Allergy and Airway: Asthma I |

FeNO Could Be an Effective Predictor for Lower Airway Eosinophilic Inflammation in Nonasthmatic Patients With Allergic Rhinitis, but Not in Patients With Non-Allergic Rhinitis FREE TO VIEW

Baojuan Liu, PhD; Yanqing Xie, PhD; KeFang Lai, PhD; Wei Luo, PhD
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Guangzhou Institute of Respiratory Disease, Guangzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A9. doi:10.1016/j.chest.2016.02.011
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Fractional exhaled nitric oxide (FeNO) is an noninvasive biomark of airway eosinophilic inflammation and well tolerant. Patients with allergic rhinitis (AR) who had eosinophilic inflammation in the lower airway might show elevated FeNO value. Whether FeNO can reflect the lower airway eosinophilic inflammation in patients with non-allergic rhinitis (NAR) or not remained unclear. Our study aims to investigate the significance of FeNO in detecting the eosinophilic inflammation in lower airway of nonasthmatic patients with NAR.

METHODS: A total of 90 NAR patients and 196 AR patients were included. Patients with other nasal or pulmonary diseases were strictly excluded. All patients went through series of tests, including FeNO, spirometry, skin prick test, induced sputum test. All patients with either AR or NAR would be divided into subgroups, according to FeNO value higher or lower than 25ppb.

RESULTS: The proportion of increased FeNO value in NAR and AR was 15.6% and 35.2%, respectively. The prevalence of sputum eosinophilia was significantly higher in increased FeNO group than that in normal FeNO group in AR (59.42% Vs 12.60%, P<0.01), but was similar between increased FeNO group than that in normal FeNO group in NAR (7.1% Vs 10.5%, P=0.754). FeNO value was positively related to sputum eosinophils in AR (r=0.376, P<0.01). Increase FeNO was closely related to sputum eosinophilia (r=0.503, P<0.01). FeNO value >25.5ppb was a cutoff value to identify eosinophilic inflammation in the airway with sensitivity of 73.2% and specificity of 80%, ROC=0.787. While FeNO value was irrelevant to sputum eosinophils in NAR (r=0.096, P=0.379).

CONCLUSIONS: FeNO can be an effective predictor for eosinophilic inflammation in lower airway of nonasthmatic patients with allergic rhinitis with a cutoff value of 25.5ppb. But FeNO value can not reflect the sputum eosinophilia in non-allergic rhinitis. Atopy status might be contributed to this inconsistency between AR and NAR. A further study with larger sample will be needed to confirm our result.

CLINICAL IMPLICATIONS: Our results indicated that normal FeNO value in NAR patients need a careful interpretation, as FeNO can not effectively reflect the lower airway inflammatory status in these patients.

DISCLOSURE: The following authors have nothing to disclose: Baojuan Liu, Yanqing Xie, KeFang Lai, Wei Luo

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