Chest
Volume 124, Issue 2, August 2003, Pages 633-638
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Clinical Investigations
NITRIC OXIDE
Nitric Oxide Metabolites Are Not Reduced in Exhaled Breath Condensate of Patients With Primary Ciliary Dyskinesia*

https://doi.org/10.1378/chest.124.2.633Get rights and content

Study objectives

To investigate whether nitric oxide (NO) metabolites would be reduced in children affected by primary ciliary dyskinesia (PCD).

Design

Single-center observational study.

Patients

Fifteen children with PCD (seven boys; mean [± SEM] age, 10.3 ± 0.7 years; mean FEV1, 73 ± 2.1% predicted) were recruited along with 14 healthy age-matched subjects (seven boys; mean age, 11.5 ± 0.4 years; mean FEV1, 103 ± 5% predicted).

Interventions

We assessed the levels of nitrite (NO2), NO2/NO3 (NO2/NO3), and S-nitrosothiol in exhaled breath condensate, exhaled NO, and nasal NO from children with PCD compared to those in healthy children.

Measurements and results

The mean exhaled and nasal NO levels were markedly decreased in children with PCD compared to those without PCD (3.2 ± 0.2 vs 8.5 ± 0.9 parts per billion [ppb], respectively [p < 0.0001]; 59.6 ± 12.2 vs 505.5 ± 66.8 ppb, respectively [p < 0.001]). Despite the lower levels of exhaled NO in children with PCD, no differences were found in the mean levels of NO2 (2.9 ± 0.4 vs 3.5 ± 0.3 μM, respectively), NO2/NO3 (35.2 ± 5.0 vs 34.3 ± 4.5 μM, respectively), or S-nitrosothiol (1.0 ± 0.2 vs 0.6 ± 0.1 μM, respectively) between children with PCD and healthy subjects.

Conclusion

These findings suggest that NO synthase activity may not be decreased as much as might be expected on the basis of low exhaled and nasal NO levels.

Section snippets

Patients

Patients were recruited from the pediatric PCD Clinic at the Royal Brompton Hospital. PCD was diagnosed by nasal brushing with an estimation of CBF and the determination of ultrastructural defects using electron microscopy. We studied 15 patients with PCD (seven boys; mean [± SEM] age, 10.3 ± 0.7 years; age range, 7 to 14 years) who had a mean FEV1 of 73 ± 2.1% of predicted. Eight patients were receiving therapy with inhaled corticosteroids. The age-matched control group consisted of 14 healthy

Lower and Upper Airway NO

The mean exhaled NO levels were significantly decreased in PCD patients compared to those in healthy subjects (3.2 ± 0.2 vs 8.4 ± 0.9 parts per billion [ppb], respectively; p < 0.0001) [Fig 1]. There was no significant difference between the steroid-naive and steroid-treated groups (3.4 ± 0.3 vs 3.0 ± 0.3 ppb, respectively). There was no correlation between exhaled NO and FEV1, NO2, NO2/NO3 and S-nitrosothiol levels in exhaled breath condensate. Upper airway NO levels also were found to be

Discussion

This study was designed to investigate whether the levels of NO metabolites, such as NO2, NO2/NO3, and S-nitrosothiol, in exhaled breath condensate were reduced in PCD patients, as might be expected from the lower levels of exhaled and nasal NO that have been described previously.12 Surprisingly, no differences were found in the levels of exhaled NO2, NO2/NO3, or exhaled S-nitrosothiol between patients with PCD and healthy subjects. There was a trend toward decreased exhaled NO2 levels

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    This study was supported by the European and Hungarian Respiratory Society, the Hungarian Immunology and Allergology Society (Hungary), and the National Heart and Lung Institute (UK).

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