Date: Monday, November 9, 2015
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: We evaluated the ability of alveolar and conducting airway nitric oxide (NO) to discriminate between systemic sclerosis (SSc) with and without lung involvement, idiopathic PAH (IPAH), and healthy subjects.
Methods: Consecutive patients in the University Health Network Pulmonary Hypertension Program and Toronto Scleroderma Program were screened. Exhaled nitric oxide was measured at 50, 100, 150, 200 and 250 mL/s using chemiluminescent detection. Alveolar and conducting airway NO were partitioned using a two-compartment model of axial diffusion (CMAD) and the trumpet model of axial diffusion (TMAD).
Results: 60 subjects were recruited: SSc (n=18), SSc-PAH (n=7), SSc-ILD (n=4), SSc-PAH and ILD (n=6), SLE-PAH (n=6), IPAH (n=9) and healthy controls (n=10). Using the CMAD model, healthy subjects had lower median (IQR) alveolar NO than all PAH patients (2.0 ppb (1.5,2.5) versus 3.14 ppb (2.3,4.0), p=0.008). SSc-ILD patients had significantly lower median conducting airway NO compared to controls (1009.5 versus 1342.1 ml*ppb/s, p=0.04). SSc-PAH patients had increased conducting airway NO that inversely correlated with DLCO (Pearson’s r -0.88 (95%CI -0.99, -0.26). Median serum BNP values were higher in SSc-PAH patients than SSc patients without pulmonary involvement (358.8 versus 11.6 pg/ml, p=0.01).
Conclusion: Compartmental exhaled NO measurements vary depending on the type of pulmonary pathology present in individuals with SSc, supporting discriminative validity in SSc lung disease.
To cite this abstract in AMA style:Kozij NK, Granton JT, Silkoff PE, Thenganatt J, Chakravorty S, Johnson SR. Exhaled Nitric Oxide in Systemic Sclerosis Lung Disease [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/exhaled-nitric-oxide-in-systemic-sclerosis-lung-disease/. Accessed April 16, 2021.
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