Use of the exhaled nitric oxide for management of asthma and respiratory diseases

Kim, Sang Heon; Yoon, Ho Joo

Abstract

Measurement of fractional exhaled nitric oxide (FeNO) is one of the useful markers for airway inflammation. It detects NO in exhaled breath, which is increased along airway inflammation such as asthma. While there are a few tests assessing airway inflammation in noninvasive manners, FeNO has many advantages in that it can be measured easily and repeatedly in very short time with accuracy. In addition it reflects eosinophilic airway inflammation with significant correlation with eosinophilia in bronchial biopsy and sputum. The use of FeNO is useful in screening and diagnosis of asthma, prediction of steroid response, estimation of treatment response, and assessment of asthma control. Furthermore dose of medication can be titrated based on FeNO. The measurement of FeNO can play complementary role in asthma management along with pulmonary function test and airway hyperresponsiveness. In addition to asthma, FeNO maybe used for diagnosis of chronic obstructive pulmonary disease and chronic cough. With advent of new and cheap NO analyzer in near future, the use of FeNO could be introduced in routine practice of asthma.