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ORIGINAL ARTICLE

Serial Exhaled Nitric Oxide Measurements in the Assessment of Laboratory Animal Allergy

, M.B., Ch.B., , M.B., Ch.B., , , B.Sc., , B.Sc. & , M.D.
Pages 101-107 | Published online: 02 Jul 2009
 

Abstract

Background. Laboratory animal allergy (LAA) may cause eosinophilic airway inflammation, for which exhaled nitric oxide (FENO) measurements are sensitive and specific. Our objective was to assess whether serial FENO measurements might detect exposure-related inflammation in laboratory animal workers. Methods. Fifty laboratory animal workers participated. Measurements of FENO and spirometry were obtained at baseline (Friday) and twice-daily following a weekend with no animal contact. Results. Eleven of 50 subjects had work-related symptoms, and 2 of 11 had positive serology for LAA. Baseline FENO was high (> 150 ppb) in the two seropositive subjects and increased progressively during the working week in one subject, confirming exposure-driven airway inflammation. In seronegative subjects, mean FENO levels were 19.8 (standard deviation [SD], 20.1) and 21.7 (SD, 20.8) in the symptomatic and nonsymptomatic groups, respectively, with no significant changes in FENO over time. Conclusion. Serial FENO measurements may provide complementary information in the assessment of possible occupational sensitisation. The sensitivity and specificity of this approach to diagnosing occupational asthma requires further evaluation.

Abbreviations
AHR=

Airway hyper-responsiveness

COPD=

Chronic obstructive pulmonary disease

FENO=

Fraction of nitric oxide in exhaled air

FEV1=

Forced expiratory volume in one second

FVC=

Forced vital capacity

ICS=

Inhaled corticosteroid

IgE=

Immunoglobulin E

LAA=

Laboratory animal allergy

LAR=

Late asthmatic reaction

PD20=

Provocative dose causing a 20% fall in FEV1

PEFR=

Peak expiratory flow rate

RAST=

Radio-allergosorbent test

SD=

Standard deviation

Abbreviations
AHR=

Airway hyper-responsiveness

COPD=

Chronic obstructive pulmonary disease

FENO=

Fraction of nitric oxide in exhaled air

FEV1=

Forced expiratory volume in one second

FVC=

Forced vital capacity

ICS=

Inhaled corticosteroid

IgE=

Immunoglobulin E

LAA=

Laboratory animal allergy

LAR=

Late asthmatic reaction

PD20=

Provocative dose causing a 20% fall in FEV1

PEFR=

Peak expiratory flow rate

RAST=

Radio-allergosorbent test

SD=

Standard deviation

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