Exhaled Nitric Oxide in Patients with Asthma: Association with NOS1 Genotype

ME Wechsler, H Grasemann, A Deykin… - American journal of …, 2000 - atsjournals.org
ME Wechsler, H Grasemann, A Deykin, EK Silverman, CN Yandava, E Israel, M Wand
American journal of respiratory and critical care medicine, 2000atsjournals.org
An increased concentration of nitric oxide (NO) in exhaled air (FeNO) is now recognized as
a critical component of the asthmatic phenotype. When we identified patients with asthma on
the basis of a standard case definition alone, we found that they were remarkably
heterogeneous with respect to their FeNO. However, when we included genotype at a
prominent asthma candidate gene (ie, NOS1) in the case definition, and determined the
number of AAT repeats in intron 20, we identified a remarkably homogenous cohort of …
An increased concentration of nitric oxide (NO) in exhaled air (FeNO) is now recognized as a critical component of the asthmatic phenotype. When we identified patients with asthma on the basis of a standard case definition alone, we found that they were remarkably heterogeneous with respect to their FeNO. However, when we included genotype at a prominent asthma candidate gene (i.e., NOS1) in the case definition, and determined the number of AAT repeats in intron 20, we identified a remarkably homogenous cohort of patients with respect to FeNO. Both mean FeNO (p = 0.00008) and variability around the mean (p = 0.000002) were significantly lower in asthmatic individuals with a high number ( ⩾ 12) of AAT repeats at this locus than in those with fewer repeats. These data provide a biologically tenable link between genotype at a candidate gene in a region of linkage, NOS1, and an important component of the asthmatic phenotype, FeNO. We show that addition of NOS1 genotype to the case definition of asthma allows the identification of a uniform cohort of patients, with respect to FeNO, that would have been indistinguishable by other physiologic criteria. Our isolation of this homogenous cohort of patients ties together the well-established associations among asthma, increased concentrations of NO in the exhaled air of asthmatic individuals, and variations of trinucleotide repeat sequences as identified in several neurologic conditions.
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