Evaluate the role of therapeutic intervention on endogenous markers of inflammation in asthma.
Spirometry and total exhaled nitric oxide at 100ml/s (FENO), bronchial NO flux and alveolar NO were measured using the technique of Tsoukias and George(JAP 2001;91:477=487). We studied 7 non-smoking, stable asthmatics (4M) age 60±23 yr (mean±SD) after 3 weeks of fluticasone 250ug(F)/salmeterol 50ug (S) bid, after 3 weeks of S, after 3 weeks of S plus monteleukast 10mg (M) daily, and after 3 weeks of FS plus M.
After 3 weeks of FS the FEV 1 was 2.2±0.7L (82±25%pred) and did not change with different regimens.After 3 weeks of FS the FENO was 38±15ppb (normal value:12±15ppb) and increased with S and S + M and unchanged with FS+M. Bronchial NO flux after 3 weeks of FS was 3.1±1.7 nl/s (normal value:0.85±0.55nl/s) and increased with S and S+M but unchanged with FS + M. Alveolar NO after 3 weeks of FS was 7.5±4.6ppb(normal value:3.2±2.0 ppb)and increased with S and S+M but reduced with FS +M.
Stable non-smoking asthmatics with mild to moderate reduction in FEV 1 despite being on FS have elevated FENO,bronchial NO flux and alveolar NO.The combination of FS + M reduced the alveolar NO.
Combination of FS + M may have an important role in reducing alveolar NO in clinically stable asthmatics.
A.F. Gelb, None.