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Fractional Exhaled nitric oxide (FeNO) is a quantitative, non-invasive and simple method of measuring airway inflammation that provides a complementary tool to other established methods of assessing airways disease in asthma patients.
Specifically, FeNO is an objective measurement of allergic/eosinophilic inflammation. This type of airway inflammation results from the activation of mast cells and antigen-specific T-helper cells type 2 (Th2) resulting in the production of cytokines including interleukin (IL)-4, IL-5, and IL-13.3
Adapted from Fahy 2015, Godard 2018.4,5
Measuring FeNO with NIOX VERO® across the entire patient care continuum can help in:
References: 1. Alving K, Malinovschi A. Basic aspects of exhaled nitric oxide. Eur Respir Mon. 2010;49:1-31. 2. Dweik RA, Boggs PB, Erzurum SC, et al; on behalf of the American Thoracic Society Committee on Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med. 2011;184(5):602-615. 3. Mahr TA, Malka J, Spahn JD, et al; Inflammometry in pediatric asthma: A review of fractional exhaled nitric oxide in clinical practice. Allergy Asthma Proc. 2013;34:210-219. 4. Fahy JV. Type-2 inflammation in asthma; present in most, absent in many. Nat Rev Immunol. 2015; 15(1): 57-65 5. Godar M, Blanchetot C, de Haard H, et al. Personalized medicine with biologics for severe type 2 asthma: current status and future prospects. MABS. 2018; 10(1): 34-45. 6. NICE guideline [NG80]: Asthma: diagnosis, monitoring and chronic asthma management. 2017 7. McNicholl DM, Stevenson M, McGarvey LP, Heaney LG. The utility of fractional exhaled nitric oxide suppression in the identification of nonadherence in difficult asthma. Am J Respir Crit Care Med. 2012;186(11):1102–1108. 8. Beck-Ripp J, Griese M, Arenz S, Köring C, Pasqualoni B, Bufler P. Changes of exhaled nitric oxide during steroid treatment of childhood asthma. Eur Respir J. 2002;19(6):1015–1019. 9. Delgado-Corcoran C, Kissoon N, Murphy SP, Duckworth LJ. Exhaled nitric oxide reflects asthma severity and asthma control. Pediatr Crit Care Med. 2004;5(1):48–52. 10. Petsky et al. Exhaled nitric oxide levels to guide treatment for children with asthma. Cochrane Database Syst Rev. 2016 11:CD011439. 11. Petsky et al. Exhaled nitric oxide levels to guide treatment for adults with asthma. Cochrane Database Syst Rev. 2016 11:CD011440. 12. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention, 2018 Update. 2018. 13. Syk J, Malinovschi A, Johansson G, et al. Anti-inflammatory treatment of atopic asthma guided by exhaled nitric oxide: a randomized, controlled trial. J Allergy Clin Immunol Pract. 2013;1(6):639-648. 14. Peirsman EJ, Carvelli TJ, Hage PY, et al. Exhaled nitric oxide in childhood allergic asthma management: a randomised controlled trial. Pediatr Pulmonol. 2014;49(7):624-631.