Idiopathic pulmonary fibrosis (IPF) and sarcoidosis have an unknown etiology and require, periodic monitoring due to the insidious, unpredictable, and irreversible nature of disease progression. Exhaled nitric oxide (NO) has been used as a non-invasive marker of monitoring airway inflammation in patients with asthma and may have utility in monitoring airway inflammation in patients with IPF and sarcoidosis.
The purpose of this pilot study was to explore the utility of exhaled NO in monitoring disease progression and response to therapy in patients with IPF and sarcoidosis. Individuals with IPF (n=15) and sarcoidosis (n=43), and healthy non-smokers (n=20) underwent single breath end-tidal NO (FeNO) measurement at 7 flow-rates (50, 100, 150, 200, 250, 300, & 400 ml/s) using a chemiluminescence analyzer (LR1800; Logan Research, UK) following ATS/ERS guidelines (2005). Alveolar NO concentration (CAlvNO) and airway NO flux (JAWNO) were estimated using the model by Tsoukias, et al. (1998). In individuals with active sarcoidosis, follow-up measurements were performed after being on treatment
The findings in patients with IPF were: 1) FeNO was not significantly different from that of controls for the 7 flow rates; 2) while there was no significant difference in JAWNO compared with controls, CAlvNO was significantly higher, and 3) CAlvNO showed significant negative correlations with FEV1% and FVC%. In patients with sarcoidosis,: 1) FeNO at a flow rate of 50 ml/sec was lower than that of controls with marginal statistical significance (p=.05); 2) JAWNO , was significantly lower in patients with sarcoidosis compared to controls; there was no significant difference in CAlvNO; 3) CAlvNO showed significant negative correlations with FVC% and DLCO%. The subset of patients with active sarcoidosis (n=8) had significantly lower CAlvNO compared with those with inactive sarcoidosis (n=35), but no significant difference in FeNO and JAWNO. In six patients with active sarcoidosis who completed follow-up at various intervals, exhaled NO (FeNO, CAlvNO and JAWNO) did not change significantly as a result of treatment. Due to a large inter-subject variability in FeNO, confounding from medications used to manage this disease and variable concentrations of ambient NO, exhaled NO does not appear to be effective in detecting changes in airway inflammation in this population.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-05152008-100429 |
| Date | 16 May 2008 |
| Creators | Choi, JiYeon |
| Contributors | Thomas Zullo, PhD, Jigme M. Sethi, MD, Richard Henker, PhD, RN, CRNA, Leslie A. Hoffman, PhD, RN, FAAN, Kevin F. Gibson, MD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-05152008-100429/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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