Skip to main content
SpringerLink
Log in

Exhaled Nitric Oxide Levels Are Elevated in Persons with Tetraplegia and Comparable to that in Mild Asthmatics

  • Published:
Lung Aims and scope Submit manuscript

Abstract

The role of airway inflammation in mediating airflow obstruction in persons with chronic traumatic tetraplegia is unknown. Measurement of the fraction of exhaled nitric oxide (FeNO) affords a validated noninvasive technique for gauging the airway inflammatory response in asthma, although it has never been assessed in persons with tetraplegia. This study was designed to determine the FeNO in individuals with chronic tetraplegia compared with that in patients with mild asthma and healthy able-bodied individuals. Nine subjects with chronic tetraplegia, seven subjects with mild asthma, and seven matched healthy able-bodied controls were included in this prospective, observational, pilot study. All subjects were nonsmokers and clinically stable at the time of study. Spirometry was performed on all participants at baseline. FENO was determined online by a commercially available closed circuit, chemiluminescence method, using a single-breath technique. Subjects with tetraplegia had significantly higher values of FeNO than controls (17.72 ± 3.9 ppb vs. 10.37 ± 4.9 ppb; P ≤ 0.01), as did subjects with asthma (20.23 ± 4.64 ppb vs. 10.37 ± 4.9 ppb, P ≤ 0.001). There was no significant difference in FeNO between subjects with tetraplegia and those with asthma (17.72 ± 3.9 ppb vs. 20.23 ± 4.64 ppb, P ≤ 0.27). Individuals with chronic tetraplegia have FeNO levels that are comparable to that seen in mild asthmatics and higher than that in healthy able-bodied controls. The clinical relevance of this observation has yet to be determined.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Dicpinigaitis PV et al (1994) Bronchial hyperresponsiveness after cervical spinal cord injury. Chest 105(4):1073–1076

    Article  CAS  PubMed  Google Scholar 

  2. Singas E et al (1996) Airway hyperresponsiveness to methacholine in subjects with spinal cord injury. Chest 110(4):911–915

    Article  CAS  PubMed  Google Scholar 

  3. Grimm DR et al (1999) Airway hyperresponsiveness to ultrasonically nebulized distilled water in subjects with tetraplegia. J Appl Physiol 86(4):1165–1169

    CAS  PubMed  Google Scholar 

  4. Schilero GJ, Grimm DR, Bauman WA, Lenner R, Lesser M (2005) Assessment of airway caliber and bronchodilator responsiveness in subjects with spinal cord injury. Chest 127(1):149–155

    Article  PubMed  Google Scholar 

  5. Almenoff PL, Alexander LR, Spungen AM, Lesser MD, Bauman WA (1995) Bronchodilatory effect of ipratropium bromide in patients with tetraplegia. Paraplegia 33(5):274–277

    CAS  PubMed  Google Scholar 

  6. Zitt M (2005) Clinical applications of exhaled nitric oxide for the diagnosis and management of asthma: a consensus report. Clin Ther 27(8):1238–1250

    Article  CAS  PubMed  Google Scholar 

  7. Barnes PJ, Belvisi MG (1993) Nitric oxide and lung disease. Thorax 48(10):1034–1043

    Article  CAS  PubMed  Google Scholar 

  8. Barnes PJ, Liew FY (1995) Nitric oxide and asthmatic inflammation. Immunol Today 16(3):128–130

    Article  CAS  PubMed  Google Scholar 

  9. Kharitonov SA et al (1994) Increased nitric oxide in exhaled air of asthmatic patients. Lancet 343(8890):133–135

    Article  CAS  PubMed  Google Scholar 

  10. Miller MR et al (2005) Standardisation of spirometry. Eur Respir J 26(2):319–338

    Article  CAS  PubMed  Google Scholar 

  11. The official statement of the American Thoracic Society (1999) Recommendations for standardized procedures for the on-line and off-line measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide in adults and children. Am J Respir Crit Care Med 160:2104–2117

    Google Scholar 

  12. DeVivo MJ, Black KJ, Stover SL (1993) Causes of death during the first 12 years after spinal cord injury. Arch Phys Med Rehabil 74(3):248–254

    CAS  PubMed  Google Scholar 

  13. Jackson AB, Groomes TE (1994) Incidence of respiratory complications following spinal cord injury. Arch Phys Med Rehabil 75(3):270–275

    Article  CAS  PubMed  Google Scholar 

  14. Fischer A et al (1993) Nitric oxide synthase in guinea pig lower airway innervation. Neurosci Lett 149(2):157–160

    Article  CAS  PubMed  Google Scholar 

  15. Asano K, Chee CBE, Gaston B, Lilly CM, Gerard C, Drazen JM, Stamler JS (1994) Constitutive and inducible nitric oxide synthase gene expression, regulation and activity in human epithelial cells. Proc Natl Acad Sci USA 91:10089–10093

    Article  CAS  PubMed  Google Scholar 

  16. Barnes PJ, Belvisi MG (1993) Nitric oxide and lung disease. Thorax 48:1034–1043

    Article  CAS  PubMed  Google Scholar 

  17. Dweik RA, Laskowski D, Abu-Soud HM, Kaneko FT, Hutte R, Stuehr DJ, Erzurum SC (1998) Nitric oxide synthesis in the lung: regulation by oxygen through a kinetic mechanism. J Clin Invest 101:660–666

    Article  CAS  PubMed  Google Scholar 

  18. Di Maria GU, Spicuzza L, Mistretta A (2000) Role of endogenous nitric oxide in asthma. Allergy 55(Suppl 61):31–35

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was funded by a Rehabilitation Research and Development (RR&D) Service Career Development award (B4335 V) & RR&D Center of Excellence for the Medical Consequences of Spinal Cord Injury (B4162C). The authors thank The James J. Peters Medical Center, Bronx, NY, and Department of Veterans Affairs Rehabilitation Research and Development service for their support.

Author information

Authors and Affiliations

  1. Rehabilitation Research and Development Center of Excellence for the Medical Consequences of Spinal Cord Injury, The James J. Peters VA Medical Center, Rm. 1E-02, 130 West Kingsbridge Road, Bronx, NY, 10468, USA

    Miroslav Radulovic, Gregory J. Schilero, Jill M. Wecht, Michael La Fountaine, Dwindally Rosado-Rivera & William A. Bauman

  2. Medical Service, The James J. Peters VA Medical Center, Bronx, NY, USA

    Miroslav Radulovic, Gregory J. Schilero, Jill M. Wecht & William A. Bauman

  3. Department of Medicine, The Mount Sinai School of Medicine, New York, NY, USA

    Miroslav Radulovic, Gregory J. Schilero, Jill M. Wecht & William A. Bauman

  4. Department of Rehabilitation Medicine, The Mount Sinai School of Medicine, New York, NY, USA

    Jill M. Wecht & William A. Bauman

Authors
  1. Miroslav Radulovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gregory J. Schilero
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jill M. Wecht
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael La Fountaine
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dwindally Rosado-Rivera
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. William A. Bauman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miroslav Radulovic.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Radulovic, M., Schilero, G.J., Wecht, J.M. et al. Exhaled Nitric Oxide Levels Are Elevated in Persons with Tetraplegia and Comparable to that in Mild Asthmatics. Lung 188, 259–262 (2010). https://doi.org/10.1007/s00408-009-9207-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-009-9207-x

Keywords

Search

Navigation