Introduction: Asthmatics can experience recurrent exacerbations (AEs), irrespectively of asthma severity. Airway inflammatory monitoring could be fundamental to optimize the asthma management. The present study evaluated whether exhaled NO concentrations in proximal and distal respiratory compartments are different in AE-prone patients in combination with T2 blood biomarkers and resting oxygen saturation (SpO₂). Methods: In this observational cross-sectional study, 91 mild-to-severe asthmatics were enrolled. Clinical characteristics, blood and lung function parameters including SpO₂, and F_ENO were evaluated. On 50 randomly selected patients, C_ANO and J_awNO were also analyzed. Then, patients were stratified in frequent exacerbators (FEs) or non-frequent exacerbators (nFEs), according to AE frequency in the previous year (phase I). Chart data were re-evaluated through a 12-month follow-up period post exhaled NO measurement to detect occurrence of novel AE (phase II). Results: FE asthmatics had poorer asthma control and required higher therapeutic intensity (p #x3c; 0.05). F_ENO, C_ANO, and J_awNO were similar between FE and nFE. FE exhibited higher total serum IgE levels and residual volume values but reduced SpO₂ than nFE (p #x3c; 0.05); SpO₂#x3c;96.5% characterized the FE patient (odds ratio = 2.94). In phase II, C_ANO was higher in the group with novel AE at 1-month post-NO measurement (p #x3c; 0.05), but not afterward. A higher prevalence of C_ANO #x3e;6 ppb was detected in asthmatics who developed AE within 1 month, suggesting its potential clinical use as biomarker in predicting near-future AE (RR = 11.20). Conclusion: AE-susceptible asthmatics are characterized by air trapping and distal airway inflammation in conjunction with lower oxygen saturation. C_ANO and SpO₂ could exert specific roles, respectively, in predicting AE and monitoring FE asthmatics.
Int Arch Allergy Immunol

中文翻译：

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哮喘频繁加重者的肺泡一氧化氮和外周氧饱和度：一项初步研究

简介：无论哮喘严重程度如何，哮喘患者都会经历反复发作 (AE)。气道炎症监测可能是优化哮喘管理的基础。本研究结合 T2 血液生物标志物和静息血氧饱和度 (SpO ₂ ) 评估了 AE 倾向患者近端和远端呼吸室呼出的 NO 浓度是否不同。方法：在这项观察性横断面研究中，招募了 91 名轻度至重度哮喘患者。评估临床特征、血液和肺功能参数，包括 SpO ₂和 F _E NO。在 50 名随机选择的患者中，C _A NO 和 J _awNO也进行了分析。然后，根据前一年的 AE 频率（I 期），将患者分为频繁加重（FE）或非频繁加重（nFE）。图表数据通过 12 个月的随访期在呼出的 NO 测量后重新评估，以检测新 AE 的发生（II 期）。结果：FE哮喘患者的哮喘控制较差，需要较高的治疗强度（p #x3c；0.05）。FE 和 nFE 之间_的F _E NO、C _A NO和 Jaw NO 相似。FE 表现出更高的总血清 IgE 水平和残余体积值，但SpO ₂低于 nFE（p #x3c；0.05）；血氧饱和度₂#x3c;96.5% 表征了 FE 患者（优势比 = 2.94）。在第二阶段，在 NO 测量后 1 个月，新 AE 组的 C _A NO 较高（p #x3c；0.05），但之后没有。在 1 个月内发生 AE 的哮喘患者中检测到更高的 C _A NO #x3e;6 ppb 患病率，表明其作为预测近期 AE 的生物标志物具有潜在的临床用途 (RR = 11.20)。结论： AE 易感哮喘患者的特征是空气滞留和远端气道炎症以及低氧饱和度。C _A NO 和 SpO ₂可分别在预测 AE 和监测 FE 哮喘患者中发挥特定作用。
Int Arch 过敏免疫