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Current evidence and future research needs for FeNO measurement in respiratory diseases.

Bjermer, Leif LU ; Alving, Kjell; Diamant, Zuzana LU ; Magnussen, Helgo; Pavord, Ian; Piacentini, Giorgio; Price, David; Roche, Nicolas; Sastre, Joaquin and Thomas, Mike, et al. (2014) In Respiratory Medicine 108(6). p.830-841
Abstract
Although not yet widely implemented, fraction of exhaled nitric oxide (FeNO) has emerged in recent years as a potentially useful biomarker for the assessment of airway inflammation both in undiagnosed patients with non-specific respiratory symptoms and in those with established airway disease. Research to date essentially suggests that FeNO measurement facilitates the identification of patients exhibiting T-helper cell type 2 (Th2)-mediated airway inflammation, and effectively those in whom anti-inflammatory therapy, particularly inhaled corticosteroids (ICS), is beneficial. In some studies, FeNO-guided management of patients with established airway disease is associated with lower exacerbation rates, improvements in adherence to... (More)
Although not yet widely implemented, fraction of exhaled nitric oxide (FeNO) has emerged in recent years as a potentially useful biomarker for the assessment of airway inflammation both in undiagnosed patients with non-specific respiratory symptoms and in those with established airway disease. Research to date essentially suggests that FeNO measurement facilitates the identification of patients exhibiting T-helper cell type 2 (Th2)-mediated airway inflammation, and effectively those in whom anti-inflammatory therapy, particularly inhaled corticosteroids (ICS), is beneficial. In some studies, FeNO-guided management of patients with established airway disease is associated with lower exacerbation rates, improvements in adherence to anti-inflammatory therapy, and the ability to predict risk of future exacerbations or decline in lung function. Despite these data, concerns regarding the applicability and utility of FeNO in clinical practice still remain. This article reviews the current evidence, both supportive and critical of FeNO measurement, in the diagnosis and management of asthma and other inflammatory airway diseases. It additionally provides suggestions regarding the practical application of FeNO measurement: how it could be integrated into routine clinical practice, how its utility could be assessed and its true value to both clinicians and patients could be established. Although some unanswered questions remain, current evidence suggests that FeNO is potentially a valuable tool for improving the personalised management of inflammatory airway diseases. (Less)
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Contribution to journal
publication status
published
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Respiratory Medicine
volume
108
issue
6
pages
830 - 841
publisher
Elsevier
external identifiers
  • pmid:24636813
  • wos:000338409500002
  • scopus:84902244482
ISSN
1532-3064
DOI
10.1016/j.rmed.2014.02.005
language
English
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yes
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b1495afb-9504-4fa1-a69b-98db00462779 (old id 4383108)
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http://www.ncbi.nlm.nih.gov/pubmed/24636813?dopt=Abstract
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2014-04-03 19:58:26
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2017-10-29 03:12:40
@article{b1495afb-9504-4fa1-a69b-98db00462779,
  abstract     = {Although not yet widely implemented, fraction of exhaled nitric oxide (FeNO) has emerged in recent years as a potentially useful biomarker for the assessment of airway inflammation both in undiagnosed patients with non-specific respiratory symptoms and in those with established airway disease. Research to date essentially suggests that FeNO measurement facilitates the identification of patients exhibiting T-helper cell type 2 (Th2)-mediated airway inflammation, and effectively those in whom anti-inflammatory therapy, particularly inhaled corticosteroids (ICS), is beneficial. In some studies, FeNO-guided management of patients with established airway disease is associated with lower exacerbation rates, improvements in adherence to anti-inflammatory therapy, and the ability to predict risk of future exacerbations or decline in lung function. Despite these data, concerns regarding the applicability and utility of FeNO in clinical practice still remain. This article reviews the current evidence, both supportive and critical of FeNO measurement, in the diagnosis and management of asthma and other inflammatory airway diseases. It additionally provides suggestions regarding the practical application of FeNO measurement: how it could be integrated into routine clinical practice, how its utility could be assessed and its true value to both clinicians and patients could be established. Although some unanswered questions remain, current evidence suggests that FeNO is potentially a valuable tool for improving the personalised management of inflammatory airway diseases.},
  author       = {Bjermer, Leif and Alving, Kjell and Diamant, Zuzana and Magnussen, Helgo and Pavord, Ian and Piacentini, Giorgio and Price, David and Roche, Nicolas and Sastre, Joaquin and Thomas, Mike and Usmani, Omar},
  issn         = {1532-3064},
  language     = {eng},
  number       = {6},
  pages        = {830--841},
  publisher    = {Elsevier},
  series       = {Respiratory Medicine},
  title        = {Current evidence and future research needs for FeNO measurement in respiratory diseases.},
  url          = {http://dx.doi.org/10.1016/j.rmed.2014.02.005},
  volume       = {108},
  year         = {2014},
}