, 1121, Budapest, Hungary

    Szabolcs Soter & Balazs Antus

  2. Department of Pathophysiology, National Koranyi Institute of TB and Pulmonology, Piheno ut 1, 1121, Budapest, Hungary

    Imre Barta & Balazs Antus

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  1. Szabolcs Soter
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  2. Imre Barta
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Correspondence to Balazs Antus.

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Soter, S., Barta, I. & Antus, B. Predicting Sputum Eosinophilia in Exacerbations of COPD Using Exhaled Nitric Oxide. Inflammation 36, 1178–1185 (2013). https://doi.org/10.1007/s10753-013-9653-8

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