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Inflammatory Markers, Spirometry, and Acoustic Rhinometry Measurements in Allergic Rhinitis Patients With or Without Airway Hyperresponsiveness
October 2012, Vol 142, No. 4_MeetingAbstracts
Obstructive Lung Diseases | October 2012
Inflammatory Markers, Spirometry, and Acoustic Rhinometry Measurements in Allergic Rhinitis Patients With or Without Airway Hyperresponsiveness Xiaofang Liu*, MMed; Yongchang Sun, DMD; Luo Zhang, DMD Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China Chest. 2012;142(4_MeetingAbstracts):703A. doi:10.1378/chest.1380694
Abstract SESSION TYPE: Asthma Posters PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM PURPOSE: Allergic rhinitis (AR) and asthma represent a continuum of atopic diseases. Some patients with AR and no clinical evidence of asthma suffered airway hyperresponsiveness (AHR), and may facilitate development of asthma. However, some difficulties existed for EarsNose-Throat (ENT) specialists to select appropriate clinical items for screening AHR cases from AR patients without asthma. Our objective was to explore sputum and nasal inflammatory markers, spirometric and acoustic rhinometric measurements for identification of AHR in patients with persistent allergic rhinitis (PER). METHODS: Fifty-six patients suffered PER without asthma were selected and evaluated by asthma symptom questionnaire and physical examinations. Then all received nasal and induced sputum eosinophil count, nasal and exhaled nitric oxide measurements, acoustic rhinometry, spirometry and methacholine challenge. The patients were categorized into AHR and non-AHR groups, and statistical analyses were done by SPSS. RESULTS: Eighteen (8 males and 10 females) PER patients were confirmed with AHR and 38 (21 males and 17 females) without AHR by methacholine challenge. A higher percentage of the patients with AHR had nasal eosinophilia (1+~4+) and induced sputum eosinophilia (>3%) as compared to those without AHR [72.2% vs. 39.5% and 66.7% vs. 31.6%]. The levels of nasal nitric oxide (1165.8 vs. 1043.7 ppb) and exhaled NO (FENO, 29.5 vs. 22.2 ppb) were significantly higher and closely associated in AHR patients. No significant difference in FEV1% presented between AHR and non-AHR groups, while significantly lower FEF25-75 (70.0% vs. 84.4%) was found in AHR group. Nasal volume and area reversibility to a-agonist were greater in AHR patients. CONCLUSIONS: Nasal and induced sputum eosinophilia and higher levels of nasal nitric oxide and FENO indicated AHR occurrence. Increases in reversibility to a-agonist in both nasal volume and nasal area of PER patients showed the presence of AHR. Moreover, FEF25-75 was useful for identifying AHR in PER patients. CLINICAL IMPLICATIONS: In summary, the measurements aforementioned may be helpful to identify AHR and early diagnosis of asthma in PER patients.
DISCLOSURE: The following authors have nothing to disclose: Xiaofang Liu, Yongchang Sun, Luo Zhang No Product/Research Disclosure Information Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
Obstructive Lung Diseases | October 2012
Inflammatory Markers, Spirometry, and Acoustic Rhinometry Measurements in Allergic Rhinitis Patients With or Without Airway Hyperresponsiveness Xiaofang Liu*, MMed; Yongchang Sun, DMD; Luo Zhang, DMD Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China Chest. 2012;142(4_MeetingAbstracts):703A. doi:10.1378/chest.1380694
Abstract SESSION TYPE: Asthma Posters PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM PURPOSE: Allergic rhinitis (AR) and asthma represent a continuum of atopic diseases. Some patients with AR and no clinical evidence of asthma suffered airway hyperresponsiveness (AHR), and may facilitate development of asthma. However, some difficulties existed for EarsNose-Throat (ENT) specialists to select appropriate clinical items for screening AHR cases from AR patients without asthma. Our objective was to explore sputum and nasal inflammatory markers, spirometric and acoustic rhinometric measurements for identification of AHR in patients with persistent allergic rhinitis (PER). METHODS: Fifty-six patients suffered PER without asthma were selected and evaluated by asthma symptom questionnaire and physical examinations. Then all received nasal and induced sputum eosinophil count, nasal and exhaled nitric oxide measurements, acoustic rhinometry, spirometry and methacholine challenge. The patients were categorized into AHR and non-AHR groups, and statistical analyses were done by SPSS. RESULTS: Eighteen (8 males and 10 females) PER patients were confirmed with AHR and 38 (21 males and 17 females) without AHR by methacholine challenge. A higher percentage of the patients with AHR had nasal eosinophilia (1+~4+) and induced sputum eosinophilia (>3%) as compared to those without AHR [72.2% vs. 39.5% and 66.7% vs. 31.6%]. The levels of nasal nitric oxide (1165.8 vs. 1043.7 ppb) and exhaled NO (FENO, 29.5 vs. 22.2 ppb) were significantly higher and closely associated in AHR patients. No significant difference in FEV1% presented between AHR and non-AHR groups, while significantly lower FEF25-75 (70.0% vs. 84.4%) was found in AHR group. Nasal volume and area reversibility to a-agonist were greater in AHR patients. CONCLUSIONS: Nasal and induced sputum eosinophilia and higher levels of nasal nitric oxide and FENO indicated AHR occurrence. Increases in reversibility to a-agonist in both nasal volume and nasal area of PER patients showed the presence of AHR. Moreover, FEF25-75 was useful for identifying AHR in PER patients. CLINICAL IMPLICATIONS: In summary, the measurements aforementioned may be helpful to identify AHR and early diagnosis of asthma in PER patients.
DISCLOSURE: The following authors have nothing to disclose: Xiaofang Liu, Yongchang Sun, Luo Zhang No Product/Research Disclosure Information Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China