Production and absorption of nitric oxide gas in the nose

DuBois, Arthur B.; Douglas, James S.; Stitt, John T.; Mohsenin, Vahid

doi:10.1152/jappl.1998.84.4.1217

Cited by 45 publications

(43 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They were also able to exhale and inhale through the nose at different flow rates; 0.05 L?s -1 was chosen for comparison with exhaled NO (the ATS standard flow for exhaled NO) as were 0.1, 0.2 and 0.3 L?s -1 since some of the patients deviated 0.1 L?s -1 from the target flow of 0.2 L?s -1 . The finding of a flow-dependent nitric-oxide output from the nose is in line with previous studies [16,32]. This may be explained by an increased gradient of nitric oxide from the nasal mucosa to the lumen when the luminal concentration is lowered by the increased flow.…”

Section: Inhaled Nitric Oxidesupporting

confidence: 92%

Nasal and oral contribution to inhaled and exhaled nitric oxide: a study in tracheotomized patients

Törnberg¹,

Marteus²,

Schedin³

et al. 2002

European Respiratory Journal

View full text Add to dashboard Cite

Nitric oxide (NO) is produced at different sites in the human airways and may have several physiological effects. Orally-produced NO seems to contribute to the levels found in exhaled air. Autoinhalation of nasal NO increases oxygenation and reduces pulmonary artery pressure in humans. The aim of this study was to measure the concentration and output of NO during nasal, oral and tracheal controlled exhalation and inhalation.Ten tracheotomized patients and seven healthy subjects were studied. The mean ¡ SEM fraction of exhaled NO from the nose, mouth and trachea was 56 ¡ 8, 14 ¡ 4 and 6 ¡ 1 parts per billion (ppb), respectively. During single-breath nasal, oral and tracheal inhalation the fraction of inhaled NO was 64 ¡ 14, 11 ¡ 3 and 4 ¡ 1, respectively. There was a marked flow dependency on nasal NO output in the healthy subjects, which was four-fold greater at the higher flow rates, during inhalation when compared to exhalation.There is a substantial contribution of nasal and oral nitric oxide during both inhalation and exhalation. Nasal nitric oxide output is markedly higher during inhalation, reaching levels similar to those that are found to have clinical effects in the trachea. These findings have implications for the measurement of nitric oxide in exhaled air and the physiological effects of autoinhaled endogenous nitric oxide.

show abstract

Section: Inhaled Nitric Oxidesupporting

confidence: 92%

Nasal and oral contribution to inhaled and exhaled nitric oxide: a study in tracheotomized patients

Törnberg¹,

Marteus²,

Schedin³

et al. 2002

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…It should be considered that the model presented here does not mimic the continuous NO production occurring normally in the human sinuses [5] and the complex dynamics of production and absorption from nasal airway mucosa [18,19]. Moreover, the sinus ostium diameter could not be directly measured in the healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

Assessment of nasal and sinus nitric oxide output using single-breath humming exhalations

Maniscalco¹,

Weitzberg²,

Sundberg³

et al. 2003

European Respiratory Journal

View full text Add to dashboard Cite

Nasal nitric oxide (NO) levels increase greatly during humming compared to silent exhalation. In this study, the physiological and anatomical factors that regulate NO release during humming have been characterised in 10 healthy subjects and in a model of the sinus and the nose.Single-breath humming caused a large initial peak in nasal NO output, followed by a progressive decline. The NO peak decreased in a step-wise manner during repeated consecutive humming manoeuvres but recovered completely after a silent period of 3 min. Topical nasal application of an NO synthase inhibitor reduced nasal NO by w50% but had no effect on the increase evoked by humming. Silently exhaled nasal NO measured immediately after repeated humming manoeuvres was between 5-50% lower than basal silent NO exhalation, suggesting variable continuous contribution from the sinuses to nasal NO. Among the factors known to influence normal sinus ventilation, ostium size was the most critical during humming, but humming frequency was also of importance.In conclusion, humming results in a large increase in nasal nitric oxide, which is caused by a rapid gas exchange in the paranasal sinuses. Combined nasal nitric oxide measurement with and without humming could be of use to estimate sinus ventilation and to better separate nasal mucosal nitric oxide output from sinus nitric oxide in health and disease. Eur Respir J 2003; 22: 323-329. This study was supported by a grant from the Swedish Heart-Lung Foundation, the Swedish Research Council and by a grant from University Federico II "Progetto scambi internazionali".Nitric oxide (NO) is released into the airway lumen [1], in particular in the upper airways [2][3][4]. The exact origin of NO found in nasal air and the relative contribution from different sources within the nasal airways are not known. The paranasal sinuses are major sources of NO in adult healthy subjects [5] and the concentrations in a healthy sinus may be very high, ranging 5-20 parts per million (ppm) [5]. The sinuses communicate with the nasal cavity through the ostia and the rate of gas exchange between these cavities is dependent on several factors, such as the size of the ostia, the volume of the sinus, the nasal airflow and intra-nasal pressure [6,7]. Proper ventilation is essential for maintenance of sinus integrity, and blockage of the ostium is a central event in the pathogenesis of sinusitis [8,9]. During normal ventilation, the time required to exchange all air in the sinuses is y30 min, with large inter-individual variation [7,10]. Sinus ventilation is much slower in patients with sinus disorders [10].Recently, the current authors have shown that nasal NO levels increase greatly during humming compared to normal silent nasal exhalation, probably by speeding up the sinus gas exchange, thereby increasing nasal NO output [11]. In a twocompartment model of the nose and sinus the authors demonstrated that pulsating airflow, created by humming, causes a dramatic increase in gas exchange between these cavities [11].In the ...

show abstract

“…An advantage of the suggested nose-mask method for the recording of nasal NO compared to the method using direct nasal aspiration as recommended by the ATS [14] is the better possibility of inhalation of NO-free air in times of and places with high ambient NO levels [28,29]. High ambient levels of NO could also be a reason to add a second nasal olive for the introduction of NO-free air to the ATS recommendations.…”

Section: Discussionmentioning

confidence: 99%

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Palm¹,

Gräf

Lundberg³

et al. 2000

Eur Respir J

View full text Add to dashboard Cite

Nitric oxide (NO) is present in the human nasal airways and has been suggested to originate primarily from the paranasal sinuses. The aim of this study was to establish a new and reproducible method for measurement of nasal NO.Through repeated single-breath measurements the intra-and inter-individual variations of NO levels in nasally (into a tightly fitting mask covering the nose) and orally exhaled air were determined in healthy humans. Variations due to the methods used were investigated. The contribution of oral NO to the nasal exhalations by introducing a mouthwash procedure was also studied.This study shows distinct individual values of NO in nasally and orally exhaled air of healthy humans. Some diurnal variability was also found with a rise in NO in nasally and orally exhaled air over the day, but no, or little, day-to-day variability when comparing the results from separate mornings. There was no correlation between NO levels in nasally and orally exhaled air, whereas there was a strong correlation between NO levels in air exhaled through the left and right nostril. The levels of NO in air exhaled at 0.17 L . s -1 through either nostril separately were higher than in air exhaled at the same flow rate through both nostrils simultaneously. After the introduction of a mouthwash procedure the level of NO in orally, but not nasally exhaled air was reduced.To conclude the method using nasal exhalation into a nose mask is highly reproducible. It is also suggested that subtracting the level of NO in orally exhaled air, after mouthwash, from that in nasally exhaled air, would adequately reflect nasal NO levels. Eur Respir J 2000; 16: 236±241.

show abstract

Production and absorption of nitric oxide gas in the nose

Cited by 45 publications

References 16 publications

Nasal and oral contribution to inhaled and exhaled nitric oxide: a study in tracheotomized patients

Nasal and oral contribution to inhaled and exhaled nitric oxide: a study in tracheotomized patients

Assessment of nasal and sinus nitric oxide output using single-breath humming exhalations

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Contact Info

Product

Resources

About