Study on nasal nitric oxide measurement in allergic rhinitis patient with asthma

• 第一著者: Yaacob, Wan Norsyafiqah W
• フォーマット: 学位論文
• 言語: 英語
• 出版事項: 2025
• 主題: R Medicine; RC705-779 Diseases of the respiratory system
• オンライン･アクセス: http://eprints.usm.my/63248/

This study explored the potential of nasal nitric oxide (nNO) as a biomarker to distinguish allergic rhinitis (AR) patients with and without asthma. The study was conducted at the Otorhinolaryngology Head and Neck (ORL-HNS) Clinic, Specialist Hospital Universiti Sains Malaysia, which included 154 participants: asthmatic (n=77) and non-asthmatic groups (n=77). The primary objectives were to compare nNO levels between these groups and to examine the correlation between nNO levels and symptom severity, measured by the Visual Analogue Scale (VAS). Asthmatic AR patients had significantly lower nNO levels (median 74.0 ppb) with interquartile range of 49.00-151.00 ppb, compared to non-asthmatic AR patients (median 440.0 ppb) with interquartile range of 238.00-687.00 ppb, with a p-value of <0.001. This finding suggests that asthma significantly impacted nNO levels, potentially due to factors such as sinus ostium obstruction, which is more common in patients with both conditions. While the overall correlation between nNO levels and VAS scores was not significant, a significant positive correlation was detected in the non-asthmatic AR subgroup, indicating that higher nNO levels were associated with greater symptom severity. This highlighted the potential of nNO as a biomarker for symptom assessment in non-asthmatic AR patients. In this study, nNO is a potential biomarker for distinguishing between AR patients with and without asthma. It serves as a biomarker for airway inflammation and symptom assessment, particularly in non-asthmatic AR patients, where higher nNO levels are associated with greater symptom severity. In contrast, the lack of significant correlation in asthmatic AR patients suggested a more complex relationship between nNO levels and symptom severity, possibly due to the interplay of lower and upper airway inflammation. Demographic analysis showed that asthmatic patients were generally older (mean age 39.7 years) compared to non-asthmatic patients (mean age 33.3 years), with a significant p-value of 0.006. Gender and ethnicity did not show significant differences between the groups. VAS scores indicated that asthmatic patients experienced higher overall symptom severity (mean VAS score 10.3) compared to non-asthmatic patients (mean VAS score 7.9), with a significant p-value of 0.007. From this study, it can be concluded that nNO levels are significantly lower in AR patients with asthma, suggesting a potential association between lower nNO and asthma presence, possibly due to sinus blockage. While nNO levels didn’t consistently correlate with symptom severity overall, non-asthmatic AR patients showed a positive relationship such that higher nNO levels matched worse symptoms, whereas asthmatic patients showed a more complex pattern due to combined airway inflammation. The findings underscored the importance of considering different measurement techniques and anatomical factors when interpreting nNO levels in AR patients. Future research should focus on larger sample sizes, longitudinal studies, and exploring the underlying mechanisms contributing to the observed differences in nNO levels. This study contributed to the understanding of nNO as a biomarker in AR and its potential role in differentiating between asthmatic and non-asthmatic patients, ultimately improving patient management and outcomes