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Vol. 45. Issue 3.
Pages 143-147 (March 2009)
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Vol. 45. Issue 3.
Pages 143-147 (March 2009)
Techniques and procedures
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Determining the Alveolar Component of Nitric Oxide in Exhaled Air: Procedures and Reference Values for Healthy Persons
Determinación de la concentración de óxido nítrico alveolar en aire espirado: procedimiento y valores de referencia en personas sanas
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Ana María Fortuna
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afortuna@santpau.cat

Corresponding author.
, Marco Balleza, Núria Calaf, Mercedes González, Teresa Feixas, Pere Casan
Unidad de Función Pulmonar, Departamento de Neumología, Hospital de la Santa Creu i Sant Pau, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
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Abstract

Nitric oxide (NO) production has been described using a 2-compartment model for the synthesis and movement of NO in both the alveoli and the airways. The alveolar concentration of NO (CaNO), an indirect marker of the inflammatory state of the distal portions of the lung, can be deduced through exhalation at multiple flow rates. Our objective was to determine reference values for CaNO. The fraction of exhaled NO (FeNO) was measured in 33 healthy individuals at a rate of 50 mL/s; the subjects then exhaled at 10, 30, 100, and 200mL/s to calculate CaNO. A chemiluminescence analyzer (NIOX Aerocrine) was used to perform the measurements. The mean (SD) FeNO was 15 (6) ppb. The mean CaNO was 3.04 (1.30) ppb. These values of CaNO measured in healthy individuals will allow us to analyze alveolar inflammatory behavior in respiratory and systemic processes.

Keywords:
Fraction of exhaled nitric oxide
Alveolar concentration of nitric oxide
Two-compartment model
Multiple flow rates exhalation
Resumen

La producción de óxido nítrico (NO) se describe mediante un modelo bicompartimental que relaciona la producción y la movilidad de NO desde los alvéolos hacia las vías aéreas. La espiración a múltiples flujos permite deducir la concentración alveolar de NO (CaNO), marcador indirecto del estado inflamatorio de las zonas distales del pulmón. El objetivo fue determinar los valores de referencia de CaNO. En 33 individuos sanos se determinaron la concentración espirada de NO (FeNO) a 50ml/s y la CaNO a 10, 30, 100 y 200ml/s mediante un sensor de quimioluminiscencia (NIOX Aerocrine). El valor medio (± desviación estándar) de FeNO fue de 15±6ppb y de CaNO fue de 3,04±1,30ppb. Los valores de CaNO obtenidos en individuos sanos permitirán analizar el comportamiento inflamatorio alveolar en procesos respiratorios y sistémicos.

Palabras clave:
Óxido nítrico en aire espirado
Concentración alveolar de óxido nítrico
Modelo bicompartimental
Espiración a múltiples flujos
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References
[1.]
Q. Hamid, D.R. Springall, V. Riveros-Moreno, P. Chanez, P. Howarth, A. Redington, et al.
Induction of nitric oxide synthase in asthma.
Lancet, 342 (1993), pp. 1510-1513
[2.]
Kharitonov, D. Yates, R.A. Robbins, R. Logan-Sinclair, E.A. Shinebourne, P.J. Barnes.
Increased nitric oxide in exhaled air of asthmatic patients.
Lancet, 343 (1994), pp. 133-135
[3.]
A.D. Smith, J.O. Cowan, S. Filsell, C. McLachlan, G. Monti-Sheehan, P. Jackson, et al.
Comparisons between exhaled nitric oxide measurements and conventional tests.
Am J Respir Crit Care Med, 169 (2004), pp. 473-478
[4.]
J.C. de Jongste.
Yes to NO: the first studies on exhaled nitric oxide-driven asthma treatment.
Eur Respir J, 26 (2005), pp. 379-381
[5.]
A.P. Pietropaoli, I.B. Perillo, A. Torres, P.T. Perkins, L.M. Frasier, M.J. Utell, et al.
Simultaneous measurement of nitric oxide production by conducting and alveolar airways of humans.
J Appl Physiol, 87 (1999), pp. 1532-1542
[6.]
N.M. Tsoukias, S.C. George.
A two-compartment model of pulmonary nitric oxide exchange dynamics.
J Appl Physiol, 85 (1998), pp. 653-666
[7.]
P.E. Silkoff, J.T. Sylvester, N. Zamel, S. Permutt.
Airway nitric oxide diffusion in asthma. Role in pulmonary function and bronchial responsiveness.
Am J Respir Crit Care Med, 161 (2000), pp. 1218-1228
[8.]
American Thoracic Society.
Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide.
Am J Respir Crit Care Med, 171 (2005), pp. 912-930
[9.]
S.C. George, M. Hogman, S. Permutt, P.E. Silkoff.
Modeling pulmonary nitric oxide exchange.
J Appl Physiol, 96 (2004), pp. 831-839
[10.]
R.A. Dweik, D. Laskowski, H.M. Abu-Soud, F. Kaneko, R. Hutte, D.J. Stuehr, et al.
Nitric oxide synthesis in the lung: regulation by oxygen through a kinetic mechanism.
J Clin Invest, 101 (1998), pp. 660-666
[11.]
L. Lehtimäki, H. Kankaanranta, S. Saarelainen, P. Hahtola, R. Järvenpää, T. Koivula, et al.
Extended exhaled NO measurement differentiates between alveolar and bronchial inflammation.
Am J Respir Crit Care Med, 163 (2001), pp. 1557-1561
[12.]
H.W. Shin, C.M. Rose-Gottron, F. Pérez, D.M. Cooper, A.F. Wilson, S.C. George.
Flow-independent nitric oxide exchange parameters in healthy adults.
J Appl Physiol, 91 (2001), pp. 2173-2181
[13.]
C. Brindicci, K. Ito, O. Resta, N.B. Pride, P.J. Barnes, S.A. Kharitonov.
Exhaled nitric oxide from lung periphery is increased in COPDC.
Eur Respir J, 26 (2005), pp. 52-59
[14.]
A. Malinovschi, C. Janson, T. Holmkvist, D. Norbäck, P. Meriläinene, M. Högman.
Effect of smoking on exhaled nitric oxide and flow independent nitric oxide exchange parameters.
Eur Respir J, 28 (2006), pp. 339-345
[15.]
M. Berry, B. Hargadon, A. Morgan, M. Shelley, J. Richter, D. Shaw, et al.
Alveolar nitric oxide in adults with asthma: evidence of distal lung inflammation in refractory asthma.
Eur Respir J, 25 (2005), pp. 986-991
[16.]
M. Malerba, A. Radaeli, B. Ragnoli, P. Airo, M. Corradi, A. Ponticiello, et al.
Exhaled nitric oxide levels in systemic sclerosis with and without pulmonary involvement.
Chest, 132 (2007), pp. 575-580
[17.]
C. Brindicci, I. Kazuhiro, P.J. Barnes, S.A. Kharitonov.
Differential flow analysis of exhaled nitric oxide in patients with asthma of differing severity.
Chest, 131 (2007), pp. 1353-1362
[18.]
I.H. van Veen, P.J. Sterk, R. Schot, S.A. Gauw, K.F. Rabe, E.H. Bel.
Alveolar nitric oxide versus measures of peripheral airway dysfunction in severe asthma.
Eur Respir J, 27 (2006), pp. 951-956
[19.]
R.M. Wever, T. van Dam, H.J. van Rijn, F. de Groot, T.J. Rabelink.
Tetrahydrobiopterin regulates superoxide and nitric oxide generation by recombinant, endothelial nitric oxide synthase.
Biochem Biophys Res Commun, 237 (1997), pp. 340-344
[20.]
M.J. Therriault, L.I. Proulx, A. Castonguay, E.Y. Bissonnette.
Immunomodulatory effects of the tobacco-specific carcinogen, NNK, on alveolar macrophages.
Clin Exp Immunol, 132 (2003), pp. 232-238
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