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Exhaled nitric oxide in bronchiectasis: the effects of inhaled corticosteroid therapy

Authors: Tsang, K. W.1; Tan, K. C.1; Ho, P. L.2; Ooi, G. C.3; Khong, P-L.3; Leung, R.1; Mak, J. C.1; Tipoe, G. L.4; Ko, C.1; Lam, W. K.1

Source: The International Journal of Tuberculosis and Lung Disease, Volume 8, Number 11, November 2004 , pp. 1301-1307(7)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

SETTING: While exhaled nitric oxide (eNO) levels are reduced by inhaled corticosteroid therapy in asthma, such treatment effect is unclear in bronchiectasis.

DESIGN: Stable non-smoking bronchiectasis patients were randomised to receive either fluticasone (1 mg/daily) or identical placebo via the Accuhaler device.

RESULTS: Sixty non-smoking patients (38 women; mean age 56.4 ± 12.7 years) were recruited. Of these, half received inhaled fluticasone and half placebo therapy. eNO was measured using a chemiluminescence analyser at 0, 4, 12, 24, 36 and 52 weeks. There was no significant difference in eNO levels between fluticasone and placebo patients over the study period. There was no correlation between baseline eNO with age, FEV1, FVC, 24 h sputum volume or number of bronchiectatic segments. Patients with Pseudomonas aeruginosa (PA) infection, but not their counterparts, displayed a correlation between 0- and 52-week eNO levels. PA infection was associated with significantly lower eNO levels among the patients.

CONCLUSIONS: Inhaled fluticasone therapy, despite being an effective anti-inflammatory agent, has no significant effect on eNO production, either at individual time points or over the entire 52-week profile, in bronchiectasis. It appears that eNO might not reflect the extent of airway inflammation in bronchiectasis.

Keywords: Pseudomonas aeruginosa; bronchiectasis; inhaled corticosteroid therapy; nitric oxide

Document Type: Regular Paper

Affiliations: 1: University Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China 2: Department of Microbiology, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China 3: Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China 4: Department of Anatomy, University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China

Publication date: November 1, 2004

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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