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Bartley, J., W. Fergusson, et al. (1999). "Normal adult values, diurnal variation, and repeatability of nasal nitric oxide measurement." American Journal of Rhinology 13(5):401-5. Bartoli, M. L., E. Bacci, et al. (2004). "Clinical assessment of asthma severity partially corresponds to sputum eosinophilic airway inflammation." Respiratory Medicine 98(2): 184-93. Bastain, T. M., F. D. Gilliland, et al. (2003). "Intraindividual reproducibility of nasal allergic responses to diesel exhaust particles indicates a susceptible phenotype." eli&41 Immunology 109(2): I 30-6. Bastian, N. R. and J. B. Hibbs, Jr. (1994). "Assembly and regulation of NADPH oxidase and nitric oxide synthase." Current Opinion in Immunology 6(l): 131-9. Bates, D. V. (1995). "The effects of air pollution on children." Environmental Health Perspectives 103 Suppl 6:49-53. Bates, D. V. (2000). "Lines that connect: assessing the causality inference in the case of particulate pollution. " Environmental Health Perspecti ves 108(2) : 9 | -2. Battaglia, S., H. den Hertog, et al. (2005). "Small airways function and molecular markers in exhaled air in mild asthma." Thorax 60(8): 639-44. Baylis, C. and P. Vallance (1998). "Measurement of nitrite and nitrate levels in plasma and urine--what does this measure tell us about the activity of the endogenous nitric oxide system?" Current Opinion in Nephrology & Hypertension 7(l):59-62. Beasley, R., C. Burgess, et al. (1993). "Pathology of asthma and its clinical implications." Journal of Allergy & Clinical Immunology 92(lPt2): 148-54. Beasley, R., M. Cushley, et al. (1989). "A self management plan in the treatment of adult asthma. " Thorax 44(3): 200-4. Beck-Ripp, J., M. Griese, et al. (2002). "Changes of exhaled nitric oxide during steroid treatment of childhood asthma." European Respiratory Journal 19(6): 1015-9. Beckett, P. A. and P. H. Howarth (2003). "Phamacotherapy and airway remodelling in asthma?" Thorax 58(2): 163-74. Beckman, J. S. (1996). "Oxidative damage and tyrosine nitration from peroxynitrite." Chemical Research in Toxicology 9(5):836-44. Beckman, J. S., T. W. Beckman, et al. (1990). "Apparent hydroxyl radical production by peroxynitrite: implications for endothelial injury from nitric oxide and superoxide." Proceedings of the National Academy of Sciences of the United States of America 87(a): rc20-4. Beckman, J. S. and J. P. Crow (1993). "Pathological implications of nitric oxide, superoxide and peroxynitrite formation." Biochemical Society Transactions 2l(2):330-4. Beckman, J. S., H. Ischiropoulos, et al. (1992). "Kinetics of superoxide dismutase- and ironcata|yzednitrationofphenolicsbyperoxynitrite.', Biophysics 298(2): 438-45. Beeh, K. M., J. Beier, et al. (2003). "A single nasal allergen challenge increases induced sputum inflammatory markers in non-asthmatic subjects with seasonal allergic rhinitis: correlation with plasma interleukin-5." Clinical & Experimental Allergy 33(a): 475-82. Beier, J., K. M. Beeh, et al. (2004). "Induced sputum methodology: Validity and reproducibility of total glutathione measurement in supernatant of healthy and asthmatic individuals." Journal of Laboratory & Clinical Medicine 144(l):38-44. Belcher, N. G., T. H. Lee, et al. (1989). "Airway responses to hypertonic saline, exercise and histamine challenges in bronchial asthma." European Respirator], Journal 2(l): M-8. Belcher, N. G., R. D. Murdoch, et al. (1988). "A comparison of mediator and catecholamine release between exercise- and hypertonic saline-induced asthma." American Review of Respirator), Disease 137(5): 1026-32. 279
Belda, J., P. Hussack, et al. (2001). "Sputum induction: effect of nebulizer output and inhalation time on cell counts and fluid-phase measures." Clinical & Experimental Allergy 31(11): 17404. Belda, J., K. Parameswaran, et al. (2006). "Predictors of loss of asthma control induced by corticosteroid withdrawal." 13(3): L29-33. Bellia, V., A. Bonanno, et al. (1996). "Urinary leukotriene Bl in the assessment of nocturnal asthma." Journal of Allergy & Clinical Immunology 97(3):73541. Bellia, V., F. Catalano, et al. (2OO4). "Aging on quality of spirometry." American Journal of Respiratory & Critical Care Medicine 170(1): 100; author reply 100-1. Bellia, V., F. Cibella, et al. (1985). "Characteristics and prognostic value of morning dipping of peak expiratory flow rate in stable asthmatic subjects." Chest 88(l): 89-93. Bellia, V., G. Cuttitta, et al. (1997). "Effect of ageing on peak expiratory flow variability and nocturnal exacerbations in bronchial asthma." European Respiratory Journal 10(8): 1803-8. Belmont, H. M., D. Levartovsky, et al. (1997). "Increased nitric oxide production accompanied by the up-regulation of inducible nitric oxide synthase in vascular endothelium from patients with systemic lupus erythematosus." Arthritis & Rheumatism 40(10): 18 10-6. Belvisi, M., P. J. Barnes, et al. (1995). "Nitric oxide synthase activity is elevated in inflammatory lung disease in humans." 283(1-3): 255-8. Belvisi, M. G., C. D. Stretton, et al. (1992). "Inhibitory NANC nerves in human tracheal smoothmuscle:aquestfortheneurotransmitter.'' 73(6):2505-10. Belvisi, M. G., J. K. Ward, et al. (1995). "Nitric oxide as a neurotransmitter in human airways." Archives Internationales de Pharmacodynamie et de Therapie 329(l): 97- 110. Benayoun, L., A. Druilhe, et al. (2003). "Airway structural alterations selectively associated with severe asthma." American Journal of Respiratory & Critical Care Medicine 167(10): 1360-8. Bentley, A. M., Q. Hamid, et al. (1996). "Prednisolone treatment in asthma. Reduction in the numbers of eosinophils, T cells, tryptase-only positive mast cells, and modulation of L-4, L-5, and interferon-gamma cytokine gene expression within the bronchial mucosa." American Journal of Respiratory & Critical Care Medicine 153(2): 551-6. Bergeron, C. and L. P. Boulet (2006). "Structural changes in airway diseases: characteristics, mechanisms, consequences, and pharmacologic modulation." Ches! 129(4):1068-87. Berkman, N., A. Avital, et al. (2003). "The effect of montelukast on bronchial provocation tests and exhaled nitric oxide levels in asthmatic patients." Israel Medical Association Journal: Imaj 5(11): 778-81. Berkman, N., A. Avital, et al. (2005). "Exhaled nitric oxide in the diagnosis of asthma: comparison with bronchial provocation tests." Thorax 60(5): 383-8. Berlyne, G. S., C. Irmiere, et al. (1998). "Evaluation of repeated sputum inductions in asthmatic subjects. " European Respiratory Journal 12: 245s. Berlyne, G. S., K. Parameswaran, et al. (2000). 'A comparison of exhaled nitric oxide and induced sputum as markers of airway inflammation." Immunolog), 106(4): 638-4r'.. Bernstein, I. L., H. A. Boushey, et al. (1985). "NHLBI recommendations of a workshop on the bronchoscopyand bronchoalveolar lavage in Respiratory Disease 132: 180-182. 280 workshop summaries: Summary and investigative use of fiberoptic asthmatics." @
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UNIVERSITV OF AUCKI'AND Abstract -
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There was no significant difference
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This is Dedicated: Dedication To th
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New Zealand The Paediatric Departme
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Contents Abstract ........tr Dedica
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6.5.4 The subjects............... .
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XIV
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List of Figures Figure l.l: Top l0
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List of Abbreviations ABPA allergic
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LADA N*N* dimethyl L-arginine LFA1
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t}ryem(eNoS)Typeltrendothelialnifti
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area, some of it has been expanded
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In addition, both of these groups a
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studies conducted throughout the Un
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Video clips of infants with a varie
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the Paediatric Society of New 7*ala
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inhaled anti-cholinergic agents and
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ecommended to monitor asthma at hom
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improvement to 70Vo PEF would have
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Furthermore, investigators have als
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poorer predictor of a diagnosis of
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Bronsky et al. 1998), and a long-te
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SIGN guideline (SIGN 2005) stated "
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In brief, the human airway can be d
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The ability to biopsy has led to st
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small proportion of cells recovered
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methodology of sputum induction and
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et al. 1999; Giannini, Di Franco et
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over a six month treatment prograrn
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There are other studies suggesting
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So is induced sputum in adults and
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asymptomatic patients independent o
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onchial hyper-responsiveness (Reich
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led to research which looked for le
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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
Page 251 and 252: symptoms. Steroid response was sign
Page 253 and 254: 'difficult asthma' also had higher
Page 255 and 256: season and then reduced down to bas
Page 257 and 258: of cross sectional studies with a t
Page 259 and 260: Ciabattoni et al. 2004; Petersen, A
Page 261 and 262: FEV9.5, symptom score and airways r
Page 263 and 264: Indomethacin - This medication alte
Page 265 and 266: 89Vo for PCD, and above that exclud
Page 267 and 268: This low NO occurs despite higher t
Page 269 and 270: patients were followed through one
Page 271 and 272: differences noted based on filter,
Page 273 and 274: 9.L6 Nitric oxide levels in exercis
Page 275 and 276: another study of 111 school childre
Page 277 and 278: Almost all studies used sedation, w
Page 279 and 280: peak exhaled NO production in the f
Page 281 and 282: flow and to minimize nasal contamin
Page 283 and 284: ecruit blood vessels in the lung. S
Page 285 and 286: Chapter 10: Reflections The outcome
Page 287 and 288: and I enrolled 52 asthmatic childre
Page 289 and 290: Edwards EA, Douglas C, Broome S, Je
Page 291 and 292: 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: Baraldi, E., N. M. Azzolin, et al.
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.
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Peters, S. P. (2006). "Safety of in
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Prieto, L., L. Bruno, et al. (2003)
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Ribbons, K. A., X. J. Zhang, et al.
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Sacco, O., R. Sale, et al. (2003).
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Sessa, W. C., K. Pritchard, et al.
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Silvestri, M., F. Sabatini, et al.
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Stamler, J. S. (1994). "Redox signa
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Stuehr, D. J., N. S. Kwon, et al. (
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Tierney, W. M., J. F. Roesner, et a
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Upchurch, G. R., G. N. Welch, et al
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Wadsworth, R., E. Stankevicius, et
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Williams, O., R. Y. Bhat, et al. (2
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Yates, D. H., S. A. Kharitonov, et
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