Combined measurements of fractional exhaled nitric oxide and nasal nitric oxide levels for assessing upper airway diseases in asthmatic patients

Asano, Tomohiko; Takemura, Masashi; Kanemitsu, Yoshihiro; Yokota, Makoto; Fukumitsu, Kensuke; Takeda, Norihisa; Ichikawa, Hiroya; Hijikata, Hisatoshi; Uemura, Takashi; Takakuwa, Osamu; Ohkubo, Hirotsugu; Maeno, Ken; Ito, Yutaka; Oguri, Tetsuya; Nakamura, Atsushi; Maki, Y; Nakamura, Yoshihisa; Suzuki, Motohiko

doi:10.1080/02770903.2017.1332203

Cited by 19 publications

(15 citation statements)

References 46 publications

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“…Finally, 19 papers were not included after a complete evaluation of the text. Therefore, 23 papers were considered for the conclusive analysis [16][17][18][19][20][21][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] (Figure 1). Of these, seven studies [16,31,32,[36][37][38]40] provided data on CRSwNP patients and healthy controls, two studies [17,27] on CRSsNP and healthy subjects, six studies [18][19][20][41][42][43] on CRSwNP and CRSsNP patients, while eight studies [21,[28][29][30][33][34][35]39] evaluated both clinical settings (CRSwNP and CRSsNP) and healthy subjects.…”

Section: Resultsmentioning

confidence: 99%

“…In these cases, different groups were evaluated as different data sets. Most included studies [16][17][18]20,21,27,28,[30][31][32][33][34][35]37,38,40,42,43] evaluated nNO by nasal aspiration method, while only five studies [19,29,36,39,41] used nasal exhalation.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In 15 studies (18 data sets) [16,21,[28][29][30][31][32][33][34][35][36][37][38][39][40], the 461 CRSwNP subjects presented significantly reduced nNO values with respect to the 384 healthy subjects (SMD: −1.495; 95% CI: −2.135, −0.854; p < 0.0001, Figure 2 (Panel A)). Statistical significance (I 2 = 93.9%; p < 0.0001) was found for studies' heterogeneity, and it was not reduced after individually eliminating each study.…”

Section: Nno In Crswnp and Healthy Controlsmentioning

confidence: 99%

“…Ten studies [17,21,[27][28][29][30][33][34][35]39] on 183 cases and 260 controls indicated that CRSsNP subjects exhibit considerably reduced levels of nNO in comparison to controls (SMD: −0.696; 95% CI: −1.189, −0.202; p = 0.006, Figure 2 (Panel B)). The reports presented a statistically significant high heterogeneity (I 2 = 78.2%; p < 0.0001); it was not reduced after individually eliminating each study.…”

Section: Nno In Crssnp and Healthy Subjectsmentioning

confidence: 99%

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Nasal Nitric Oxide in Chronic Rhinosinusitis with or without Nasal Polyps: A Systematic Review with Meta-Analysis

Ambrosino

Molino

Spedicato³

et al. 2020

JCM

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Background and Aims: There has been a recent growing interest in the role of nasal nitric oxide (nNO) as a biomarker for osteomeatal complex obstruction in paranasal sinus diseases. By using meta-analysis, we systematically reviewed the literature to establish the possible link between nNO concentration and chronic rhinosinusitis with nasal polyps (CRSwNP) or without (CRSsNP). Methods: We systematically searched the EMBASE, PubMed, Scopus, and Web of Science databases for related studies. Differences between controls and cases were reported as standardized mean difference (SMD), with 95% confidence intervals (95% CI), using the random-effects method. Results: We selected 23 articles for the final analysis: 15 with data on 461 CRSwNP patients and 384 healthy controls, 10 with data on 183 CRSsNP patients and 260 controls, and 14 studies on 372 CRSwNP and 297 CRSsNP patients. CRSwNP patients showed significantly lower nNO values when compared to both healthy controls (SMD: −1.495; 95% CI: −2.135, −0.854; p < 0.0001) and CRSsNP patients (SMD: −1.448; 95% CI: −2.046, −0.850; p < 0.0001). Sensitivity and subgroup analyses confirmed the results, which were further refined by regression models. They showed that an increasing aspiration flow is related to a greater difference in nNO levels between cases and control subjects. We also documented lower nNO levels in CRSsNP patients with respect to controls (SMD: −0.696; 95% CI: −1.189, −0.202; p = 0.006), being this result no longer significant when excluding patients in therapy with intranasal corticosteroids. As shown by regression models, the increased Lund–Mackay score indicates a high effect size. Conclusions: nNO levels are significantly lower in CRSwNP, especially when using higher aspiration flows. Additional studies are needed to define one single standardized method and normal reference values for nNO.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Nno In Crswnp and Healthy Controlsmentioning

confidence: 99%

Section: Nno In Crssnp and Healthy Subjectsmentioning

confidence: 99%

See 2 more Smart Citations

Nasal Nitric Oxide in Chronic Rhinosinusitis with or without Nasal Polyps: A Systematic Review with Meta-Analysis

Ambrosino

Molino

Spedicato³

et al. 2020

JCM

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“…The search on the monitoring of chronic sinusitis using nasal Nitric oxide (nNO) as marker of sinus health resulted in 97 articles, of them 81 articles were irrelevant and six articles were reviews. The included studies in this review were 10 studies [14][15][16][17][18][19][20][22][23][24] . Overall sample size ranged between 12 to 187 patients.…”

Section: Nno= Nasal Nitric Acid Crswnp= Chronic Rhinosinusitis With mentioning

confidence: 99%

Monitoring of Chronic Sinusitis Using Nasal Nitric Oxide as a Marker of Sinus Health: A Systematic Review

Kariri

Majrashi

Fagehi

et al. 2019

Int J Life Sci Pharm Res

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It was reported that, nasal nitric oxide (nNO) is continuously released in the paranasal sinuses which acts as antibacterial and antiviral agent and improves mucociliary clearance in sinuses environment. The levels of nasal nitric oxide (nNO) are significantly changed with inflammatory stimuli as well as with medical or surgical treatment for chronic sinusitis. The present systematic review is aimed at evaluating the role of nNO as biomarker for monitoring chronic sinusitis. A webbased search was conducted in MEDLINE with inclusion criteria of human studies in English language that aimed to evaluate the role of nNO as in monitoring chronic sinusitis. Study designs adoptedwereobservational studies or clinical trials with comparisons between patient with chronic sinusitis in study group and control group of patients with flu or healthy population. The outcome assessed was the level of nNO in both groups. Data were collected for characteristics of included study such as study design, sample size, mean age, type and location of sinusitis, and technique and procedures used to monitor nitric oxide. The search on the monitoring of chronic sinusitis using nasal Nitric oxide (nNO) as marker of sinus health resulted in 97 articles, of them 81 articles were irrelevant and six articles were reviews. The included studies in this review were 10 studies. Overall findings showed that significantly lower levels of Nasal NO were reported in the patients with chronic rhinosinusitis (CRS) (irrespective of nasal polyps or allergic rhinitis concomitance) compared to healthy volunteers. The lower levels of Nasal NO in chronic rhinosinusitis are related to the decreasing of NO metabolites. The nasal nitric oxide could be employed as a good biomarker for monitoring the sinus health. The lower levels of nasal NO are indicators to the incidence ofchronic sinus inflammation in patients with chronic rhinosinusitis (CRS) These lower levels of nasal nitric oxide increase significantly after sinus therapy or surgical treatment.

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Clinical CFD Applications 1

Zhao

Shusterman

et al. 2020

Biological and Medical Physics, Biomedical Engineering

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Combined measurements of fractional exhaled nitric oxide and nasal nitric oxide levels for assessing upper airway diseases in asthmatic patients

Abstract: Higher nasal NO levels reflect the presence of AR, irrespective of asthma concomitance. Higher FeNO levels reflect the presence of CRS and asthma. These NO measurements are useful for assessing comorbid UAD in asthmatics.

Cited by 19 publications

References 46 publications

Nasal Nitric Oxide in Chronic Rhinosinusitis with or without Nasal Polyps: A Systematic Review with Meta-Analysis

Nasal Nitric Oxide in Chronic Rhinosinusitis with or without Nasal Polyps: A Systematic Review with Meta-Analysis

Monitoring of Chronic Sinusitis Using Nasal Nitric Oxide as a Marker of Sinus Health: A Systematic Review

Clinical CFD Applications 1

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