Exhaled nitric oxide measurements: clinical application and interpretation

Taylor, D. R.; Pijnenburg, M. W.; Smith, A. D.; De Jongste, J. C.
September 2006
Thorax;Sep2006, Vol. 61 Issue 9, p817
Academic Journal
The use of exhaled nitric oxide measurements (FENO) in clinical practice is now coming of age. There are a number of theoretical and practical factors which have brought this about. Firstly, FENO is a good surrogate marker for eosinophilic airway inflammation. High FENO levels may be used to distinguish eosinophilic from non-eosinophilic pathologies. This information complements conventional pulmonary function testing in the assessment of patients with non-specific respiratory symptoms. Secondly, eosinophilic airway inflammation is steroid responsive. There are now sufficient data to justify the claim that FENO measurements may be used successfully to identify and monitor steroid response as well as steroid requirements in the diagnosis and management of airways disease. FENO measurements are also helpful in identifying patients who do/do not require ongoing treatment with inhaled steroids. Thirdly, portable nitric oxide analysers are now available, making routine testing a practical possibility. However, a number of issues still need to be resolved, including the diagnostic role of FENO in preschool children and the use of reference values versus individual FENO profiles in managing patients with difficult or severe asthma.


Related Articles

  • Exhaled nitric oxide in paediatric asthma. Ratnawati, R.; Thomas, P. S. // Chronic Respiratory Disease;2005, Vol. 2 Issue 3, p163 

    Assessment of airway function is difficult in young children with asthma, and in addition, only reflects the status of the disease at the time of the measurement. Thus, there is increasing interest in monitoring airway inflammation in asthma, which may provide a longer term assessment of disease...

  • Clinical patterns in asthma based on proximal and distal airway nitric oxide categories. Puckett, James L.; Taylor, Richard W. E.; Szu-Yun Leu; Guijon, Olga L.; Aledia, Anna S.; Galant, Stanley P.; George, Steven C. // Respiratory Research;2010, Vol. 11, p47 

    Background: The exhaled nitric oxide (eNO) signal is a marker of inflammation, and can be partitioned into proximal [J'awNO (nl/s), maximum airway flux] and distal contributions [CANO (ppb), distal airway/alveolar NO concentration]. We hypothesized that J'awNO and CANO are selectively elevated...

  • Budesonide Inhalation Suspension for the Treatment of Asthma in Infants and Children. Berger, William E. // Drugs;2005, Vol. 65 Issue 14, p1973 

    On the basis of the well recognised role of inflammation in the pathogenesis of asthma, anti-inflammatory therapy, in the form of inhaled corticosteroids, has become the mainstay of treatment in patients with persistent asthma. Budesonide inhalation suspension (BIS) is a nonhalogenated...

  • MANAGEMENT OF ASTHMA BY HERBAL THERAPY WITH SPECIAL REFERENCE TO POLYHERBAL FORMULATION. Barik, C. S.; Kanungo, S. K.; Panda, J. R.; Tripathy, N. K. // Pharma Science Monitor;Apr-Jun2014, Vol. 5 Issue 2, p73 

    In traditional systems of medicine, various plants have been acknowledged to be useful for the treatment of different types of respiratory disorders including asthma. In few decades the use of medicinal plants has been increased dramatically throughout the world. Current synthetic drugs used in...

  • Monitoring Growth in asthmatic children treated with high dose inhaled glucocorticoids does not predict adrenal suppression. Dunlop, K. A.; Carson, D. J.; Steen, H. J.; McGovern, V.; McNaboe, J.; Shields, M. D. // Archives of Disease in Childhood;Aug2004, Vol. 89 Issue 8, p713 

    Aims: To determine whether routine outpatient monitoring of growth predicts adrenal suppression in prepubertal children treated with high dose inhaled glucocorticoid. Methods: Observational study of 35 prepubertal children (aged 4-10 years) treated with at least 1000 pg/day of inhaled budesonide...

  • Role of nitric oxide in inflammatory diseases. Sharma, J. N.; Al-Omran, A.; Parvathy, S. S. // Inflammopharmacology;Dec2007, Vol. 15 Issue 6, p252 

    Nitric oxide (NO) is a signaling molecule that plays a key role in the pathogenesis of inflammation. It gives an anti-inflammatory effect under normal physiological conditions. On the other hand, NO is considered as a pro-inflammatory mediator that induces inflammation due to over production in...

  • Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE. Caudri, Daan; Wijga, Alet H.; Hoekstra, Maarten O.; Kerkhof, Marjan; Koppelman, Gerard H.; Brunekreef, Bert; Smit, Henriette A.; de Jongste, Johan C. // Thorax;Sep2010, Vol. 65 Issue 9, p4 

    Rationale For clinicians it remains very difficult to predict whether preschool children with symptoms suggestive of asthma will develop asthma in later childhood. Objective To investigate whether measurement of fraction of exhaled nitric oxide (FENO), interrupter resistance (Rint) or specific...

  • Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice. Jenkins, Christine; Costello, John; Hodge, Linda // BMJ: British Medical Journal (International Edition);2/21/2004, Vol. 328 Issue 7437, p434 

    Abstract Objectives: To reassess the prevalence of aspirin induced asthma and other issues related to the syndrome. Data sources: Biosis, SciSearch (1990 to March 2002), Embase (1974 to March 2002), Medline (1966 to March 2002), Toxline, Derwent Drug File (1964 to March 2002), Conference Papers...

  • Comparison of three NSAIDs in the treatment of bovine respiratory disease.  // Veterinary Record: Journal of the British Veterinary Association;3/29/2003, Vol. 152 Issue 13, p380 

    Reports on the results of a study which compares three types of nonsteroidal anti-inflammatory agents (NSAID) used for treating bovine respiratory diseases.


Read the Article


Sign out of this library

Other Topics