Increased amount of nitric oxide in exhaled air of asthmatics

The presence of nitric oxide (NO) in the exhaled air of humans has recently been described. We wanted to assess at what level exhaled NO originates in normal airways, and to determine whether airway inflammation induces changes in the levels of exhaled NO. Exhaled NO was continuously measured by chemiluminescence technique during normal tidal breathing through the nose or mouth, with a detection limit of 1 part per billion (ppb). Twelve control subjects were compared to eight patients with mild atopic asthma and rhinitis caused by occupational allergen. In control subjects, the major part of NO in exhaled air (up to 30 ppb) seemed to originate in the nasal airways, with only minor contribution from the lower airways and the oral cavity. However, in mild asthmatics, the level of exhaled NO during oral breathing, indicating the involvement of the lower airways, was increased 2-3 fold. Since increased production of NO in the lower airways may involve activated macrophages or neutrophils, we suggest that exhaled NO may be used to instantly monitor ongoing bronchial inflammation, at least when involving inducible NO synthase.

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				S. L. JONES, J. KITTELSON, J. O. COWAN, E. M. FLANNERY, R. J. HANCOX, C. R. MCLACHLAN, and D. R. TAYLOR The Predictive Value of Exhaled Nitric Oxide Measurements in Assessing Changes in Asthma Control Am. J. Respir. Crit. Care Med., September 1, 2001; 164(5): 738 - 743. [Abstract] [Full Text] [PDF]

				C. Kotaru, M. Skowronski, A. Coreno, and E. R. McFadden Jr. Inhibition of nitric oxide synthesis attenuates thermally induced asthma J Appl Physiol, August 1, 2001; 91(2): 703 - 708. [Abstract] [Full Text] [PDF]

				D C Chambers and J G Ayres Effect of nebulised L- and D-arginine on exhaled nitric oxide in steroid naive asthma Thorax, August 1, 2001; 56(8): 602 - 606. [Abstract] [Full Text] [PDF]

				N. M. Tsoukias, H.-W. Shin, A. F. Wilson, and S. C. George A single-breath technique with variable flow rate to characterize nitric oxide exchange dynamics in the lungs J Appl Physiol, July 1, 2001; 91(1): 477 - 487. [Abstract] [Full Text] [PDF]

				M. Van Den BERGE, R. J. MEIJER, H. A. M. KERSTJENS, D. M. de REUS, G. H. KOETER, H. F. KAUFFMAN, and D. S. POSTMA PC20 Adenosine 5'-Monophosphate Is More Closely Associated with Airway Inflammation in Asthma Than PC20 Methacholine Am. J. Respir. Crit. Care Med., June 1, 2001; 163(7): 1546 - 1550. [Abstract] [Full Text] [PDF]

				L. LEHTIMAKI, H. KANKAANRANTA, S. SAARELAINEN, P. HAHTOLA, R. JARVENPAA, T. KOIVULA, V. TURJANMAA, and E. MOILANEN Extended Exhaled NO Measurement Differentiates between Alveolar and Bronchial Inflammation Am. J. Respir. Crit. Care Med., June 1, 2001; 163(7): 1557 - 1561. [Abstract] [Full Text] [PDF]

				S. A. KHARITONOV and P. J. BARNES Exhaled Markers of Pulmonary Disease Am. J. Respir. Crit. Care Med., June 1, 2001; 163(7): 1693 - 1722. [Full Text] [PDF]

				P. E. Silkoff, P. McClean, M. Spino, L. Erlich, A. S. Slutsky, and N. Zamel Dose-Response Relationship and Reproducibility of the Fall in Exhaled Nitric Oxide After Inhaled Beclomethasone Dipropionate Therapy in Asthma Patients Chest, May 1, 2001; 119(5): 1322 - 1328. [Abstract] [Full Text] [PDF]

				A E Redington, Q-H Meng, D R Springall, T J Evans, C Créminon, J Maclouf, S T Holgate, P H Howarth, and J M Polak Increased expression of inducible nitric oxide synthase and cyclo-oxygenase-2 in the airway epithelium of asthmatic subjects and regulation by corticosteroid treatment Thorax, May 1, 2001; 56(5): 351 - 357. [Abstract] [Full Text]

				L. R. Narasimhan, W. Goodman, and C. K. N. Patel Correlation of breath ammonia with blood urea nitrogen and creatinine during hemodialysis PNAS, April 10, 2001; 98(8): 4617 - 4621. [Abstract] [Full Text] [PDF]