Nasal Nitric Oxide (nNO)

What is nNO?

NIOX VERO nasal application is CE marked and approved for clinical use in the EU, Australia, and South Korea only.

Measurement of the nasal Nitric Oxide (nNO) in the aspirated air from the nasal cavity has been shown to be significantly low in patients with Primary Ciliary Dyskinesia (PCD).^1,2

Most nitric oxide (NO) in exhaled air originates from the nasopharyngeal aspect of the upper airways.^2,3 In PCD, nNO values are less than 10% of the normal values (average values found in healthy control subjects).¹

Measurement of nNO can assist in the identification of cases of PCD and is recommended as part of the diagnostic work-up of PCD by the guidelines published by the European Respiratory Society (ERS) and the American Thoracic Society (ATS).^2,4

Early diagnosis is crucial to try to minimise the development of bronchiectasis and irreversible lung damage.⁵

The NIOX VERO^® nNO application can also helpfully rule out any non-PCD cases due to its highly accurate positive predictive value. This could therefore avoid potentially more invasive and expensive PCD testing.^6-8

NIOX VERO is the only fully portable device for nNO measurement, and delivers the following:

Two options for measuring, either tidal measurement or exhalation against a resistor*
30 second aspiration time
Ease of use⁹
Battery and mains powered
Documented clinical data for helping to differentiate patients with known PCD from healthy individuals⁹

* As recommended in the European Respiratory Society guidelines for the diagnosis of Primary Ciliary Dyskinesia²

References

References: 1. Leigh MW, Hazucha MJ, Kunal, KC, et al. Standardizing Nasal Nitric Oxide Measurement as a Test for Primary Ciliary Dyskinesia. Annals of the American Thoracic Society; 2013 December; 10(6): 574-581. 2. Lucas JS, Barbato A, Collins SA, et al. European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia. European Respiratory Journal 2017; 49: 1601090. 3. Alving K, Weitzberg E, Lundberg JM. Increased amount of nitric oxide in exhaled air of asthmatics. European Respiratory Journal 1993; 6 (9) 1368-1370. 4. Diagnosis of Primary Ciliary Dyskinesia: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 197:e24– e39. 5. Sagel SD, Davis SD, Campisi P, Dell SD. Update of respiratory tract disease in children with primary ciliary dyskinesia. Proc Am Thorac Soc. 2011;8(5):438–443. 6. Jackson CL, Behan L, Collins SA, et al. Accuracy of diagnostic testing in primary ciliary dyskinesia. Eur Respir J. 2016;47(3):837–848. 7. Leigh MW, O'Callaghan C, Knowles MR. The challenges of diagnosing primary ciliary dyskinesia. Proc Am Thorac Soc. 2011;8(5):434–437. 8. Walker WT, Jackson CL, Lackie PM, Hogg C, Lucas JS. Nitric oxide in primary ciliary dyskinesia. Eur Respir J. 2012;40(4):1024–1032. 9. Lucas J, Leigh M. Ferkol T, et al. New, portable nasal nitric oxide (nNO) analyser differentiates primary ciliary dyskinesia (PCD) from healthy individuals. Circassia clinical study ERS poster. 2017