Device comparison study to measure nasal nitric oxide in relation to primary ciliary dyskinesia

IF 3.7 4区 医学 Q1 BIOCHEMICAL RESEARCH METHODS Journal of breath research Pub Date : 2023-12-13 DOI:10.1088/1752-7163/ad10f9
Nils Oskar Jõgi, Karin Ersson, Kjell Alving, Christina Krantz, Andrei Malinovschi
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Abstract

Primary ciliary dyskinesia (PCD) is a genetic respiratory disease characterized by chronic cough, recurrent respiratory infections, and rhinosinusitis. The measurement of nasal nitric oxide (nNO) against resistance has been suggested as a sensitive screening method. However, current recommendations argue for the use of expensive, chemiluminescence devices to measure nNO. This study aimed to compare nNO measurement using three different devices in distinguishing PCD patients from healthy controls and cystic fibrosis (CF) patients and to evaluate their diagnostic precision. The study included 16 controls, 16 PCD patients, and 12 CF patients matched for age and sex. nNO measurements were performed using a chemiluminescence device (Eco Medics CLD 88sp), and two devices based on electrochemical sensors (Medisoft FeNO+ and NIOX Vero) following standardized guidelines. Correlation estimation, Bland–Altman, ROC curve, and one-way ANOVA were used to assess device differences and diagnostic performance. Significantly lower nNO output values were observed in PCD and CF patients compared to controls during exhalation against resistance. The correlation analysis showed high agreement among the three devices. ROC curve analysis demonstrated 100% sensitivity and specificity at different cut-off values for all devices in distinguishing PCD patients from controls (optimal cut-offs: EcoMedics 73, Medisoft 92 and NIOX 87 (nl min−1 )). Higher nNO output values were obtained with the Medisoft and NIOX devices as compared to the EcoMedics device, with a bias of−19 nl min−1 (95% CI: −73–35) and −21 nl min−1 (−73–31) accordingly. These findings indicate that all three tested devices can potentially serve as diagnostic tools for PCD if device specific cut-off values are used. This last-mentioned aspect warrants further studies and consideration in defining optimal cut-offs for individual device.
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测量与原发性睫状肌运动障碍有关的鼻腔一氧化氮的设备比较研究
原发性睫状肌运动障碍(PCD)是一种遗传性呼吸系统疾病,以慢性咳嗽、反复呼吸道感染和鼻炎为特征。有人建议将鼻腔一氧化氮(nNO)抗阻性测量作为一种灵敏的筛查方法。然而,目前的建议主张使用昂贵的化学发光设备来测量 nNO。本研究旨在比较使用三种不同设备测量一氧化氮对 PCD 患者与健康对照组和囊性纤维化(CF)患者的区分效果,并评估其诊断精确度。nNO 测量采用了一种化学发光设备(Eco Medics CLD 88sp)和两种基于电化学传感器的设备(Medisoft FeNO+ 和 NIOX Vero),并遵循了标准化指南。相关性估计、Bland-Altman、ROC 曲线和单向方差分析用于评估设备差异和诊断性能。与对照组相比,PCD 和 CF 患者在呼气对抗阻力时的 nNO 输出值明显较低。相关性分析表明三种设备之间的一致性很高。ROC 曲线分析表明,在不同的截断值下,所有设备在区分 PCD 患者和对照组方面的灵敏度和特异性均为 100%(最佳截断值:EcoMedics 73、Medical 73、EcoMedics 73、Medical 73):EcoMedics 73、Medisoft 92 和 NIOX 87 (nl min-1 ))。与 EcoMedics 设备相比,Medisoft 和 NIOX 设备获得的 nNO 输出值更高,偏差分别为-19 nl min-1 (95% CI:-73-35)和-21 nl min-1 (-73-31)。这些结果表明,如果使用特定的临界值,所有三种测试设备都有可能成为 PCD 的诊断工具。最后提到的这一点值得进一步研究和考虑,以确定每个设备的最佳临界值。
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来源期刊
Journal of breath research
Journal of breath research BIOCHEMICAL RESEARCH METHODS-RESPIRATORY SYSTEM
CiteScore
7.60
自引率
21.10%
发文量
49
审稿时长
>12 weeks
期刊介绍: Journal of Breath Research is dedicated to all aspects of scientific breath research. The traditional focus is on analysis of volatile compounds and aerosols in exhaled breath for the investigation of exogenous exposures, metabolism, toxicology, health status and the diagnosis of disease and breath odours. The journal also welcomes other breath-related topics. Typical areas of interest include: Big laboratory instrumentation: describing new state-of-the-art analytical instrumentation capable of performing high-resolution discovery and targeted breath research; exploiting complex technologies drawn from other areas of biochemistry and genetics for breath research. Engineering solutions: developing new breath sampling technologies for condensate and aerosols, for chemical and optical sensors, for extraction and sample preparation methods, for automation and standardization, and for multiplex analyses to preserve the breath matrix and facilitating analytical throughput. Measure exhaled constituents (e.g. CO2, acetone, isoprene) as markers of human presence or mitigate such contaminants in enclosed environments. Human and animal in vivo studies: decoding the ''breath exposome'', implementing exposure and intervention studies, performing cross-sectional and case-control research, assaying immune and inflammatory response, and testing mammalian host response to infections and exogenous exposures to develop information directly applicable to systems biology. Studying inhalation toxicology; inhaled breath as a source of internal dose; resultant blood, breath and urinary biomarkers linked to inhalation pathway. Cellular and molecular level in vitro studies. Clinical, pharmacological and forensic applications. Mathematical, statistical and graphical data interpretation.
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