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1/2021 vol. 28
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RESEARCH PAPER
Modification of exhaled air nitric oxide in patients with asthma – cortisone monotherapy or dual inhalation therapy?
Victoria Maria Ruta 1
,
 
Nicoleta Stefania Motoc 2
,
 
Doina Adina Todea 2
,
 
Teodora Gabriela Alexescu 3
,
 
Dan Valean 4
,
 
Stefania Cozac 4
,
 
Sorina Cezara Coste 3
,
 
Razvan Andrei Codea 5
,
 
Rodica Ana Ungur 6
,
 
Carmen Monica Pop 2
,
 
Adina Man Milena 2
 
 
 
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1
Iuliu Hatieganu’ University of Medicine and Pharmacy, Cluj-Napoca, Romania
 
2
Department of Pneumology, ’Iuliu Hatieganu’ University of Medicine and Pharmacy, Cluj-Napoca, Romania
 
3
Department of Internal Medicine, ‚Iuliu Hatieganu’ University of Medicine and Pharmacy, Cluj-Napoca, Romania
 
4
MD student ‚Iuliu Hatieganu’ University of Medicine and Pharmacy, Cluj-Napoca, Romania
 
5
Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, Cluj-Napoca, Romania
 
6
Department of Rehabilitation, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
 
 
Corresponding author
Rodica Ana Ungur   

, Department of Rehabilitation, ‚Iuliu Hatieganu’ University of Medicine and Pharmacy Cluj-Napoca, 46-50 Viilor Street, 400347, Cluj-Napoca, Romania.
 
 
Ann Agric Environ Med. 2021;28(1):89-93
DOI: https://doi.org/10.26444/aaem/130712
 
 
Article (PDF)
References (40)
 
KEYWORDS
asthma
dual therapy
fractional expired nitric oxide (FeNO)
inhalation monotherapy
wheezing
 
TOPICS
Health effects of chemical pollutants in agricultural areas , including occupational and non-occupational effects of agricultural chemicals (pesticides, fertilizers) and effects of industrial disposal (heavy metals, sulphur, etc.) contaminating the atmosphere, soil and water
 
ABSTRACT
Introduction:
Asthma, a chronic lung disease, is a major health challenge worldwide with increased addressability to health services. There are different asthma phenotypes, which have different evolution and can be specifically tracked. The measurement of fractional expired nitric oxide (FeNo) with different devices reflects the eosinophilic inflammation of the airways, and can be used to evaluate the allergic phenotype and predict the treatment responses. The new GINA (Global Initiative for Asthma) guideline recommends FeNO monitoring to assess adherence to cortisone treatment in high doses before prescribing biological treatment, and as a means of monitoring the decrease in oral corticosteroid treatment.

Objective:
The aim of the study is to analyze the applicability of FeNO in monitoring response to therapy.

Material and methods:
An observational study was carried out on 129 subjects with a previously established diagnosis of asthma. The research was based on the determination of FeNO with NObreath. Those with intermediate FeNO received a low dose of inhaled corticosteroids in mono/dual therapy, those with increased FeNO received medium ICS mono/dual therapy. FeNO testing, its values and doses of ICS were below the the ATS / ERS guidelines.

Results:
FeNO reduction is strictly dependent on the cortisone dose. Applying the dual therapy from the beginning does not bring additional benefits in comparison with cortisone in monotherapy, in terms of FeNO value.

Conclusions:
Recommendations that include FeNO testing can help monitor response to treatment.

ACKNOWLEDGEMENTS
The first two authors have equal rights to this paper.
Ruta VM, Motoc NS, Todea DA, Alexescu TG, Valean D, Cozac S, Coste SC, Codea RA, Ungur RA, Pop CM, Milena AM. Modification of exhaled air nitric oxide in patients with asthma: cortisone monotherapy or dual inhalation therapy? Ann Agric Environ Med.doi: 10.26444/aaem/130712
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