Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And Asthma

Sy Duong-Quy1,2 1Department of Respiratory Diseases, Medical and Biological Research Centre, Lam Dong Medical College, Dalat City, Lam Dong Province, Vietnam; 2Department of Immuno-Allergology, Penn State Medical College, Hershey, PA, USACorrespondence: Sy Duong-QuyDepartment of Respiratory Diseases...

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Main Author: Duong-Quy S
Format: Article
Language:English
Published: Dove Medical Press 2019-10-01
Series:Journal of Asthma and Allergy
Subjects:
Online Access:https://www.dovepress.com/clinical-utility-of-the-exhaled-nitric-oxide-no-measurement-with-porta-peer-reviewed-article-JAA
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author Duong-Quy S
author_facet Duong-Quy S
author_sort Duong-Quy S
collection DOAJ
description Sy Duong-Quy1,2 1Department of Respiratory Diseases, Medical and Biological Research Centre, Lam Dong Medical College, Dalat City, Lam Dong Province, Vietnam; 2Department of Immuno-Allergology, Penn State Medical College, Hershey, PA, USACorrespondence: Sy Duong-QuyDepartment of Respiratory Diseases, Medical and Biological Research Center, Lam Dong Medical College, 16 Ngo Quyen, Dalat, VietnamTel +84 263918 413813Fax +84 263 3815000Email sduongquy.jfvp@gmail.comAbstract: Nitric oxide (NO) is a potential bioactive gas produced continuously and constantly in the airways of healthy subjects. In allergic airway inflammation, the level of exhaled NO is usually increased and mediated by inducible nitric oxide synthase (iNOS) enzyme presenting in the epithelium and different inflammatory cells. The measurement of NO concentration in the airway is possible with portable devices which use an electroluminescence technique. In subjects with upper airway with allergic inflammation such as in allergic rhinitis, the measurement of nasal NO (nNO) may help to diagnose and manage the disease. In the lower airway, increased fractional exhaled NO (FENO) reflects directly the inflammatory process that occurs in the airways that are typically seen in asthma. It has been shown that there is a strong correlation between FENO levels and increased activity of airway inflammation mediated by immuno-allergic cells and mediators. Thus, FENO has higher specificity and sensitivity than other methods in diagnosing the severity of inflammation in asthmatic patients. Moreover, the correlation between increased FENO levels and a high risk of bronchial hyperresponsiveness has also been demonstrated. FENO is also a relevant biomarker to evaluate asthma status due to the change of its values occurring earlier than clinical manifestations and spirometry parameters. In addition, the measurement of FENO with portable devices helps to support the diagnosis of asthma, to follow-up the control of asthma and to personalize asthmatic patients for target treatment with biologic therapy. Therefore, measuring FENO with portable devices in the diagnosis and treatment of allergic airway inflammation, especially in asthma, is one of the most essential applications of NO biomarkers in exhaled breath.Keywords: nitric oxide, iNOS, nNO, FENO, allergic rhinitis, asthma
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spelling doaj.art-67205ca6b19b4a9ca6e14ff44f69cb832022-12-22T03:35:30ZengDove Medical PressJournal of Asthma and Allergy1178-69652019-10-01Volume 1233134148993Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And AsthmaDuong-Quy SSy Duong-Quy1,2 1Department of Respiratory Diseases, Medical and Biological Research Centre, Lam Dong Medical College, Dalat City, Lam Dong Province, Vietnam; 2Department of Immuno-Allergology, Penn State Medical College, Hershey, PA, USACorrespondence: Sy Duong-QuyDepartment of Respiratory Diseases, Medical and Biological Research Center, Lam Dong Medical College, 16 Ngo Quyen, Dalat, VietnamTel +84 263918 413813Fax +84 263 3815000Email sduongquy.jfvp@gmail.comAbstract: Nitric oxide (NO) is a potential bioactive gas produced continuously and constantly in the airways of healthy subjects. In allergic airway inflammation, the level of exhaled NO is usually increased and mediated by inducible nitric oxide synthase (iNOS) enzyme presenting in the epithelium and different inflammatory cells. The measurement of NO concentration in the airway is possible with portable devices which use an electroluminescence technique. In subjects with upper airway with allergic inflammation such as in allergic rhinitis, the measurement of nasal NO (nNO) may help to diagnose and manage the disease. In the lower airway, increased fractional exhaled NO (FENO) reflects directly the inflammatory process that occurs in the airways that are typically seen in asthma. It has been shown that there is a strong correlation between FENO levels and increased activity of airway inflammation mediated by immuno-allergic cells and mediators. Thus, FENO has higher specificity and sensitivity than other methods in diagnosing the severity of inflammation in asthmatic patients. Moreover, the correlation between increased FENO levels and a high risk of bronchial hyperresponsiveness has also been demonstrated. FENO is also a relevant biomarker to evaluate asthma status due to the change of its values occurring earlier than clinical manifestations and spirometry parameters. In addition, the measurement of FENO with portable devices helps to support the diagnosis of asthma, to follow-up the control of asthma and to personalize asthmatic patients for target treatment with biologic therapy. Therefore, measuring FENO with portable devices in the diagnosis and treatment of allergic airway inflammation, especially in asthma, is one of the most essential applications of NO biomarkers in exhaled breath.Keywords: nitric oxide, iNOS, nNO, FENO, allergic rhinitis, asthmahttps://www.dovepress.com/clinical-utility-of-the-exhaled-nitric-oxide-no-measurement-with-porta-peer-reviewed-article-JAANitric oxideiNOSnNOFENOallergic rhinitisasthma.
spellingShingle Duong-Quy S
Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And Asthma
Journal of Asthma and Allergy
Nitric oxide
iNOS
nNO
FENO
allergic rhinitis
asthma.
title Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And Asthma
title_full Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And Asthma
title_fullStr Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And Asthma
title_full_unstemmed Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And Asthma
title_short Clinical Utility Of The Exhaled Nitric Oxide (NO) Measurement With Portable Devices In The Management Of Allergic Airway Inflammation And Asthma
title_sort clinical utility of the exhaled nitric oxide no measurement with portable devices in the management of allergic airway inflammation and asthma
topic Nitric oxide
iNOS
nNO
FENO
allergic rhinitis
asthma.
url https://www.dovepress.com/clinical-utility-of-the-exhaled-nitric-oxide-no-measurement-with-porta-peer-reviewed-article-JAA
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