Document Detail

Basal and induced NO formation in the pharyngo-oral tract influences estimates of alveolar NO levels.
MedLine Citation:
PMID:  19036899     Owner:  NLM     Status:  MEDLINE    
The present study analyzed how models currently used to distinguish alveolar from bronchial contribution to exhaled nitric oxide (NO) are affected by manipulation of NO formation in the pharyngo-oral tract. Exhaled NO was measured at multiple flow rates in 15 healthy subjects in two experiments: 1) measurements at baseline and 5 min after chlorhexidine (CHX) mouthwash and 2) measurements at baseline, 60 min after ingestion of 10 mg NaNO(3)/kg body wt, and 5 min after CHX mouthwash. Alveolar NO concentration (Calv(NO)) and bronchial flux (J'aw(NO)) were calculated by using the slope-intercept model with or without adjustment for trumpet shape of airways and axial diffusion (TMAD). Salivary nitrate and nitrite were measured in the second experiment. Calv(NO) [median (range)] was reduced from 1.16 ppb (0.77, 1.96) at baseline to 0.84 ppb (0.57, 1.48) 5 min after CHX mouthwash (P < 0.001). The TMAD-adjusted Calv(NO) value after CHX mouthwash was 0.50 ppb (0, 0.85). The nitrate load increased J'aw(NO) from 32.2 nl/min (12.2, 60.3) to 57.1 nl/min (22.0, 119) in all subjects and Calv(NO) from 1.47 ppb (0.73, 1.95) to 1.87 ppb (10.85, 7.20) in subjects with high nitrate turnover (>10-fold increase of salivary nitrite after nitrate load). CHX mouthwash reduced Calv(NO) levels to 1.15 ppb (0.72, 2.07) in these subjects with high nitrate turnover. All these results remained consistent after TMAD adjustment. We conclude that estimated alveolar NO concentration is affected by pharyngo-oral tract production of NO in healthy subjects, with a decrease after CHX mouthwash. Moreover, unknown ingestion of dietary nitrate could significantly increase estimated alveolar NO in subjects with high nitrate turnover, and this might be falsely interpreted as a sign of peripheral inflammation. These findings were robust for TMAD.
Andrei Malinovschi; Christer Janson; Lena Holm; Lennart Nordvall; Kjell Alving
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-26
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  106     ISSN:  8750-7587     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-06     Completed Date:  2009-03-12     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  513-9     Citation Subset:  IM    
Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden.
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MeSH Terms
Breath Tests*
Bronchi / metabolism
Chlorhexidine / administration & dosage
Middle Aged
Models, Biological
Mouth / drug effects,  metabolism*
Mouthwashes / administration & dosage
Nitrates / administration & dosage,  metabolism
Nitric Oxide / metabolism*
Nitrites / metabolism
Pharynx / drug effects,  metabolism*
Pulmonary Alveoli / drug effects,  metabolism*
Reproducibility of Results
Saliva / metabolism
Young Adult
Reg. No./Substance:
0/Mouthwashes; 0/Nitrates; 0/Nitrites; 10102-43-9/Nitric Oxide; 55-56-1/Chlorhexidine; 8M4L3H2ZVZ/sodium nitrate

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