Nitric oxide exhaled

J.C. Ojoo, S.A. Mulrennan, J.A. Kastelik, A.H. Morice, and A.E. Redington, Exhaled breath condensate pH and exhaled nitric oxide in allergic asthma and in cystic fibrosis. Thorax 60, 22-26 (2005). 

Nitric oxide may suppress THi subset and its high levels may increase the expression of TH2 subset. The action of inducible nitric oxide synthetase may result in increased exhaled nitric oxide in asthmatics. The airway epithelial cells are the predominant source of increased nitric oxide in asthmatic subjects. Since nitric oxide has both beneficial and adverse effects on bronchial airways, its precise contribution to the etiology and pathogenesis of asthmatic disease requires additional investigation. 

Franklin, P., Dingle, P. and Dick, S. (2000) Formaldehyde exposure in homes is associated with increased levels of exhaled nitric oxide in healthy children. Proceedings of Healthy Buildings 2000, August 6-10, Espoo, Finland, Vol. 1, pp. 65-70. 

Franklin P, Dingle P, Stick S (2000) Raised exhaled nitric oxide in healthy children is associated with domestic formaldehyde levels. Am J Respir Crit Care Med, 161 1757-1759. 

Brindicci C, Ito K, Resta O, Pride NB, Barnes PJ, Kharitonov SA. Exhaled nitric oxide from lung periphery is increased in COPD. Eur. Respir. J. 2005 26 52-59. 

Hussain SN, Abdul Hussain MN and el Dwairi Q, Exhaled nitric oxide as a marker for serum nitric oxide concentration in acute endotoxemia. 7 CnV Care 11(4) 167-75, 1996. 

Massaro, A., Gaston, B. Fanta, C.H., Stamler, J.S. et al. (1994). The effects of treatment with steroids on the levels of exhaled nitric oxide in patients with asthma. Am. ]. Respir. Crit. Care Med., in press (1995). 

Paredi P, Kharitonov SA, Loukides S, Pentelidi S, Bois RM, Barnes PJ. 1999. Exhaled nitric oxide is increased in active fibrosing alveolitis. Chest 115 1352-56... 

Exhaled nitric oxide was used as the marker of airway inflammation after patients who had asthma were found to have increased levels of exhaled nitric oxide and nitric oxide synthase expression [17]. Exhaled nitric oxide correlated with a response to steroid, defined as change in pulmonary function testing, asthma symptoms, and BHR [18]. Patients who have symptoms of asthma who respond to steroids have higher exhaled nitric oxide than those who do not, implying inadequate anti-inflammatory treatment. The cutoff of exhaled nitric oxide for steroid response was determined to be approximately 48 parts per billion in one study [18], but no standards are widely used. 

Smith AD, Cowan JO, Brassett KP, et al. Exhaled nitric oxide a predictor of steroid response. Am J Respir Crit Care Med 2005 172 453-9. 

The response to ICSs is somewhat delayed. Mostpatients symptoms will improve in the first 1 to 2 weeks of therapy and will reach maximum improvement in 4 to 8 weeks. Improvement in baseline FEVi and PEFs may require 3 to 6 weeks for maximum improvement, whereas improvement in BHR requires 2 to 3 weeks and approaches maximum in 1 to 3 months but may continue to improve over 1 year. Most of the improvement in these parameters occurs at low to medium doses, and there is a large variabflity in response, with 10% of patients not demonstrating an improvement in either parameter. Whether these nonresponders also show no improvement in rates of exacerbations is unknown. Maximum decrease in exhaled nitric oxide occurs within 2 to 3 weeks. Sensitivity to exercise challenge decreases after 4 weeks of therapy. Although single doses do not inhibit the immediate asthmatic response to antigen challenge, continued therapy for 1 week partially suppresses the response. These two latter effects are likely due to a reduction in mucosal mast cells. ... 

Adamkiewicz G, Ebelt S, Syring M et al (2004) Association between air pollution exposure and exhaled nitric oxide in an elderly population. Thorax 59 204-209 Araujo JA, Barajas B, Kleinman M et al (2008) Ambient particulate pollutants in the ultrafine range promote early atherosclerosis and systemic oxidative stress. Circ Res 102 589-596 Aufderheide M (2005) Direct exposure methods for testing native atmospheres. Exp Toxicol Pathol 57 213-226... 

Carter JM, Corson N, Driscoll KE et al (2006) A comparative dose-related response of several key pro- and anti-inflammatory mediators in the lungs of rats, mice, and hamsters after subchronic inhalation of carbon black. J Occup Environ Med 48 1265-1278 Cohen AJ, Anderson HR, Ostro B et al (2005) The global burden of diseases due to outdoor air pollution. J Toxicol Environ Health 68 1301-1307 Delfino RJ, Sioutas C, Malik S (2005) Potential role of ultrafine particles in associations between airborne particle mass and cardiovascular health. Environ Health Perspect 113 934—946 Delfino RJ, Staimer N, Gillen D et al (2006) Personal and ambient air pollution is associated with increased exhaled nitric oxide in children with asthma. Environ Health Perspect 114 1736-1743... 

Air pollution is associated with increased level of exhaled nitric oxide in non-smoking healthy subjects (Van Amsterdam et al. 1999). 

Justino CIL, Rocha-Santos TA, Duarte AC, Rocha-Santos TA (2010) Review of analytical figures of merit of sensors and biosensors in clinical applications. Trends Anal Chem 29(10) 172-1183 Keefe MK, Benkstein KD, Hup JT (2000) Luminescent sensor molecules based on coordinated metals a review of recent developments. Coord Chem Rev 205(l) 201-228 Kharitonov SA, Barnes PJ (2000) CUnical aspects of exhaled nitric oxide. Eur Respir J 16 781-792 King WH Jr (1964) Piezoelectric sorption detector. Anal Chem 36 1735-1739... 

Studies measuring exhaled nitric oxide (NO) at several exhalation flow rates have revealed that the alveolar NO concentration correlates negatively with Dlco. vital capacity, and alveolar volume, suggesting that it may be a marker of disease severity (53). 

Kanamori H, Fujisawa S, Tsuburai T, et al. Increased exhaled nitric oxide in bronchiolitis obliterans organizing pneumonia after allogeneic bone marrow transplantation. Transplantation 2002 74(9) 1356-1358. 

Zitt, M., 2005. Clinical appHcations of exhaled nitric oxide for the diagnosis and management of asthma a consensus report. Chn. Ther. 27 (8), 1238—1250. 

Olin, A.C., Ljungkvist, G., Bake, B., et al., 1999. Exhaled nitric oxide among pulpmill workers reporting gassing incidents involving ozone and chlorine... 

Just AC, Whyatt RM, Miller RL et al (2012a) Children s urinary phthalate metabolites and fractional exhaled nitric oxide in an urban cohort. Am J Respir Crit Care Med 86(9) 830-837 Just AC, Whyatt RM, Perzanowski MS et al (2012b) Prenatal exposure to butylbenzyl phthalate and early eczema in an urban cohort. Environ Health Perspect 120(10) 1475-1480 Kang SC, Lee BM (2005) DNA methylation of estrogen receptor alpha gene by phthalates. 

Verleden GM, Dupont LJ, Van Raemdonck D, Vanhaecke J (2003) Effect of switching from cyclosporine to tacrolimus on exhaled nitric oxide and pulmonary function in patients with chronic rejection after lung transplantation. J Heart Lung Transplant 22 908-913... 

Montuschi P, Santonico M, Mondino C, Penazza G, Mantini G, Martinelli E, Capuano R, Ciabattoni G, Paolesse R, Di Natale C, Barnes P, D Amico A (2010) Diagnostic performance of an electronic nose, fractional exhaled nitric oxide, and lung function testing in asthma. Chest 137 790-796... 

Mora BN, Boasquevisque CFl, Uy G, McCarthy TJ, Welch MJ, Boglione M, Patterson GA. Exhaled nitric oxide correlates with experimental lung transplant rejection. Ann Thorac Surg 2000 69 210-215. 

Piacentini GL, Bodini A, Costella S, Vicentini L, Peroni D, Zanolla L, et al. Allergen avoidance is associated with a fall in exhaled nitric oxide in asthmatic children. J Allergy Clin Immunol 1999 104(6) 1323-1324. 

Exhaled nitric oxide (eNO) has been considered as a marker of airway inflammation in asthma (41,42). Levels of eNO are elevated in steroid-naive asthmatic subjects compared with normal subjects and decrease with corticosteroid treatment (43). A study in children found that eNO was elevated in atopic asthmatics compared with nonatopics, correlated with serum IgE, and children with non-atopic asthma had levels similar to those of nonasthmatics (44). Extending these findings, Simpson (45) reported that eNO was elevated in patients with atopic asthma who were exposed to their relevant allergen compared with sensitized patients who were not exposed. 

Figure 4 Xolair reduces exhaled nitric oxide, a marker of airway inflammation. Exhaled NO levels studied in 6- to 12-year-old asthmatics were controlled on inhaled CS and rescue P-agonist use. During a 12-week protocol-defined withdrawal of CS, eNO levels increased in those children receiving placebo. Omalizumab-treated patients were protected against increased eNO while achieving significantly greater withdrawal of CS.

Simpson A, Custovic A, Pipis S, Adisesh A, Faragher B, Woodcock A. Exhaled nitric oxide, sensitization, and exposure to allergens in patients with asthma who are not taking inhaled steroids. Am J Respir Crit Care Med 1999 160 45-49. Silknff PE, Romero F, MUgrom H, Tran ZV, Townley R, Gupta N, Rohane P, Fick R. Exhaled nitric oxide (eNO) and anti-inflammatory effects of a recombinant humanized monoclonal antibody to IgE (rhuMAb-E25) in pediatric asthma. Chest 2000 118(4) 101S. 

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