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Exhaled Nitric Oxide in Patients with Interstitial Lung Disease: A Pilot Study

Choi, JiYeon (2008) Exhaled Nitric Oxide in Patients with Interstitial Lung Disease: A Pilot Study. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Idiopathic pulmonary fibrosis (IPF) and sarcoidosis have an unknown etiology and require, periodic monitoring due to the insidious, unpredictable, and irreversible nature of disease progression. Exhaled nitric oxide (NO) has been used as a non-invasive marker of monitoring airway inflammation in patients with asthma and may have utility in monitoring airway inflammation in patients with IPF and sarcoidosis.The purpose of this pilot study was to explore the utility of exhaled NO in monitoring disease progression and response to therapy in patients with IPF and sarcoidosis. Individuals with IPF (n=15) and sarcoidosis (n=43), and healthy non-smokers (n=20) underwent single breath end-tidal NO (FeNO) measurement at 7 flow-rates (50, 100, 150, 200, 250, 300, & 400 ml/s) using a chemiluminescence analyzer (LR1800; Logan Research, UK) following ATS/ERS guidelines (2005). Alveolar NO concentration (CAlvNO) and airway NO flux (JAWNO) were estimated using the model by Tsoukias, et al. (1998). In individuals with active sarcoidosis, follow-up measurements were performed after being on treatmentThe findings in patients with IPF were: 1) FeNO was not significantly different from that of controls for the 7 flow rates; 2) while there was no significant difference in JAWNO compared with controls, CAlvNO was significantly higher, and 3) CAlvNO showed significant negative correlations with FEV1% and FVC%. In patients with sarcoidosis,: 1) FeNO at a flow rate of 50 ml/sec was lower than that of controls with marginal statistical significance (p=.05); 2) JAWNO , was significantly lower in patients with sarcoidosis compared to controls; there was no significant difference in CAlvNO; 3) CAlvNO showed significant negative correlations with FVC% and DLCO%. The subset of patients with active sarcoidosis (n=8) had significantly lower CAlvNO compared with those with inactive sarcoidosis (n=35), but no significant difference in FeNO and JAWNO. In six patients with active sarcoidosis who completed follow-up at various intervals, exhaled NO (FeNO, CAlvNO and JAWNO) did not change significantly as a result of treatment. Due to a large inter-subject variability in FeNO, confounding from medications used to manage this disease and variable concentrations of ambient NO, exhaled NO does not appear to be effective in detecting changes in airway inflammation in this population.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Choi, JiYeonjic11@pitt.eduJIC11
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHoffman, Leslie Alhof@pitt.eduLHOF
Committee MemberSethi, Jigme
Committee MemberGibson, Kevin
Committee MemberHenker, Richardrhe001@pitt.eduRHE001
Committee MemberZullo, Thomaszullo@pitt.eduZULLO
Date: 16 May 2008
Date Type: Completion
Defense Date: 18 April 2008
Approval Date: 16 May 2008
Submission Date: 15 May 2008
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: exhaled gas; exhaled nitric oxide; idiopathic pulmonary fibrosis; interstitial lung disease; sarcoidosis
Other ID:, etd-05152008-100429
Date Deposited: 10 Nov 2011 19:44
Last Modified: 15 Nov 2016 13:43


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