Reference values for exhaled nitric oxide (reveno) study

Olivieri, Mario; Talamini, Giorgio; Corradi, Massimo; Perbellini, Luigi; Mutti, Antonio; Tantucci, Claudio; Malerba, Mario

doi:10.1186/1465-9921-7-94

Cited by 134 publications

(137 citation statements)

References 26 publications

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“…However, a recent study reports that FeNO reference values in healthy Japanese adults [18] were similar to those of Caucasians [19][20][21]. Thus, whether or not ethnic differences of FeNO levels between Caucasians and Asians are restricted to children warrants further study.…”

Section: Discussionmentioning

confidence: 99%

Reference values of exhaled nitric oxide in healthy Asian children aged 5 to 18 years

Yao

Wi²,

Ls³

et al. 2011

European Respiratory Journal

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This study was undertaken to establish reference values of exhaled nitric oxide fraction (FeNO) and its determinants in healthy Asian children.693 healthy Asian children aged 5-18 yrs were assessed using a single-breath online FeNO measurement (exhaled flow 50 mL?s -1 ), questionnaires, anthropometric measurements, spirometry and total and specific immunoglobulin (Ig) E.Geometric mean FeNO and the upper 95% CI were 13.7 ppb and 49.7 ppb, respectively, for healthy children, and 11.2 ppb and 30.2 ppb, respectively, for those without allergic sensitisation. FeNO was positively associated with age, allergic sensitisation, total IgE, ambient nitric oxide, measurement in the afternoon, and drinking water within 1 h before testing, and was negatively associated with weight. In healthy children without allergic sensitisation, age was the single best explanatory variable. The FeNO predicted values were 1-2 ppb higher in Asian than in Caucasian children in earlier studies, while the upper 95% CI were 9-10 ppb higher.In conclusion, the upper limits of normal FeNO in Asian children depend on age, from 21 ppb in young children to 39 ppb in adolescents. Ethnicity, age, allergic sensitisation, total IgE, ambient nitric oxide, time of testing, drinking water and weight are important determinants.

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Section: Discussionmentioning

confidence: 99%

Reference values of exhaled nitric oxide in healthy Asian children aged 5 to 18 years

Yao

Wi²,

Ls³

et al. 2011

European Respiratory Journal

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“…However, this study also included subjects with asthma, atopy and receiving steroid treatment. In contrast, OLIVIERI et al [46] specifically designed a study to address FeNO normal values. They measured FeNO in a population of 204 healthy nonatopic, nonsmoking subjects aged 19-65 yrs at a flow rate of 50 mL?s -1 using the online single breath technique and identified a mean value of 10.8¡4.7 ppb.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

“…Besides the Task Force recommendations [5], the current authors found three studies primarily focused on normal values in healthy adult subjects fulfilling the literature search criteria, which were all published in 2006 (table 5) [44][45][46]. Overall, 2,452 subjects underwent FeNO measurements.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

“…Two studies were performed in Europe and one in the USA. Only one study was multicentric [46]. Ethical Committee approval and informed consent were mandatory in all studies.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

“…They include sex and sexual hormones, body weight and age, circadian changes of respiratory function in health and disease, caffeine and alcohol, meals rich in nitrate, genetic background for some enzymes, upper respiratory tract infection, exercise, drugs (including inhibitors of NO synthases) and of course smoking [46,[54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73]. Moreover, FeNO levels in healthy subjects are influenced by atopy, i.e.…”

Section: Exhaled Nitric Oxidementioning

confidence: 99%

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Bronchoalveolar lavage, sputum and exhaled clinically relevant inflammatory markers: values in healthy adults

Balbi

Pignatti

Corradi

et al. 2007

European Respiratory Journal

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Bronchoalveolar lavage (BAL), induced sputum and exhaled breath markers (exhaled nitric oxide and exhaled breath condensate) can each provide biological insights into the pathogenesis of respiratory disorders. Some of their biomarkers are also employed in the clinical management of patients with various respiratory diseases. In the clinical context, however, defining normal values and cut-off points is crucial. The aim of the present review is to investigate to what extent the issue of defining normal values in healthy adults has been pursued for the biomarkers with clinical value.The current authors reviewed data from literature that specifically addressed the issue of normal values from healthy adults for the four methodologies.Most studies have been performed for BAL (n59), sputum (n53) and nitric oxide (n53). There are no published studies for breath condensate, none of whose markers yet has clinical value. In healthy adult nonsmokers the cut-off points (mean+2SD) for biomarkers with clinical value were as follows. BAL: 16.7% lymphocytes, 2.3% neutrophils and 1.9% eosinophils; sputum: 7.7610 6 ?mL -1 total cell count and 2.2% eosinophils; nitric oxide: 20.2 ppb. The methodologies differ concerning the quantity and characteristics of available reference data. Studies focusing on obtaining reference values from healthy individuals are still required, more evidently for the new, noninvasive methodologies.

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Natural pollen exposure increases in a dose‐dependent way Fraction of exhaled Nitric Oxide (FeNO) levels in patients sensitized to one or more pollen species

Olivieri

Marchetti

Murgia

et al. 2022

Clinical & Translational All

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Background Co‐exposures and polysensitization to several pollen species are very common in real life practice. However, little information exists on allergic symptoms and airway inflammation related to natural pollen exposure in large general population samples. Objective To assess the combined effect of sensitization and/or exposure to one or more pollen species on Fraction of exhaled Nitric Oxide (FeNO) levels. Methods Within Gene Environment Interactions in Respiratory Diseases (GEIRD) multicase‐control study, 1070 adults from the general population of Verona, Italy, underwent a clinical evaluation including standardized interview, spirometry, skin prick test to inhalants and FeNO measurement. Pollen exposure was assumed, when the mean pollen concentration in the previous week was above the cutoff established by the Italian Aerobiological Monitoring Network. Results Subjects sensitized to one or more pollen species were respectively 15.5% and 29.6%. FeNO levels were directly related to the number of both pollen species around and pollen‐related sensitizations. Median FeNO levels were directly related to number of pollen species around and pollen sensitization. FeNO levels increased from 15.4 ppb (p. 25–p. 75 = 9.9–21.0) outside the pollen season to 17.5 ppb (11.2–30.5) when there were ≥3 pollen species around. Likewise FeNO levels rose from 14.8 ppb (10.0–22.3) in not sensitized subjects, to 16.7 (10.1–25.0) in monosensitized and further to 20.4 (12.3–40.6) in poly‐sensitized. According to multivariable quantile regression, median FeNO was 17.9 ppb higher (p. 25–p. 75 = 12.5–23.3) for subjects sensitized and exposed to more than one pollen species, compared to subjects who were neither sensitized nor exposed. Differences in FEV1/FVC between groups were less pronounced ( − 2.0%, −4.1 to 0.1). Median FeNO level was 15.1 ppb (p. 25–p. 75 = 10.0–23.2) in subjects without pollen‐related symptoms, 17.8 ppb (12.1–40.2) in those with nasal symptoms only, and 22.7 ppb (14.7–43.0) in those with asthma‐like symptoms ( p < 0.001). Conclusion and clinical relevance Airways inflammation, evaluated by FeNO, increases in dose‐dependent manner from subjects monosensitized to pollen species to those poly‐sensitized, especially when asthma‐like symptoms on pollen exposure are also reported. This should be considered by allergists during natural pollen seasons when evaluating both pulmonary function and airways inflammation.

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Reference values for exhaled nitric oxide (reveno) study

Abstract: Background: Despite the widespread use of fractional exhaled nitric oxide (FE NO ) as a biomarker of airways inflammation, there are no published papers describing normal FE NO values in a large group of healthy adults.

Cited by 134 publications

References 26 publications

Reference values of exhaled nitric oxide in healthy Asian children aged 5 to 18 years

Reference values of exhaled nitric oxide in healthy Asian children aged 5 to 18 years

Bronchoalveolar lavage, sputum and exhaled clinically relevant inflammatory markers: values in healthy adults

Natural pollen exposure increases in a dose‐dependent way Fraction of exhaled Nitric Oxide (FeNO) levels in patients sensitized to one or more pollen species

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