Using FeNO testing as your asthma risk estimator can help reduce exacerbations by up to 50%1
Key highlights:
Type 2 inflammation is driven by T-helper 2 cells, which produce interleukins IL-4, IL-5 and IL-13. IL-4 and IL-13 upregulate nitric oxide levels in the lungs.3
It is now understood that up to 84% of asthma patients have Type 2 airway inflammation, which is particularly associated with exacerbations.2
Elevated FeNO values are associated with 3.2x greater risk of exacerbations when compared to low FeNO levels.4
Nobel Prize-Winning Science
FeNO stands for fractional exhaled nitric oxide (NO). NO is a molecule produced by the lungs that can be measured in exhaled breath. The use of NO in medicine was a real breakthrough, leading to a Nobel Prize in 1998.
Asthma: it's about inflammation
Although asthma is traditionally diagnosed with tools that measure airway obstruction, it's actually an inflammatory condition.1
As research progresses, opinion is changing. It is now understood that up to 84% of asthma patients have Type 2 airway inflammation.2
"Type 2 airway inflammation seems to be particularly associated with asthma attacks. We know we can modify that with different treatments. So it isn't adequate now in the 2020s to just identify variable airflow obstruction. That's a good start, but you need to go beyond that.”
- Professor Ian Pavord, University of Oxford
Type 2 airway inflammation
Type 2 inflammation is driven by T-helper 2 cells, which produce interleukins IL-4, IL-5 and IL-13. IL-4 and IL-13 upregulate nitric oxide levels in the lungs.3
Numerous studies have recognised FeNO as a helpful biomarker of airway inflammation.
Biomarkers: the future of asthma management
As knowledge of the underlying causes of asthma has evolved, diagnostic and management methods have too.
Biomarkers provide objective data on biologic parameters such as airway inflammation and disease activity. This can improve the understanding of asthma and lead to better patient outcomes.
Available right at the point-of-care, FeNO testing allows physicians to instantly assess airway inflammation and optimise patient therapy and adherence.
One size doesn't fit all
Exacerbation risks can be increased by modifiable factors such as high airway inflammation, reduced lung function, poor adherence to ICS or inadequate inhaler technique.1 Elevated FeNO values are associated with 3.2x greater risk of exacerbations when compared to low FeNO levels.4 Aiming to reduce high FeNO levels can help improve patient outcomes.5
Severe AsthmaSee inflammation clearly with FeNO
Understanding the level of inflammation with FeNO can lead to improved asthma care. FeNO levels are elevated in asthma and can provide healthcare professionals with the opportunity to see inside a patient’s lungs at the point-of-care.
Measuring FeNO
More accurate diagnosis
With half of asthma cases misdiagnosed, lung function testing is not enough to make a decision. Asthma diagnosis is 7x more likely with a high FeNO level.6
This is Dan
He is 8 and was recently sent to the emergency department after suffering severe shortness of breath during a football match. A respiratory specialist suspected asthma but Dan's parents said he had no previous symptoms and doubted the diagnosis.
A quick FeNO test revealed that Dan's FeNO level was 58.ppb. This shows high Type 2 inflammation and an increased risk of exacerbation.
FeNO testing supported the asthma diagnosis and helped Dan's parents to visualise the risk. They then agreed to ensure Dan takes his inhaled corticosteroid every day.
Better management
A high FeNO level indicates a greater risk of exacerbation.4 Using FeNO testing as your asthma risk estimator can help reduce exacerbations by up to 50%.5
This is Julia
Her asthma symptoms were manageable but she had experienced some serious exacerbations in the last year, including a hospitalisation. She was reluctant to increase her steroid dose as she was worried about side-effects.
As part of her management plan, Julia's FeNO was tested, revealing a FeNO level of 68.ppb. She was advised to take a higher ICS dose to bring the inflammation under control and avoid potentially severe exacerbations. Regular testing showed her FeNO was decreasing over time.
After a year, Julia's symptoms resolved, her FeNO fell to 22.ppb and her ICS dose was safely stepped down.
Why measure FeNO?
FeNO testing is the most convenient way to assess airway inflammation at the point-of-care.
Simple
One test, one number. Airway inflammation in a single FeNO level.
Immediate
Performing a FeNO test takes approximately one minute - quicker than making a cup of coffee.
Non-invasive
Taking a FeNO test is as simple as inhaling and exhaling: no blood, sweat or tears required.
