A single dose of nebulized budesonide decreases exhaled nitric oxide in children with acute asthma

Exhaled nitric oxide distinguishes between subgroups of preschool children with respiratory symptoms

“…This finding may be surprising because it is well known that ICS treatment reduces FeNO levels in a dose-dependent manner in patients with asthma. [24][25][26][27] However, this is not the case in all children with asthma. [28][29][30] In addition, there is evidence of lack of clinical response to inhaled steroids in children with transient wheezing.…”

Offline Exhaled Nitric Oxide in Emergency Department and Subsequent Acute Asthma Control

“…Elevated fraction of exhaled NO (FE NO ) has been demonstrated in patients with acute asthma (2)(3)(4) and has been shown to decrease under steroid therapy after a few days. More recently, an early decrease, as soon as 6 to 7 hours after administration of inhaled or systemic steroid, has been suggested in children with acute asthma by a single group of investigators (5,6). Conversely, several studies have suggested that exhaled NO values are influenced by airway caliber in asthmatic patients (7,8), inasmuch as exhaled NO decreased significantly after induced-bronchoconstriction and returned to baseline after bronchodilation.…”

Budesonide/formoterol for maintenance and reliever therapy in the management of moderate to severe asthma

“…Budesonide has an array of other nongenomic effects, including rapid vasoconstriction (within 30 min), resulting in a reduction in airway oedema (23,65,66). Evidence shows that a single dose of budesonide significantly decreases sputum eosinophils in as little as 6 h (67) and reduces the level of nitric oxide in exhaled air (68), raised levels of which are predictive of loss of asthma control (69). Single doses of budesonide/formoterol protect against late-phase bronchial hyper-responsiveness provoked by allergens; this bronchoprotective/airwaystabilizing effect was not seen with budesonide and formoterol monotherapies (70).…”