PT  - JOURNAL ARTICLE
AU  - A. Bhowmik
AU  - T. A. R. Seemungal
AU  - G. C. Donaldson
AU  - J. A. Wedzicha
TI  - Effects of exacerbations and seasonality on exhaled nitric oxide in COPD
AID  - 10.1183/09031936.05.00047305
DP  - 2005 Dec 01
TA  - European Respiratory Journal
PG  - 1009--1015
VI  - 26
IP  - 6
4099  - http://erj.ersjournals.com/content/26/6/1009.short
4100  - http://erj.ersjournals.com/content/26/6/1009.full
SO  - Eur Respir J2005 Dec 01; 26
AB  - Exhaled nitric oxide (eNO) appears to be associated with airway inflammation seen in chronic obstructive pulmonary disease (COPD). The present authors studied the effects of exacerbation, season, temperature and pollution on eNO. eNO was measured seasonally and at exacerbations in 79 outpatients suffering from COPD (mean forced expiratory volume in one second = 42%). The effects of exacerbation symptoms, physiological and environmental parameters were analysed. Stable eNO levels were correlated positively with arterial oxygen tension. Median levels were found to be lower in smokers (5.3 ppb) than in ex- or nonsmokers (6.8 ppb). Levels were higher during October to December (6.9 ppb) than in April to June (4.6 ppb). Levels were also higher during 68 exacerbations in 38 patients (7.4 ppb) than in stable conditions (5.4 ppb), independent of the effects of smoking. The rise in eNO was greater in exacerbations that were associated with colds, a sore throat or dyspnoea combined with a cold. In conclusion, exhaled nitric oxide levels were higher in colder weather and in the autumn, perhaps related to the increased prevalence of viral infection at this time of year. The levels were lower in more severe chronic obstructive pulmonary disease. Exhaled nitric oxide levels were raised at the onset of exacerbation, particularly in the presence of a cold.