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Exhaled nitric oxide has been studied since 1991 and several studies have shown it to be powerful tool in management of asthma. The American Thoracic Society (ATS) and European Respiratory Society (ERS) have jointly published guidelines for the standardized measurement of eNO.1 Recent asthma guidelines (NHLBI) indicate the positive role of inflammation measurements, of which eNO is the most clinically viable.
The clinical utility of measuring eNO include:
1. Selecting and Titrating Medication
Exhaled nitric oxide has been shown to predict the likelihood of a steroid response more consistently than spirometry or bronchodilator response.2 Use of eNO to direct inhaled steroid therapy was shown to reduce dosage while maintaining asthma control.3
2. Monitoring Compliance
An elevated eNO is suggestive of inadequate anti-inflammatory therapy – either from an insufficient dose or due to patient non-compliance.4 Reduction of exhaled NO levels after the start of therapy can reassure a physician that the treatment regime is being followed, and can demonstrate to the patient the physiological change that the therapy could achieve if properly followed.5
3. Predicting Exacerbation and Loss of Control
The ability to predict a worsening of symptoms is the most exciting clinical application of eNO measurement. Exhaled nitric oxide is a better predictor over FEV1 of both asthma control, loss of control and worsening of asthma.6 Elevated eNO measured at a clinic visit indicates increased risk of an exacerbation occurring within the next two weeks.7 Pediatric studies have found that an eNO level above 47 ppb predicts loss of control when inhaled steroids are reduced or withdrawn.8 A rise in eNO among patients who cease steroid therapy is predictive of an upcoming relapse.9 A home monitoring study showed that frequent eNO measurements may have predictive power for impending instability of asthma.10,11
Last edited by Kate; 07/28/09 03:08 PM.
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I can't decide if this is spam or not. It seems to be a regurgitation of manufacturer's spiel pushing testing of Nitric Oxide. Anyone else have any comments?
If you don't care for reality, just wait a while; another will be along shortly. --A Rose
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Possibly not spam, but seems a waste of the poster's time. It doesn't invite discussion so, unless I'm proved wrong, the thread's dead in the water.
"Time is what prevents everything from happening at once" - John Wheeler
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Hi Amaranth,
It's not a spam. I am researching on asthma and I came to know that exhaled nitric oxide is increased in patients with untreated asthma and decreases with corticosteroid treatment. Exhaled nitric oxide also generally correlates with eosinophilic inflammation in asthmatic patients.I thought of sharing this information with everyone so that it will be helpful for patients suffering from asthma.
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Nitric Oxide, here's a report of related research on asthma and other allergic diseases. I expect you know about it, but it might be of general interest as an example of the random, hit-and-miss mutations of Darwinian evolution - this one apparently a miss rather than a hit: http://www.medicalnewstoday.com/articles/157040.php"A study just published on bmj.com concludes that the defects in a particular gene known as the filaggrin gene are linked to a considerably amplified risk of developing allergic disorders such as eczema, rhinitis, and asthma..." - 10 Jul 2009 Actually, the news is not that new. This from April 2007: http://www.nature.com/ng/journal/v39/n5/abs/ng2020.html"We recently reported two common filaggrin (FLG) null mutations that cause ichthyosis vulgaris1 and predispose to eczema and secondary allergic diseases..." - 8 April 2007
"Time is what prevents everything from happening at once" - John Wheeler
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Hey redewenur,
Thank you so much for that links. It was really helpful.In recent research they found that using Exhaled nitric oxide is an effective way to monitor asthma. I have come across medical journals, which states that Measuring Nitric Oxide (NO) from the breath (during exhalation) has proven to be a useful tool for some asthma specialists in the U.S. and other parts of the world.
Do we have any device that measures exhaled nitric oxide? Can you help me with this?
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"Since 1991, however, measurement of in vivo NO production in humans have been proven to be technically feasible by means of ex vivo manoeuvres, i.e. by sampling the exhaled breath and analysing it for NO content using a chemiluminescent NO analyser" http://www.erj.ersjournals.com/cgi/reprint/12/5/1005.pdfChemiluminescence is what makes the glow worm glow, but in that case it's called bioluminescence.
"Time is what prevents everything from happening at once" - John Wheeler
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Hey redewenur,
Thanks for your swift reply. That link was really excellent. It explains very clearly about the function of Nitric Oxide and how it's used to monitor airway inflammation. But I'm not very clear about the device "chemiluminescent NO analyser". This device can be used by consumers to measure Nitric oxide or it can be used only by physicians.Do we have any other device to monitor nitric oxide? I am researching on the same. Anybody has any information on this?
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Hi, I am new here and i came across this topic on this forum. I am asthma patient, and i would like to get more information on asthma and everything related to asthma. I too would like to share whatever information i get about asthma.
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Hey redewenur,
Thank you so much for the links. I have gone through the links and it's quiet interesting. I was researching on medical devices recently which measures exhaled nitric oxide and I came across a device called "Insight eNO system". The Insight eNO System measures exhaled nitric oxide and provides accurate measurement of patients airway inflammation. Any idea about this device?
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Hey Marcus,
Welcome to the Forum.
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Hi There, Thank You for the welcome nitric oxide. Like i said in my earlier post, that i will share whatever information i get on asthma, i will share it. This is one link i found on the internet the other day. Just have a look at it http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=22583?p=p2
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nitric
- Local internet connections are almost unusable right now - fibre-optic problems, I'm told. Just managed to get this page open to let you know that you're not being ignored.
--- Marcus
- Hope to get a peek at your linked page when my connection permits.
--- Whilst assuming that certain products are NOT being promoted in this thread, I would like to make an observation:
In the medical industry the hard-sell tends to be avoided in favour of an appeal to educated scientific reason - which is fine, except that the reasoning is sometimes heavily profit-biased, resulting in the sale of products that are either extortionately expensive, entirely unnecessary, or both. Although I'm not passing personal judgement on specific hardware, neither would I recommend any product solely on the basis of the manufacturer's blurb.
"Time is what prevents everything from happening at once" - John Wheeler
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Hey redewenur,
Thanks for your reply.I have been diagnosed with asthma recently, and i am scared and confused. The doctors told me that asthma is a disease that cannot be cured. The doctors also told me that there is cure to control the asthma attacks. What i want to know is how useful are these devices which say that they can help in controlling asthma? This is such an useful topic I felt like discussing with you because it can be helpful for people like me suffering from asthma.
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nitric
Sorry that you're afflicted with this condition. Naturally, you're concerned to receive the most effective treatment. How useful any device is depends, at least in part, upon the individual. Of course, you can do no better than consult a specialist - taking into account allergens, atopy, general health, stress/anxiety, precipitating ailments and so on, they would also be in the best position to advise you regarding treatment options. As you're no doubt aware, a common starting point is a bronchodilator nebuliser (Ventolin/albuterol/salbutamol). That's all that many people need.
"Time is what prevents everything from happening at once" - John Wheeler
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Marcus, your link is bad. Do you have another?
If you don't care for reality, just wait a while; another will be along shortly. --A Rose
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Hey redewenur,
Thanks for the info. I am already on Ventolin now. But according to my view,the devices such as "Insight eNO" detects the amount of nitric oxide molecules present in asthma patients.Based on the amount of nitric oxide present in patients doctors can make clinical decisions more confidently. By continuous monitoring of patients eNO levels,doctors can tune their medication accordingly which helps them to bring their asthma in control. Let me know if I am wrong any where. So I feel that if we have such devices at home, we can monitor our asthma levels regularly and improve the effectiveness of our therapy for asthma.
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Is there verifiable statistical data to support the contention that having these devices at home would provide a significant benefit?
Sure, it sounds like a good idea. But is it? Even supposing that treatment can be more effective, how severe does the asthma have to be to justify the cost. For that matter, what is the cost?
"Time is what prevents everything from happening at once" - John Wheeler
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