Lower Airway Nitric Oxide is Increased in Children with Sickle Cell Disease - 08/12/11

Doi : 10.1016/j.jpeds.2011.06.048

Dhenuka K. Radhakrishnan, MD ^1,⁴, Glenda N. Bendiak, MD ¹, Dimas Mateos-Corral, MD ¹, Suhail Al-Saleh, MD ¹, Rakesh Bhattacharjee, MD ¹, Melanie Kirby-Allen, MD ², Hartmut Grasemann, MD ^1,^3,^⁎
¹ Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, and University of Toronto, Toronto, Ontario, Canada
² Division of Hematology and Oncology, Department of Pediatrics, The Hospital for Sick Children, and University of Toronto, Toronto, Ontario, Canada
³ Program in Physiology and Experimental Medicine, Research Institute, The Hospital for Sick Children, and University of Toronto, Toronto, Ontario, Canada
⁴ Children’s Hospital, London Health Sciences Centre, London, Ontario, Canada

Reprint requests: Hartmut Grasemann, MD, Associate Professor, Paediatrics, Hospital For Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.

Abstract

Objectives

To determine alveolar and airways nitric oxide (NO) levels in children with sickle cell disease (SCD).

Study design

Multiple flows fractional exhaled NO (FE_NO), bronchial NO flux (J’aw_NO), and alveolar NO concentration (Ca_NO) were determined prospectively in 16 non-atopic children with SCD in a tertiary ambulatory clinic and compared with those in 10 children with primary ciliary dyskinesia and 22 healthy control subjects. Differences in FE_NO, J’aw_NO, and Ca_NO were compared with mixed model analysis and Mann-Whitney tests.

Results

Children with SCD had reference range FE_NO at 50 mL/sec, but FE_NO was elevated across all flows compared with healthy control subjects (mean difference=2.10±0.91 parts per billion, P=.03). Subjects with SCD had increased J’aw_NO (1177±533 picoliters per second versus 833±343 picolitres per second, P=.03), and Ca_NO was no different from control subjects. In contrast, children with primary ciliary dyskinesia had decreased FE_NO (mean difference=3.36±1.24 parts per billion, P<.01) and J’aw_NO (507±259 picoliters per second versus 833±343 picoliters per second, P<.01).

Conclusions

Lower airways NO is increased in children with SCD. Elevation of J’aw_NO may represent dysregulation of NO metabolism or subclinical airways inflammation.

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Mots-clés : ACS, ATS, Ca_NO, ERS, FEF_25-75, FE_NO, FEV₁, FVC, HbSC, HbSβthal, HbSS, J’aw_NO, NO, PCD, ppb, SCD

Plan

Methods

FE_NO Measurements and Calculation of Flow-Independent NO-Parameters

Funded by the Hospital for Sick Children pediatric consultants. The authors declare no conflicts of interest.

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Vol 160 - N° 1

P. 93-97 - janvier 2012 Retour au numéro

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Lower Airway Nitric Oxide is Increased in Children with Sickle Cell Disease - 08/12/11

Abstract

Objectives

Study design

Results

Conclusions

Plan

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