Abstract
Asthma is defined as the chronic inflammation of the large airways that is characterized by reversible airflow obstruction and airway hyper-responsiveness. On the other hand, Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammation that is marked by progressive and irreversible airflow obstruction. Both conditions are manifested by symptoms of wheezing, coughing, and shortness of breath. Similarity in symptoms between these two conditions could lead to misdiagnosis and mistreatment. Although inflammation is present in both conditions, there are some marked differences. The main difference is that inflammation in asthma is an IgE mediated and involves the release of histamine while it is absent in the case of COPD. There is now a new trend for measuring the content of exhaled nitric oxide as a marker for assessing airway inflammation and especially for asthma diagnosis and monitoring. This study aimed at utilizing biomarkers to differentiate between the different types of respiratory inflammations. In this study, 23 patients with asthma, 20 with allergic rhinitis, 10 with COPD, and 17 healthy controls were recruited into the study at a local hospital clinic and assessed based on the level of their exhaled nitric oxide (eNO), serum specific IgE antibodies, and relative blood eosinophilia count. The results demonstrated that the many asthmatics (74%) had high eNO levels, while only 25% of patients with allergic rhinitis, 10% of those with COPD, and 6% of the healthy individuals similarly had elevated eNO levels. The results confirmed the fact that exhaled nitric oxide could be an effective parameter for differentiating asthma from other allergic diseases (e.g. allergic rhinitis) and other respiratory inflammations (COPD).
Highlights
Allergic diseases could be atopic and non-atopic
Asthma is defined as a chronic airway inflammation characterized by reversible airflow obstruction, yet most physicians still rely on subjective measures in the diagnosis and monitoring of asthma
Three laboratory tests were used, the exhaled Nitric oxide level, the percentage blood eosinophilia and the allergic sensitization tests. The results of this preliminary study clearly showed that exhaled nitric oxide level is higher in asthmatic patients compared to healthy individual and it is relatively higher than other clinical groups with respiratory inflammation
Summary
Allergic diseases (asthma, rhinitis, and eczema/dermatitis) could be atopic and non-atopic. Atopy is the genetic contribution or the tendency for the development of allergic diseases [1]. The risk of a child developing allergic diseases is 20% if both parents are not affected, but the risk increases with a single defective parent to be 25%-30% and 50-75% if both is allergic [2] Both environmental and genetic factors contribute to the development of an allergic phenotype. Asthmatics have the haplotype HLA B7, SC31, DR2 while allergic rhinitis (AR) patients have the haplotype HLA B8, SC01, DR3 [6] Environmental factors such as air borne allergens, air pollutants, and microbial antigens are considered to be a risk factor for the development of allergic diseases. Allergic phenotypes are the result of complex interactions between genetics and the environment [7,8]
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