Low levels of nitric oxide and carbon monoxide in 1-antitrypsin deficiency

Machado, Roberto F., James K. Stoller, Daniel Laskowski, Shuo Zheng, Joseph A. Lupica, Raed A. Dweik, and Serpil C. Erzurum. Low levels of nitric oxide and carbon monoxide in 1-antitrypsin deficiency. J Appl Physiol 93: 2038–2043, 2002. First published August 30, 2002; 10.1152/japplphysiol.00659.2002.—Quantitations of exhaled nitric oxide (NO) and carbon monoxide (CO) have been proposed as noninvasive markers of airway inflammation. We hypothesized that exhaled CO is increased in individuals with 1-antitrypsin (AT) deficiency, who have lung inflammation and injury related to oxidative and proteolytic processes. Nineteen individuals with 1-AT deficiency, 22 healthy controls, and 12 patients with non1-AT-deficient chronic obstructive pulmonary disease (COPD) had NO, CO, CO2, and O2 measured in exhaled breath. Individuals with 1-AT deficiency had lower levels of NO and CO than control or COPD individuals. 1-AT-deficient and COPD patients had lower exhaled CO2 than controls, although only 1-ATdeficient patients had higher exhaled O2 than healthy controls. NO was correlated inversely with exhaled O2 and directly with exhaled CO2, supporting a role for NO in regulation of gas exchange. Exhaled gases were not significantly related to corticosteroid use or lung function. Demonstration of lower than normal CO and NO levels may be useful as an additional noninvasive method to evaluate 1-AT deficiency in individuals with a severe, early onset of obstructive lung disease.