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| |  FeNO Superior to C-Reactive Protein to Differentiate Between Bronchial and Cough-Variant Asthma: Presented at AAAAI By Carole VanSickle Ellis NEW ORLEANS -- March 1, 2010 -- While the use of fractional exhaled nitric oxide (FeNO) levels for diagnosing asthma has been in place for years, recently levels of high-sensitivity C-reactive protein (hs-CRP), a common predictor of coronary artery disease, have been reported to also be effective. However, when compared with the use of FeNO levels as an indicator of both bronchial asthma and cough-variant asthma, the FeNO protocols still are more reliable and function as superior predictors, particularly when it comes to specifying between bronchial asthma and cough-variant asthma, researchers said here at the 2010 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting on February 27. Tadakazu Shimoda, MD, Fukuoka National Hospital, Fukuoka, Japan established these findings while determining cutoff values for both FeNO and hs-CRP in patients with bronchial and cough-variant asthma. The study included 194 patients with cough-variant asthma, 295 patients with bronchial asthma, and 110 healthy controls. FeNO concentrations were determined using on-line analysis with an NO analyser, and latex nephelometry was used to take hs-CRP values. In the healthy group, hs-CRP levels were 245 +- 118 ng/mL and FeNO levels were 17.9 +- 6.1 parts per billion (ppb). In the cough-variant group, hs-CRP levels were recorded at 554 +-750 ng/mL and FeNO at 35.6 +-47.2 ppb, while the bronchial asthma group measured 721 +- 1,150 ng/mL for hs-CRP and 90.9 +-79.2 ppb for FeNO. In terms of sensitivity, FeNO outperformed hs-CRP. At a sensitivity of 80%, hs-CRP levels in the bronchial asthma group were 300 ng/mL (vs healthy group specificity 60%) and 700 ng/mL (vs cough-variant specificity 30%). At the same sensitivity, FeNO values were 25 ppb for the bronchial asthma group (vs healthy group specificity 80%) and 35 ppb (vs cough-variant specificity 60%). Both types of measurement are relatively easy to obtain and are completely noninvasive, which allowed for repeated examinations during the study. Both methods are certainly useful indicators, stated the research team, when it comes to identifying airway inflammation in bronchial asthma and cough-variant asthma. However, FeNO is superior to hs-CRP in terms of both sensitivity and specificity, making it a better tool for differentiating between bronchial asthma and cough-variant asthma once airway inflammation has been established. [Presentation title: A Comparative Study of the Cut-Off Values of Fractional Exhaled Nitric Oxide Level and Serum High-Sensitivity C-Reactive Protein Level for the Differentiation Between Bronchial Asthma and Cough-Variant Asthma. Abstract 20]
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