Exhaled Nitric Oxide Research Articles

Personal exposure to particulate matter oxidative potential and airway inflammation: differences between asthmatic and non-asthmatic adults.

Personal exposure to particulate matter oxidative potential and airway inflammation: differences between asthmatic and non-asthmatic adults.

Long-Term Longitudinal Analysis of Pulmonary Function Before and After Biological Therapy in Severe Asthma.

Biological agents are essential treatment options for severe asthma, particularly in cases with Type 2 (T2) inflammation, due to their ability to improve symptoms, prevent exacerbations, and reduce the use of oral corticosteroids. However, limited data exist regarding their long-term effects on lung function, particularly on forced expiratory volume in one second (FEV₁). This study aimed to analyze the longitudinal changes in FEV₁ before and after the initiation of biological agents by following cases over an extended period. This study included patients with at least three spirometric measurements before and after the initiation of biological agents, and a follow-up period of at least two years. The primary outcome was the annual change in FEV₁ (ΔFEV₁). Secondary outcomes included comparisons between patients with improved and deteriorated ΔFEV₁, differences based on the type of biological agent used, and comparisons between patients who achieved clinical remission and those who did not. A total of 41 patients with severe asthma were analyzed. The overall ΔFEV₁ significantly improved after the introduction of biological agents (p < 0.001). Patients with greater declines in FEV₁ prior to treatment showed more pronounced improvements, especially among those treated with anti-IL-5 biologics (mepolizumab and benralizumab) or anti-IL-4 receptor antibodies (p = 0.016 and p = 0.026, respectively). Furthermore, patients with elevated T2 inflammation biomarkers, such as fractional exhaled nitric oxide (FeNO) and peripheral blood eosinophil count (PBE), exhibited greater improvements in FEV₁. This study indicates that biological agents may help prevent the progressive decline in lung function in severe asthma, particularly among patients with significantly declined lung function or elevated T2 inflammation biomarkers before treatment. Further research is needed to explore differences in efficacy across various biological agents.

The Emerging Biomarkers in Chronic Obstructive Pulmonary Disease: A Narrative Review.

The burden of chronic obstructive pulmonary disease (COPD) is increasing, especially for women in low-to-middle income countries. Biomarkers provide ever-increasing diagnostic precision for COPD and show promise for primary, secondary, and tertiary disease prevention. This review describes emerging applications for biomarkers in COPD, especially as they align with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) emphasis on prevention, early diagnosis, and response to therapy. These biomarkers include blood eosinophils; IgE; C-reactive protein; fibrinogen; procalcitonin; interleukins 6, 8, and 33; tumor necrosis factor alpha; and soluble receptor for advanced glycated products (sRAGE). They have been used in various ways to identify COPD endotypes, predict exacerbations, predict mortality, and monitor the response to therapy. The fraction of exhaled nitric oxide (FENO) is increasingly studied in eosinophilic COPD endotypes and can be a diagnostic and predictive non-invasive biomarker. Imaging biomarkers, especially the quantitative computerized tomography (QCT) assessment of airway remolding, functional small airway disease, air trapping, lung function, and volume surrogates, all serve as non-invasive biomarkers for screening, early detection, and disease progression. Biomarkers facilitate all the phases of COPD care from detecting early airflow obstruction to predicting exacerbation and mortality. Biomarkers will be increasingly used as precise diagnostic tools to improve the COPD outcomes. The aim of this narrative review is to summarize the recent investigations in COPD biomarkers and their clinical applications.

Longitudinal Study of Fractional Exhaled Nitric Oxide (FeNO) and Spirometric Indices in Trainee Bakers and Confectioners.

Longitudinal Study of Fractional Exhaled Nitric Oxide (FeNO) and Spirometric Indices in Trainee Bakers and Confectioners.

SERPINB10 promotes macrophage M2 polarization and airway inflammation in asthma

BackgroundMacrophage M2 polarization plays a critical role in type 2 airway inflammation in asthma. We previously reported that serine peptidase inhibitor, clade B, member 10 (SERPINB10) promotes airway eosinophilic inflammation in asthma.ObjectiveTo investigate the role of SERPINB10 in macrophage M2 polarization and airway inflammation in asthma.MethodsThe expression of SERPINB10 was detected in bronchoalveolar lavage (BAL) cells from 15 control subjects and 36 asthma patients. Serpinb10 knockout mice and wild type mice were sensitized and challenged with ovalbumin (OVA). Macrophage polarization and airway inflammation were evaluated. An adoptive transfer experiment of Serpinb10-deficient macrophages to macrophage-depleted mice was performed to assess the effect of Serpinb10 deficiency in macrophages on the airway inflammation in the model. The role of SERPINB10 in the activation of IL-4 receptor (IL-4R) signaling pathway and macrophage M2 polarization was investigated in cell cultures.ResultsSERPINB10 expression was markedly elevated in BAL cells from asthmatic patients, and was significantly correlated with fractional exhaled nitric oxide and CD206, a marker for macrophage M2 polarization. In the OVA-induced allergic airway inflammation mouse model, Serpinb10 deficiency significantly inhibited airway inflammation, mucous cell metaplasia and airway hyperresponsiveness. Moreover, Serpinb10 deficiency suppressed the expression of M2 markers including Cd206, Arg1 in mouse lung tissues and the protein levels of M2 macrophage effector cytokines including Ccl17 and Ccl22 in BAL fluid. Adoptive transfer of Serpinb10-deficient bone marrow-derived macrophages (BMDMs) to wild type mice depleted macrophages significantly suppressed the airway inflammation and mucous cell metaplasia. Mechanistically, SERPINB10 suppresses the degradation of IL-4Rα in macrophages, thereby upregulating the phosphorylation of Stat6 and Akt and leading to macrophage M2 polarization.ConclusionsSERPINB10 promotes macrophage M2 polarization by suppressing IL-4Rα degradation and upregulating IL-4R signaling. SERPINB10 is a potential therapeutic target for asthma.

Effect of periodontal therapy on lung function: a twelve-month follow-up intervention study

BackgroundEvidence suggest an inflammatory link between respiratory health and periodontitis. This study aims to evaluate the impact of periodontal therapy on lung function.MethodsSixty-two never-smoking patients with mild periodontitis and without other medical conditions participated in this single-blind, prospective trial. Patients underwent periodontal therapy following an infection control approach. Lung function was measured using forced oscillation technique, assessing airway resistance and reactance, and spirometry evaluating FEV1, FVC, and FEV1/FVC. Lung function and fractional exhaled nitric oxide were assessed at baseline, three and six weeks, and every three months for a year. Periodontal parameters were recorded at baseline, six weeks, six and 12 months. Data were analysed using mixed-effects regression models.ResultsPatients (mean age 36 years, 58% female) showed significant improvements in periodontal parameters (p < 0.001). Oscillometry revealed a significant decrease in airway resistance at 11 Hz and 19 Hz after six weeks, with further significant decreases throughout the study. Resistance at 5 Hz (R5) consistently declined, reaching significance at three months (p = 0.001). By one year, R5, R11, R19, and R5 − 20 showed significant reductions (all p < 0.05). Airway reactance at 5 Hz became less negative at three months (p = 0.002), while the reactance area (AX) decreased significantly at six months (p = 0.008). No significant changes were observed in spirometry or fractional exhaled nitric oxide.ConclusionA decrease in airway resistance was observed after periodontal therapy, underscoring its positive impact on small airway function. These findings suggest that oral infection control is valuable for respiratory health in young adults before chronic conditions establish.Clinical trial registrationThe trial was registered at ClinicalTrials.gov (NCT04781153) on February 19, 2021, prior to participant enrolment.

Small airway dysfunction mediates the relationship between Fractional Exhaled Nitric Oxide and asthma control.

Small airway dysfunction mediates the relationship between Fractional Exhaled Nitric Oxide and asthma control.

Comparative validation of handheld fractional exhaled nitric oxide measurements

ABSTRACT Background Fractional exhaled nitric oxide (FeNO) is a noninvasive method to determine the degree of airway inflammation. Handheld devices such as the Vivatmo Me are used for home monitoring. Differences were found between the Vivatmo Me and standard measurements with the NIOX VERO. Therefore, we aimed to determine the accuracy of the Vivatmo Me for FeNO measurements. Methods Adult patients with an appointment for FeNO-measurement according to regular care, were invited to perform the FeNO measurement with both devices. From these measurements the FeNO values were compared, and the device user-friendliness was determined. Results One hundred and sixty-four patients were included. The number of attempts needed for a successful measurement and the failure rate were higher with the Vivatmo Me. Although the measurements were highly correlated, a significant difference (p < 0.001) was found between FeNO values measured with both devices. From the Vivatmo measurements, 32% did not fall within the claimed accuracy ranges. A linear correction on the FeNO values reduced this number. Conclusion Our findings indicate that the Vivatmo Me does not comply with the claimed accuracy of clinical FeNO measurements and the measurement is challenging to perform. By applying the proposed correction, the comparative validity of the FeNO measurement improves and therefore its clinical usefulness.

Impact of Smoking on Biological Treatment Response in Patients From the German Severe Asthma (GAN) Registry.

Impact of Smoking on Biological Treatment Response in Patients From the German Severe Asthma (GAN) Registry.

Dupilumab efficacy in relation to changes in club cell secretory protein 16.

Dupilumab efficacy in relation to changes in club cell secretory protein 16.

Guidance for type 2 inflammatory biomarkers.

Type 2 inflammation in the airways and lungs is inflammation induced by type 2 cytokines such as IL-4, IL-5, and IL-13, produced primarily by type 2 helper T cells and type 2 innate lymphoid cells, and causes changes in the physiology and structure of the airways. Type 2 inflammation is currently in the spotlight because of its direct link to the treatment of several airway and lung diseases. Abundant evidences have accumulated that inflammatory biomarkers such as blood eosinophils, fractional exhaled nitric oxide, and IgE are essential clinical tools in the diagnosis and management of asthma and COPD. It is well known that asthma and COPD have diverse inflammatory phenotypes even when clinical features are similar, and it has been demonstrated that assessment of airway inflammation with biomarkers can improve diagnostic accuracy, determine safer and more effective treatment strategies, and predict future risks such as exacerbations and lung function decline. The Japanese Respiratory Society has published clinical practice guidelines for the evaluation of type 2 inflammation in the airways and lungs. In addition to asthma and COPD, the guide covers a wide range of airway and lung diseases, including interstitial lung disease, allergic bronchopulmonary mycosis, allergic rhinitis, and eosinophilic chronic rhinosinusitis. It also provides comprehensive guidelines covering a variety of clinical biomarkers. The purpose of this guidance is to provide evidences for the interpretation of type 2 inflammation measurements and to promote the widespread use of inflammation assessment to further improve the efficiency of airway and respiratory disease management.

Fractional Exhaled Nitric Oxide and Asthma Control in Moderate to Severe Asthma Patients Treated With Omalizumab: A Retrospective Cohort Study

Fractional Exhaled Nitric Oxide and Asthma Control in Moderate to Severe Asthma Patients Treated With Omalizumab: A Retrospective Cohort Study

The Impact of Smoking History on Baseline Characteristic in Patients With Severe Asthma in the German Asthma Net (GAN).

The Impact of Smoking History on Baseline Characteristic in Patients With Severe Asthma in the German Asthma Net (GAN).

Seasonal Variability of Fractional Exhaled Nitric Oxide (FeNO)

Seasonal Variability of Fractional Exhaled Nitric Oxide (FeNO)

Association Between Baseline Fractional Exhaled Nitric Oxide and Mucus Response in Patients With Uncontrolled Moderate-To-Severe Asthma Treated With Dupilumab in the Vestige Study

Association Between Baseline Fractional Exhaled Nitric Oxide and Mucus Response in Patients With Uncontrolled Moderate-To-Severe Asthma Treated With Dupilumab in the Vestige Study

Utility of Fractional Exhaled Nitric Oxide Compared With Methacholine Challenge Test for the Diagnosis of Bronchial Asthma in Adult Patients in a Tertiary Hospital in the Philippines

Utility of Fractional Exhaled Nitric Oxide Compared With Methacholine Challenge Test for the Diagnosis of Bronchial Asthma in Adult Patients in a Tertiary Hospital in the Philippines

Serial Changes of Fractional Exhaled Nitric Oxide and Periostin in the Treatment Course of Cough Variant Asthma

Serial Changes of Fractional Exhaled Nitric Oxide and Periostin in the Treatment Course of Cough Variant Asthma

Identification of bronchial epithelial genes associated with type 2 eosinophilic inflammation in asthma.

Identification of bronchial epithelial genes associated with type 2 eosinophilic inflammation in asthma.

Complementary Role of Fractional Exhaled Nitric Oxide and Blood Eosinophil Counts in Asthma Prevalence and Diagnosis: Sex-specific Evidence From NHANES

Complementary Role of Fractional Exhaled Nitric Oxide and Blood Eosinophil Counts in Asthma Prevalence and Diagnosis: Sex-specific Evidence From NHANES

The Association of Exhaled Nitric Oxide Level With Respiratory Muscle Strength, Pulmonary Function, Exercise Capacity, Sleep Quality, Functional Status, and Health-Related Quality of Life in Patients With Pulmonary Arterial Hypertension

The Association of Exhaled Nitric Oxide Level With Respiratory Muscle Strength, Pulmonary Function, Exercise Capacity, Sleep Quality, Functional Status, and Health-Related Quality of Life in Patients With Pulmonary Arterial Hypertension