The Levels of Exhaled Nitric Oxide in Mustard Airway Disease

Document Type : Original Article


1 Chemical Injuries Research Center, Systems Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

2 Pulmonary Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.



Background: The fractional excretion of exhaled nitric oxide (FeNO) has been proposed as a noninvasive measure of airway inflammation. FeNO levels were assessed in this study to evaluate airway inflammatory characteristics in mustard airway disease (MAD).
Methods:  Thirty-three MAD patients were involved in the study to determine the level of exhaled nitric oxide (NO) and its relationship to lung function; 16 MAD patients with normal symptoms and 17 MAD patients with severe symptoms were identified from this sample. To regulate their condition, severe individuals were given inhaled corticosteroids.
Results: Exhaled NO levels were greater in severe patients than in normal patients, but this was not significant. Furthermore, the findings revealed that FeNO concentrations were positively linked with carbon monoxide transfer factor in the severe group (TLCO). We were unable to find a link between pulmonary volumes and FeNO levels. We also found that 17% of patients in the severe category had FeNO levels greater than 40 ppb (cutoff point of FeNO for patients with asthma). Although, the severe group's usage of inhaled   corticosteroids may lower FeNO levels.
Conclusion: Based on the FeNO results, we conclude that MAD is a diverse disorder. Exhaled NO was found to be able to detect the asthma phenotype in MAD, and FeNO was found to be a beneficial supplement to aid lung function during MAD evaluation. FeNO levels in MAD patients were similar to those in COPD patients.