Nasal nitric oxide is a marker of poor asthma control

Abstract

Asthma control, evaluated by symptoms, exacerbations rate and lung function may be greatly influenced by comorbidities, particularly chronic rhinosinusitis (CRS). Measurement of nasal nitric oxide (nNO) is a simple way to assess the severity of CRS. We aimed to analyze the relationship between asthma control and nasal NO. All patients with moderate-to-severe asthma on regular follow-up at our Outpatients' Clinic between November 2009 and April 2010 were included into the study. All patients were evaluated for asthma control by asthma control questionnaire (ACQ) and comorbidities (rhinitis, chronic rhinosinusitis with (CRSwNP) or without nasal polyps, obesity). Exhaled nitric oxide and nNO were obtained in all patients. Eighty-two patients were enrolled (mean age: 48 years, range: 21-80; 42 females). According to ACQ, 53 patients (64.6%) reported controlled asthma. Patients with uncontrolled asthma had lower nNO and higher prevalence of CRSwNP, with a significant correlation between nNO and ACQ. nNO is a biomarker negatively related to asthma control. As low nNO values were associated to CRSwNP, our results indicate that asthma control is highly influenced by this comorbidity.

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

“…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.…”

“…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.…”

Assessment of the exhalation kinetics of volatile cancer biomarkers based on their physicochemical properties

“…As indicated earlier in the introduction, VOCs do not only appear in exhaled breath, but also in skin emanations [46,47], urine [48], blood [1] and saliva [49]. In addition to VOCs, also small inorganic molecules like hydrogen, nitric oxide [50][51][52][53][54][55][56][57][58][59][60][61] or carbon monoxide [62] are most interesting. Another most interesting application of VOCs is their use in search operations [63,64].…”

The Role of Nitric Oxide In Predicting Revisit of Patients With Exacerbated Chronic Obstructive Pulmonary Disease

“…It is also shown that nasal breathing reduces pulmonary vascular resistance and improves arterial oxygenation compared with oral breathing in subjects without lung disease (29). In a study by Heffler et al, low nasal NO levels were associated with uncontrolled asthma (31). This result was explained by the high prevalence of chronic rhinosinusitis accompanying asthma.…”