November 8, 2013

The fractional exhaled nitric oxide and serum high sensitivity C-reactive protein levels in cough variant asthma and typical bronchial asthma

Abstract
 ORIGINAL ARTICLE
The Fractional Exhaled Nitric Oxide and Serum High Sensitivity C-Reactive Protein Levels in Cough Variant Asthma and Typical Bronchial Asthma

doi:10.2332/allergolint.12-OA-0515

Terufumi Shimoda, Yasushi Obase, Reiko Kishikawa, Tomoaki Iwanaga, Akihiko Miyatake and Soji Kasayama [About this authors]
ABSTRACT
Background: Fractional exhaled nitric oxide (FeNO) is known to be a good marker of airway eosinophilic inflammation in bronchial asthma. Recently, serum high sensitivity C-reactive protein (hs-CRP) has been shown to be also useful to detect the airway inflammation.
Methods: Newly diagnosed 90 cough variant asthma and 92 bronchial asthma patients were enrolled. FeNO, serum hs-CRP, pulmonary function tests, bronchial hyperresponsiveness, IgE and sputum eosinophils ratio were compared. Ninety healthy control subjects were set for FeNO and serum hs-CRP normal range reference. We have compared the clinical utilities of FeNO and serum hs-CRP to differentiate bronchial asthma and cough variant asthma.
Results: FeNO was significantly higher in bronchial asthma (92.6 ± 85.5 ppb) than in cough variant asthma (35.6 ± 43.3; p - 0.001) and both were significantly higher than normal range (18.0 ± 6.4, p - 0.001, respectively), and in differentiating between the two groups showed a sensitivity of 0.69 and a specificity of 0.73 at the cutoff value of 28 ppb. Serum hs-CRP did not differ significantly between bronchial asthma (723 ± 1162 ng/ml) and cough variant asthma (558 ± 758) even if both were significantly higher than normal range (345 ± 401, p - 0.01 and p < 0.05 respectively).
Conclusions: FeNO is more useful than serum hs-CRP in differentiating patients with bronchial asthma from those with cough variant asthma, and healthy persons.

KEY WORDS:
airway inflammation, bronchial asthma, cough variant asthma, fractional exhaled nitric oxide, high sensitivity CRP
Received: 5 November 2012.
Accepted: 15 January 2013.
Allergology International 2013; 2: 251-257

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