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ELISA Enzyme-linked immunosorbent assav eNOS endothelial nitric oxide synthase EPNIEPX eosinophilic neuraminadase EPO eosinophilic peroxidise ERS European Respiratory Society ERSTF European Respiratory Society Task Force FAD flavin adenosine dinucleotide Fe iron FBFzs-tsn forced expiratory flow at 25 to 75 percent <strong>of</strong> forced vital capacity FEVr forced expiratory volume in 1 second FEVo.s forced expiratory volume in half a second FMN flavin mononucleotide FVC forced vital capacity GINA Global Initiative for Asthma GM-csF Granulocyte macrophage - colony stimulating factor GTP guanosine S-triphosphate Hzo HzS hydrogen sulphide HNO2 nitrous acid HRCT high resolution computerised tomography ICAMI intracellular adhesion molecule I IFNI interferon gamma IgA immunoglobulin A IgG immunoglobulin G IgE immunoglobulin E IHCS inhaled corticosteroids nl, L2, IL3, nA, IL5, IL6, ILg, ILg, ILl0, ILI l, I[-l2, ILl3, Ll7 interleukin l, interleukin 2, interreukin 3, interleukin 4, interleukin 5, interleukin 6, interleukin 8 interleukin 9, interleukin 10, interleukin I l, interleukin 12, interleukin 13, interleukin l7 iNOS inducible nitric oxide synthase ISAAC Inbrnational Study <strong>of</strong> Asthma and Allergies in Childhood Kb kilobases Umin litres per minute LABA long acting 92 agonisr xrx
LADA N*N* dimethyl L-arginine LFA1 lympocyte function-associated antigen I L-NAME N* arginine methyl ester L-NMMA N* monomethyl L-arginine L-NOARG N*-nitroarginine LNIO N- imino-ethyl-ornithine LPC lysophosphotidylcholine LPS lipopolysaccharide mC4, LTD4, WM leukotriene C4,leukotriene D4,leukotriene Bl MBP major basic protein mg/ml milligrams per millilitre mls/min millilitres per minute Mn manganese mRNA messenger ribonucleic acid Nz nitrogen NzO nitrous oxide ("laughing gas") NzOs dihydrogen trioxide NzOl dihydrogen tetraoxide NADPH nicotinamide adenosine di-nucleotide phosphate NANC non adrenergic, non cholinergic (nerves) NF-KB nuclear factor-kappa B NHANES 1 National Health and Nutrition Examination Survey I nl-/min nanolitres per minute nNOS neuronal nitric oxide synthase NO nitric oxide NO + nitrosoium cation NO- nitroxyl anion NOz nitrogen dioxide NOz- nitrite No:- nitrate NO2Tyr 3-nitrotyrosine NOS nitric oxide synthase/s NOx nitrogen oxides (usually NO, NOz and NO:) NZPAG New Zealand Paediatric Asthma Guidelines Oz oxygen
Page 1 and 2: http://researchspace.auckland.ac.nz
Page 3 and 4: UNIVERSITV OF AUCKI'AND Abstract -
Page 5 and 6: There was no significant difference
Page 7 and 8: This is Dedicated: Dedication To th
Page 9 and 10: New Zealand The Paediatric Departme
Page 11 and 12: Contents Abstract ........tr Dedica
Page 13 and 14: 6.5.4 The subjects............... .
Page 15 and 16: XIV
Page 17 and 18: List of Figures Figure l.l: Top l0
Page 19: List of Abbreviations ABPA allergic
Page 23 and 24: t}ryem(eNoS)Typeltrendothelialnifti
Page 25 and 26: area, some of it has been expanded
Page 27 and 28: In addition, both of these groups a
Page 29 and 30: studies conducted throughout the Un
Page 31 and 32: Video clips of infants with a varie
Page 33 and 34: the Paediatric Society of New 7*ala
Page 35 and 36: inhaled anti-cholinergic agents and
Page 37 and 38: ecommended to monitor asthma at hom
Page 39 and 40: improvement to 70Vo PEF would have
Page 41 and 42: Furthermore, investigators have als
Page 43 and 44: poorer predictor of a diagnosis of
Page 45 and 46: Bronsky et al. 1998), and a long-te
Page 47 and 48: SIGN guideline (SIGN 2005) stated "
Page 49 and 50: In brief, the human airway can be d
Page 51 and 52: The ability to biopsy has led to st
Page 53 and 54: small proportion of cells recovered
Page 55 and 56: methodology of sputum induction and
Page 57 and 58: et al. 1999; Giannini, Di Franco et
Page 59 and 60: over a six month treatment prograrn
Page 61 and 62: There are other studies suggesting
Page 63 and 64: So is induced sputum in adults and
Page 65 and 66: asymptomatic patients independent o
Page 67 and 68: onchial hyper-responsiveness (Reich
Page 69 and 70: led to research which looked for le
Page 71 and 72:
analyser machines. This thesis pres
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The pollution of the 'great smog of
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adults greater than 65 years (Ostro
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levels compared to those children l
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More recently 'Air Quality Indexes'
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acetylcholine. These were known to
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cyclase does not produce significan
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Garthwaite l99l), and the non adren
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significant complication, this trea
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locus for the enzyme is a susceptib
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NO synthesis and in so doing blocke
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3.1 Chapter 3: The synthesis, react
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BHa = tetrahyrobiopterin, FAD = fla
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(Knowles, McWeeny et al. 1974) and
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more potent at low oxygen tensions
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toxic products such as isoprostanes
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Figure 3.3: The nitric oxide syntha
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providing NO as a neurotransmitter
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The enzyme of this second pathway -
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inappropriate production from comme
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Nicotinamide adenosine dinucleotide
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enzyme and are competitively revers
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4.1 Introduction Chapter 4: Methods
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4.4 Nitrite and nitrate The measure
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insensitive (Braker and Mossman 197
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A group of instruments have been de
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The original group demonstrated tha
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equired it. For example, there was
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helium for 30 minutes to remove Oz.
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(Postlethwait and Bidani 1990; Post
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is set at 5ppm (AIHA 1966) based on
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5.1 Chapter 5: Methodological asses
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wanted to compare the patterns of e
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in different colours that became th
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an advisor for this work and main s
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Delay time: the time between turnin
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led to an increased water content t
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Chapter 6: Methodological studies o
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pulmonary circulation appeared to c
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al found levels of 10.3ppb compared
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Authors and Pap€r Sublect numbers
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only those measured by mouth or low
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6. Check that the pens work. Fill w
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keys but it is currently in the mid
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Calibration pressures: the test por
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T-piece: tO The first figure shows
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the rotameter. Tracings of each par
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Figure 6.6: Mean exhaled NO levels
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NO and COz results from single exha
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6.6.4 (iii) Comparison of exhaled n
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Figure 6.11b: COz levels at peak NO
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I also considered whether the diffe
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the direct to the indirect method l
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need for methodological experiments
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The exhalations were carried out in
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Figure 7.2: Example of the tracing
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7.4.4 Results There was an increase
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Table 7.3: NO, COz and duration of
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The second set of exhalations invol
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Figure 7.6: Photographs of the chan
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Table 7.5: Exhaled NO results with
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the NO concentrations taken pre and
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Figure 7.10: Hyperbolic relationshi
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pressure over the likely range enco
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subjects with respiratory disease,
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8.1 Chapter 8: Exhaled nitric oxide
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standard error of the mean (SEM), s
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T-piece sampling system to analyser
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Figure 8.2a: Comparison of peak exh
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if yes who? if yes who? if yes who?
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There are limitations with regard t
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significantly between research grou
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controls. Kharitinov et al reported
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direct method in asthmatic children
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Figure 8.4a: The eftect of commenci
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had last used her p2 agonist inhale
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higher level of exhaled NO at 4.9pp
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9.1 Introduction Chapter 9: Exhaled
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For the oral measurements options i
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Table 9.1: The recommended standard
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taken from the available literature
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compartment correlated with the ser
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measurement with variable expirator
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to settle. We may have been measuri
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9.5 Off-line measurement NO determi
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(Hyde, Geigel et al. 1997; Tsoukias
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9.6 Nasal nitric oxide measurement
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measured over two 24 hour periods,
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women who coincidently experienced
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While these cross-sectional and the
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symptoms. Steroid response was sign
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'difficult asthma' also had higher
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season and then reduced down to bas
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of cross sectional studies with a t
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Ciabattoni et al. 2004; Petersen, A
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FEV9.5, symptom score and airways r
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Indomethacin - This medication alte
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89Vo for PCD, and above that exclud
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This low NO occurs despite higher t
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patients were followed through one
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differences noted based on filter,
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9.L6 Nitric oxide levels in exercis
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another study of 111 school childre
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Almost all studies used sedation, w
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peak exhaled NO production in the f
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flow and to minimize nasal contamin
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ecruit blood vessels in the lung. S
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Chapter 10: Reflections The outcome
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and I enrolled 52 asthmatic childre
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Edwards EA, Douglas C, Broome S, Je
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o Cass Byrnes & Nicky Holt. "Drugs
Page 293 and 294:
o Byrnes CA. Paediatric fibreoptic
Page 295 and 296:
Appendix 2: Questionnaire for enrol
Page 297 and 298:
Al-Ali, M. K. and P. H. Howarth (20
Page 299 and 300:
Archer, S. L., P. J. Shultz, et al.
Page 301 and 302:
Baraldi, E., N. M. Azzolin, et al.
Page 303 and 304:
Belda, J., P. Hussack, et al. (2001
Page 305 and 306:
Bongers, T. and B. R. ODriscoll (20
Page 307 and 308:
Brown, G. C. and C. E. Cooper (1994
Page 309 and 310:
Castro-Rodriguez, J. A., C. J. Holb
Page 311 and 312:
Cockcroft, D. W., D. N. Killian, et
Page 313 and 314:
de Blic, J., V. Marchac, et al. (20
Page 315 and 316:
Donaldson, S. H., W. D. Bennett, et
Page 317 and 318:
Emi-Miwa, M., A. Okitani, et al. (1
Page 319 and 320:
Frey, U., J. Stocks, et al. (2000).
Page 321 and 322:
Gershman, N. H., H. Liu, et al. (19
Page 323 and 324:
Grasemann, H., E. Michler, et al. (
Page 325 and 326:
Hashimoto, T., K. Minoguchi, et al.
Page 327 and 328:
Holgate, S. T., D. E. Davies, et al
Page 329 and 330:
Iriso, R., P. M. Mudido, et al. (20
Page 331 and 332:
Jones, A. W., M. Fransson, et al. (
Page 333 and 334:
Kercsmar, C. M. (2006). Wheezing in
Page 335 and 336:
Kleinert, H., T. Wallerath, et al.
Page 337 and 338:
Lamblin, C., P. Gosset, et al. (199
Page 339 and 340:
Li, X. and J. W. Wilson (1997). "In
Page 341 and 342:
Lymar, S. V. and J. K. Hurst (1996)
Page 343 and 344:
Massaro, A. F., S. Mehta, et al. (1
Page 345 and 346:
Miyabara, Y., R. Yanagisawa, et al.
Page 347 and 348:
contribute to impaired endothelium-
Page 349 and 350:
ODell, T. J., R. D. Hawkins, et al.
Page 351 and 352:
Panza, J. A., C. E. Garcia, et al.
Page 353 and 354:
Peters, S. P. (2006). "Safety of in
Page 355 and 356:
Prieto, L., L. Bruno, et al. (2003)
Page 357 and 358:
Ribbons, K. A., X. J. Zhang, et al.
Page 359 and 360:
Sacco, O., R. Sale, et al. (2003).
Page 361 and 362:
Sessa, W. C., K. Pritchard, et al.
Page 363 and 364:
Silvestri, M., F. Sabatini, et al.
Page 365 and 366:
Stamler, J. S. (1994). "Redox signa
Page 367 and 368:
Stuehr, D. J., N. S. Kwon, et al. (
Page 369 and 370:
Tierney, W. M., J. F. Roesner, et a
Page 371 and 372:
Upchurch, G. R., G. N. Welch, et al
Page 373 and 374:
Wadsworth, R., E. Stankevicius, et
Page 375 and 376:
Williams, O., R. Y. Bhat, et al. (2
Page 377 and 378:
Yates, D. H., S. A. Kharitonov, et
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