Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review
Background: Fractional exhaled nitric oxide (FeNO) is a biomarker of airway inflammation associated with airway hyper-responsiveness and type-2 inflammation. Its role in the management of severe asthmatic patients undergoing biologic treatment, as well as FeNO dynamics during biologic treatment, is...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Antioxidants |
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| Online Access: | https://www.mdpi.com/2076-3921/12/2/400 |
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| author | Tommaso Pianigiani Lorenzo Alderighi Martina Meocci Maddalena Messina Beatrice Perea Simona Luzzi Laura Bergantini Miriana D’Alessandro Rosa Metella Refini Elena Bargagli Paolo Cameli |
| author_facet | Tommaso Pianigiani Lorenzo Alderighi Martina Meocci Maddalena Messina Beatrice Perea Simona Luzzi Laura Bergantini Miriana D’Alessandro Rosa Metella Refini Elena Bargagli Paolo Cameli |
| author_sort | Tommaso Pianigiani |
| collection | DOAJ |
| description | Background: Fractional exhaled nitric oxide (FeNO) is a biomarker of airway inflammation associated with airway hyper-responsiveness and type-2 inflammation. Its role in the management of severe asthmatic patients undergoing biologic treatment, as well as FeNO dynamics during biologic treatment, is largely unexplored. Purpose: The aim was to evaluate published data contributing to the following areas: (1) FeNO as a predictive biomarker of response to biologic treatment; (2) the influence of biologic treatment in FeNO values; (3) FeNO as a biomarker for the prediction of exacerbations in patients treated with biologics. Methods: The systematic search was conducted on the Medline database through the Pubmed search engine, including all studies from 2009 to the present. Results: Higher baseline values of FeNO are associated with better clinical control in patients treated with omalizumab, dupilumab, and tezepelumab. FeNO dynamics during biologic treatment highlights a clear reduction in FeNO values in patients treated with anti-IL4/13 and anti-IL13, as well as in patients treated with tezepelumab. During the treatment, FeNO may help to predict clinical worsening and to differentiate eosinophilic from non-eosinophilic exacerbations. Conclusions: Higher baseline FeNO levels appear to be associated with a greater benefit in terms of clinical control and reduction of exacerbation rate, while FeNO dynamics during biologic treatment remains a largely unexplored issue since few studies have investigated it as a primary outcome. FeNO remains detectable during biologic treatment, but its potential utility as a biomarker of clinical control is still unclear and represents an interesting research area to be developed. |
| first_indexed | 2024-03-11T09:13:51Z |
| format | Article |
| id | doaj.art-3c273887465d4d1d83a684b0bc69da75 |
| institution | Directory Open Access Journal |
| issn | 2076-3921 |
| language | English |
| last_indexed | 2024-03-11T09:13:51Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antioxidants |
| spelling | doaj.art-3c273887465d4d1d83a684b0bc69da752023-11-16T18:47:39ZengMDPI AGAntioxidants2076-39212023-02-0112240010.3390/antiox12020400Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic ReviewTommaso Pianigiani0Lorenzo Alderighi1Martina Meocci2Maddalena Messina3Beatrice Perea4Simona Luzzi5Laura Bergantini6Miriana D’Alessandro7Rosa Metella Refini8Elena Bargagli9Paolo Cameli10Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyRespiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, ItalyBackground: Fractional exhaled nitric oxide (FeNO) is a biomarker of airway inflammation associated with airway hyper-responsiveness and type-2 inflammation. Its role in the management of severe asthmatic patients undergoing biologic treatment, as well as FeNO dynamics during biologic treatment, is largely unexplored. Purpose: The aim was to evaluate published data contributing to the following areas: (1) FeNO as a predictive biomarker of response to biologic treatment; (2) the influence of biologic treatment in FeNO values; (3) FeNO as a biomarker for the prediction of exacerbations in patients treated with biologics. Methods: The systematic search was conducted on the Medline database through the Pubmed search engine, including all studies from 2009 to the present. Results: Higher baseline values of FeNO are associated with better clinical control in patients treated with omalizumab, dupilumab, and tezepelumab. FeNO dynamics during biologic treatment highlights a clear reduction in FeNO values in patients treated with anti-IL4/13 and anti-IL13, as well as in patients treated with tezepelumab. During the treatment, FeNO may help to predict clinical worsening and to differentiate eosinophilic from non-eosinophilic exacerbations. Conclusions: Higher baseline FeNO levels appear to be associated with a greater benefit in terms of clinical control and reduction of exacerbation rate, while FeNO dynamics during biologic treatment remains a largely unexplored issue since few studies have investigated it as a primary outcome. FeNO remains detectable during biologic treatment, but its potential utility as a biomarker of clinical control is still unclear and represents an interesting research area to be developed.https://www.mdpi.com/2076-3921/12/2/400nitric oxidebiomarkersevere asthmabiologic |
| spellingShingle | Tommaso Pianigiani Lorenzo Alderighi Martina Meocci Maddalena Messina Beatrice Perea Simona Luzzi Laura Bergantini Miriana D’Alessandro Rosa Metella Refini Elena Bargagli Paolo Cameli Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review Antioxidants nitric oxide biomarker severe asthma biologic |
| title | Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review |
| title_full | Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review |
| title_fullStr | Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review |
| title_full_unstemmed | Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review |
| title_short | Exploring the Interaction between Fractional Exhaled Nitric Oxide and Biologic Treatment in Severe Asthma: A Systematic Review |
| title_sort | exploring the interaction between fractional exhaled nitric oxide and biologic treatment in severe asthma a systematic review |
| topic | nitric oxide biomarker severe asthma biologic |
| url | https://www.mdpi.com/2076-3921/12/2/400 |
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