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Year : 2017  |  Volume : 12  |  Issue : 1  |  Page : 1-7

Fractional exhaled nitric oxide along with a reduced force expiratory volume are conclusive prognostic biomarkers to alert for asthma exacerbation

1 Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Al Qunfudhah, Makkah, Saudi Arabia
2 Department of Physiology, Faculty of Medicine, Al-Neelain University, Khartoum, Sudan
3 Biotechnology Park, Africa City of Technology, Khartoum, Sudan

Correspondence Address:
Mohamed Abdelrahman Mohamed Iesa
Department of Physiology, Faculty of Medicine, Umm Al-Qura University, P. O. Box: 203, Al Qunfudhah, Makkah 21912
Saudi Arabia
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DOI: 10.4103/summ.summ_13_17

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Background: Asthma is a multidimensional disease with noticeable heterogeneity in its presentation and reaction to treatment. Noninvasive biomarkers to determine disease progression are highly desirable. This study sought to identify fractional exhaled nitric oxide (FeNO), FeNO as a prognostic biomarker for asthma exacerbations, as well as a predictive biomarker for change in other known asthma indicators. Materials and Methods: A prospective, longitudinal study was conducted with a cohort of adult patients with severe asthma who required daily treatment with inhaled corticosteroids. Patients underwent lung function testing using spirometry, sputum samples were taken for inflammatory cell count, and sputum supernatant and exhaled respiration were taken for FeNO, FeNO measurement. Forced expiratory volume levels were measured, along with immunoglobulin E (IgE), eosinophil count, asthma-specific health-related quality of life, asthma-exact signs scores, and time to treatment failure. These indicators were measured over the 22-week study period. Results: A total of 1800 participants were recruited, 56.7% were female, and 70% of the participants were aged 18–27 years. FeNO was valuable prognostic biomarker for asthma exacerbations, along with forced expiratory volume in 1 s reduction. A greater quantity of eosinophils was correlated with a reduced risk of exacerbation in females, with no correlation in males. Elevated serum IgE levels were correlated with an increased risk of lung fibrosis. We found no significant relationships between the investigated indicators and hospitalization. Conclusion: FeNO, in conjunction with other biomarkers, is a useful prognostic indicator of exacerbations of symptoms in asthma patients.

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