Clinical significance of fractional exhaled nitric oxide measurement and thymic stromal lymphopoietin in patients with asthma

doi:10.3877/cma.j.issn.1674-0785.2020.04.003

Abstract

Abstract:

Objective

To investigate the correlation of fractional exhaled nitric oxide measurement (FeNO) and thymic stromal lymphopoietin (TSLP) with cough variant asthma (CVA) to reveal their possible role in the pathophysiology of CVA.

Methods

From July 2016 to December 2018, 67 CVA patients and 8 eosinophilic bronchitis (EB) patients were collected at the Department of Respiratory Medicine of Baotou Central Hospital. Fourteen healthy subjects were also included as a control group. The contents of FeNO and serum TSLP were determined in all subjects. One-way ANOVA was used to compare the differences of the above data among the three groups, and LSD-t test was used for pairwise comparison between different groups. Pearson correlation was used to analyze the correlation between FeNO and TSLP in the CVA group. Factors influencing FeNO levels in the CVA group were analyzed by multiple linear regression, and variables (α_in=0.10, α_out=0.15) were screened by stepwise method to include appropriate variables.

Results

There were statistically significant differences in FeNO levels among CVA patients, EB patients, and healthy controls (F=7.344, P=0.001). FeNO levels in CVA patients and EB patients were significantly higher than that in healthy controls [(60.88±42.85)×10^-9 mol/L vs (17.64±4.91)×10^-9 mol/L; t=4.35, P<0.001; (66.50±42.35)×10^-9 mol/L vs (17.64±4.91)×10^-9 mol/L; t=2.71, P=0.008]; however, there was no difference between CVA and EB patients (P>0.05). TSLP level was significantly higher in the CVA group than in the EB group [(421.60±111.65) ng/L vs (338.81±119.98) ng/L, t=4.11, P<0.001], in the EB group than in the control group [(338.81±119.98) ng/L vs (233.34±51.39) ng/L, t=7.36, P<0.001], and in the CVA group than in the healthy control group (t=5.88, P<0.001). There was no significant difference in serum total IgE concentration among the CVA, EB, and control groups (P>0.05). CVA group FeNo was positively correlated with serm TSPL in the CVA group (r=0.258, P=0.035). There was a positive correlation between TSPL, height, and FeNO level.

Conclusion

Both FeNO and serum TSLP levels are associated with airway inflammation. Single FeNO assay may not be used as a standard method for distinguishing CVA and EB. Serum TSLP level is involved in the occurrence and development of airway inflammation, which is helpful for the diagnosis and differential diagnosis of CVA and EB in patients with chronic cough.

Key words: Asthma, cough variability, Fractional exhaled nitric oxide, Thymic stromal lymphopoietin

Xiaoli Hu, Yong Yang, Yuan Wang, Jianhua Guo, Xiaoyue Chang. Clinical significance of fractional exhaled nitric oxide measurement and thymic stromal lymphopoietin in patients with asthma[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(04): 250-254.

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References 20

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组别	例数	年龄（岁，±s）	男/女（例）	身高（cm，±s）	体质量（kg，±s）	FEV₁%pred（±s）	FEV₁/FVC（±s）	MEF₅₀（±s）	MEF₇₅（±s）	MEF_25-75（±s）
CVA组	67	41.54±15.68	31/36	163.78±6.90^a	65.83±9.29	95.08±13.47^a	79.59±9.22	76.73±27.43	80.82±24.00	73.65±27.09
EB组	8	38.63±15.90	4/4	166.25±10.50^a	64.25±11.00	96.46±14.08^a	78.37±10.45	76.73±29.63	85.65±30.73	73.55±30.18
健康对照组	14	40.93±9.43	2/12	157.29±4.94	63.43±8.96	111.08±10.93	85.25±4.91	93.85±6.22	94.03±9.87	89.69±7.70
统计值	?	F=0.138	χ²=5.134	F=5.913	F=0.434	F=8.589	F=2.611	F=2.640	F=1.935	F=2.352
P值	?	0.871	0.077	0.004	0.650	<0.001	0.079	0.077	0.151	0.101

组别	例数	年龄（岁，±s）	男/女（例）	身高（cm，±s）	体质量（kg，±s）	FEV₁%pred（±s）	FEV₁/FVC（±s）	MEF₅₀（±s）	MEF₇₅（±s）	MEF_25-75（±s）
CVA组	67	41.54±15.68	31/36	163.78±6.90^a	65.83±9.29	95.08±13.47^a	79.59±9.22	76.73±27.43	80.82±24.00	73.65±27.09
EB组	8	38.63±15.90	4/4	166.25±10.50^a	64.25±11.00	96.46±14.08^a	78.37±10.45	76.73±29.63	85.65±30.73	73.55±30.18
健康对照组	14	40.93±9.43	2/12	157.29±4.94	63.43±8.96	111.08±10.93	85.25±4.91	93.85±6.22	94.03±9.87	89.69±7.70
统计值	?	F=0.138	χ²=5.134	F=5.913	F=0.434	F=8.589	F=2.611	F=2.640	F=1.935	F=2.352
P值	?	0.871	0.077	0.004	0.650	<0.001	0.079	0.077	0.151	0.101

组别	例数	FeNO（×10^-9mol/L）	TSLP（ng/L）	IgE（ng/ml）
CVA组	67	60.88±42.85^a	421.60±111.65^a	234.01±275.04
EB组	8	66.50±42.35^b	338.81±119.98^b	156.28±94.85
健康对照组	14	17.64±4.91	233.34±51.39	114.13±61.20
F值	?	7.344	19.250	1.601
P值	?	0.001	<0.001	0.208

组别	例数	FeNO（×10^-9mol/L）	TSLP（ng/L）	IgE（ng/ml）
CVA组	67	60.88±42.85^a	421.60±111.65^a	234.01±275.04
EB组	8	66.50±42.35^b	338.81±119.98^b	156.28±94.85
健康对照组	14	17.64±4.91	233.34±51.39	114.13±61.20
F值	?	7.344	19.250	1.601
P值	?	0.001	<0.001	0.208

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[3]	Yunxi Fan, Jingxi Zhang, Chong Bai. Clinical diagnostic characteristics and misdiagnosis analysis of bronchial asthma with atypical chief complaints [J]. Chinese Journal of Diagnostics(Electronic Edition), 2018, 06(01): 29-36.

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