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 language | English (US) |
|---|---|
| Article number | 047101 |
| Journal | Journal of Breath Research |
| Volume | 6 |
| Issue number | 4 |
| DOIs | |
| State | Published - Dec 1 2012 |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
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 journal › Review article
}
TY - JOUR
T1 - Review of exhaled nitric oxide in chronic obstructive pulmonary disease
AU - Gelb, Arthur F.
AU - Barnes, Peter J.
AU - George, Steven
AU - Ricciardolo, Fabio L.M.
AU - DiMaria, Giussepe
AU - Zamel, Noe
PY - 2012/12/1
Y1 - 2012/12/1
N2 - 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.
AB - 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.
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UR - http://www.scopus.com/inward/citedby.url?scp=84866181989&partnerID=8YFLogxK
U2 - 10.1088/1752-7155/6/4/047101
DO - 10.1088/1752-7155/6/4/047101
M3 - Review article
C2 - 22677633
AN - SCOPUS:84866181989
VL - 6
JO - Journal of Breath Research
JF - Journal of Breath Research
SN - 1752-7155
IS - 4
M1 - 047101
ER -