Clin Exp Otorhinolaryngol.  2012 Dec;5(4):228-233. 10.3342/ceo.2012.5.4.228.

Nasal and Exhaled Nitric Oxide in Allergic Rhinitis

• Lee KJ
• Cho SH
• Lee SH
• Tae K
• Yoon HJ
• Kim SH
• Jeong JH

• KMID: 1489084
• DOI: http://doi.org/10.3342/ceo.2012.5.4.228

Abstract

OBJECTIVES
The primary aim of this study was to assess whether one can use levels of nasal nitric oxide (nNO) and exhaled nitric oxide (eNO) as a means of evaluation in allergic rhinitis.
METHODS
We used a chemiluminescence analyzer to measure nNO and eNO in normal controls (n=34) and allergic rhinitis patients (n=35), and compared these measurements with various parameters of clinical symptoms and laboratory data.
RESULTS
Mean nNO (389+/-119 ppb) in allergic rhinitis patients was significantly higher than normal controls (276+/-88 ppb). Without asthma, mean eNO (64.8+/-55.9 ppb) in allergic rhinitis patients was significantly higher than normal controls (33.0+/-24.0 ppb). In the persistent allergic rhinitis group, eNO concentration was significantly higher, while nNO concentration was significantly lower than the intermittent group.
CONCLUSION
We can use nNO and eNO levels for evaluation of allergic rhinitis. However, we should consider the fact that nNO levels can be reduced, when symptoms are severe and long-lasting. Additionally, in allergic rhinitis, eNO can be elevated without asthma.

Keyword

Nitirc oxide; Nasal nitric oxide; Exhaled nitric oxide; Allergic rhinitis; Asthma

MeSH Terms

Asthma
Humans
Luminescence
Nitric Oxide
Rhinitis
Rhinitis, Allergic, Perennial
Nitric Oxide

Figure

• 

  Fig. 1 Nasal & exhaled nitric oxide (NO) in the control and allergic rhinitis groups. Nasal & exhaled NO were significantly higher in allergic rhinitis group than control group.

• 

  Fig. 2 Correlation between exhaled nitric oxide (eNO) and symptoms in the allergic rhinitis group. There was significant correlation between eNO and watery rhinorrhea, sneezing, sum of symptoms. Other symptoms showed no significant correlation with eNO.

• 

  Fig. 3 Correlation between nasal nitric oxide (nNO) and symptoms in the allergic rhinitis group. There was no significant correlation between nNO and symptoms.

Reference

1. Scadding G. Nitric oxide in the airways. Curr Opin Otolaryngol Head Neck Surg. 2007; 8. 15(4):258–263. PMID: 17620900.

2. American Thoracic Society. European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005; 4. 171(8):912–930. PMID: 15817806.

3. Kawamoto H, Takumida M, Takeno S, Watanabe H, Fukushima N, Yajin K. Localization of nitric oxide synthase in human nasal mucosa with nasal allergy. Acta Otolaryngol Suppl. 1998; 539:65–70. PMID: 10095865.

4. Kawamoto H, Takeno S, Yajin K. Increased expression of inducible nitric oxide synthase in nasal epithelial cells in patients with allergic rhinitis. Laryngoscope. 1999; 12. 109(12):2015–2020. PMID: 10591366.

5. Kharitonov SA, Rajakulasingam K, O'Connor B, Durham SR, Barnes PJ. Nasal nitric oxide is increased in patients with asthma and allergic rhinitis and may be modulated by nasal glucocorticoids. J Allergy Clin Immunol. 1997; 1. 99(1 Pt 1):58–64. PMID: 9003212.

6. Djupesland PG, Chatkin JM, Qian W, Cole P, Zamel N, McClean P, et al. Aerodynamic influences on nasal nitric oxide output measurements. Acta Otolaryngol. 1999; 119(4):479–485. PMID: 10445065.

7. Arnal JF, Didier A, Rami J, M'Rini C, Charlet JP, Serrano E, et al. Nasal nitric oxide is increased in allergic rhinitis. Clin Exp Allergy. 1997; 4. 27(4):358–362. PMID: 9146927.

8. Maniscalco M, Sofia M, Carratu L, Higenbottam T. Effect of nitric oxide inhibition on nasal airway resistance after nasal allergen challenge in allergic rhinitis. Eur J Clin Invest. 2001; 5. 31(5):462–466. PMID: 11380599.

9. Palm JP, Alving K, Lundberg JO. Characterization of airway nitric oxide in allergic rhinitis: the effect of intranasal administration of L-NAME. Allergy. 2003; 9. 58(9):885–892. PMID: 12911417.

10. Baraldi E, Azzolin NM, Carra S, Dario C, Marchesini L, Zacchello F. Effect of topical steroids on nasal nitric oxide production in children with perennial allergic rhinitis: a pilot study. Respir Med. 1998; 3. 92(3):558–561. PMID: 9692122.

11. Scott M, Raza A, Karmaus W, Mitchell F, Grundy J, Kurukulaaratchy RJ, et al. Influence of atopy and asthma on exhaled nitric oxide in an unselected birth cohort study. Thorax. 2010; 3. 65(3):258–262. PMID: 20335297.

12. Hanazawa T, Antuni JD, Kharitonov SA, Barnes PJ. Intranasal administration of eotaxin increases nasal eosinophils and nitric oxide in patients with allergic rhinitis. J Allergy Clin Immunol. 2000; 1. 105(1 Pt 1):58–64. PMID: 10629453.