Review of exhaled nitric oxide in chronic obstructive pulmonary disease

Arthur F. Gelb, Peter J. Barnes, Steven George, Fabio L.M. Ricciardolo, Giussepe DiMaria, Noe Zamel

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

The up-regulation of nitric oxide (NO) by inflammatory cytokines and mediators in central and peripheral airway sites can be easily monitored in exhaled air (F ENO). It is now possible to estimate the predominant airway site of increased F ENO i.e. large versus peripheral airway/alveoli, and its potential pathologic and physiologic role in obstructive lung disease. In asthma, six double-blind, randomized, controlled algorithm trials have reported only equivocal benefits of add-on measurements of F ENO to usual clinical guideline management including spirometry. Significant design issues, as emphasized by Gibson, may exist. However, meta-analysis of these six studies (Petsky et al 2012 Thorax 67 199-208) concluded that routine serial measurements of F ENO for clinical asthma management does not appear warranted. In COPD including chronic bronchitis and emphysema, despite significant expiratory airflow limitation, when clinically stable as well as during exacerbation, F ENO, j′ awNO and C ANO may all be normal or increased. Furthermore, the role of add-on monitoring of exhaled NO to GOLD management guidelines is less clear because of the absence of conclusive doubleblind, randomized, control trial studies concerning potential clinical benefits in the management of COPD.

Original languageEnglish (US)
Article number047101
JournalJournal of Breath Research
Volume6
Issue number4
DOIs
StatePublished - Dec 1 2012

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Chronic Obstructive Pulmonary Disease
Nitric Oxide
Asthma
Guidelines
Obstructive Lung Diseases
Pulmonary Ventilation
Spirometry
Chronic Bronchitis
Emphysema
Meta-Analysis
Up-Regulation
Thorax
Randomized Controlled Trials
Air
Cytokines

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Gelb, A. F., Barnes, P. J., George, S., Ricciardolo, F. L. M., DiMaria, G., & Zamel, N. (2012). Review of exhaled nitric oxide in chronic obstructive pulmonary disease. Journal of Breath Research, 6(4), [047101]. https://doi.org/10.1088/1752-7155/6/4/047101

Review of exhaled nitric oxide in chronic obstructive pulmonary disease. / Gelb, Arthur F.; Barnes, Peter J.; George, Steven; Ricciardolo, Fabio L.M.; DiMaria, Giussepe; Zamel, Noe.

In: Journal of Breath Research, Vol. 6, No. 4, 047101, 01.12.2012.

Research output: Contribution to journalReview article

Gelb, Arthur F. ; Barnes, Peter J. ; George, Steven ; Ricciardolo, Fabio L.M. ; DiMaria, Giussepe ; Zamel, Noe. / Review of exhaled nitric oxide in chronic obstructive pulmonary disease. In: Journal of Breath Research. 2012 ; Vol. 6, No. 4.
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