Chapter 30 - Nitric Oxide

Abstract

This chapter reviews the formation of NO, novel approaches of its measurements, and its role in the pathobiology and the management of asthma and chronic obstructive pulmonary disease (COPD). NO is now known to play a central role in the physiology and the pathophysiology of many human organ systems. Within the respiratory system, NO promotes vascular and bronchial dilation, is a key mediator of the coordinated beating of ciliated epithelial cells, promotes mucus secretion, and is an important neurotransmitter for nonadrenergic, noncholinergic neurons in the bronchial wall. Additionally, NO is a mediator of inflammatory phenomena within the lung by virtue of its ability to influence the phenotype of inflammatory cells and its contribution to the formation of reactive nitrogen products. The precise inflammatory pathways and cells, NOS enzyme isoforms, and anatomical compartments responsible for production of the NO captured in the expirate are areas of active investigation. There are two interlinked and equally important future areas of NO research: exploring further potential and prevalent sources of NO and its role in different diseases and the use of NO in clinical medicine, including home measurements and routine asthma monitoring.