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Exhaled nitric oxide from lung periphery is increased in COPD
Open accessAbstract
Single constant flow exhaled nitric oxide (eNO) cannot distinguish between the sources of NO. The present study measured eNO at multiple expired flows (MEFeNO) to partition NO into alveolar (Calv,NO) and bronchial (Jaw,NO) fractions to investigate peripheral lung contribution to eNO in chronic obstructive lung disease (COPD). MEFeNO were made in 81 subjects including 18 nonsmokers, 16 smokers and 47 COPD patients of different severity by the classification of the Global Initiative for Chronic Obstructive Lung Disease (GOLD): 0 (n = 14), 1 (n = 7), 2 (n = 11), 3 (n = 8) and 4 (n = 7). COPD severity was correlated with an increased Calv,NO regardless of the patient's smoking habit or current treatment. The levels of Calv,NO (in ppb) were 1.4+/-0.09 in nonsmokers, 2.1+/-0.1 in smokers categorised as GOLD stage 0 (smokers-GOLD0), 3.3+/-0.18 in GOLD1-2 and 3.4+/-0.1 in GOLD3-4. Jaw,NO levels (pL x s(-1)) were higher in nonsmokers than smokers-GOLD0 (716.2+/-33.3 versus 464.7+/-41.8), GOLD3-4 (609.4+/-71). Diffusion of NO in the airways (Daw,NO pL x ppb(-1) s(-1)) was higher (p<0.05) in GOLD3-4 than in nonsmokers (15+/-1.2 versus 11+/-0.5) and smokers-GOLD0 (11.6+/-0.5). MEFeNO measurements were reproducible, free from day-to-day and diurnal variation and were not affected by bronchodilators. In conclusion, chronic obstructive pulmonary disease is associated with elevated alveolar nitric oxide. Measurements of nitric oxide at multiple expired flows may be useful in monitoring inflammation and progression of chronic obstructive pulmonary disease, and the response to anti-inflammatory treatment.
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“However, the deleterious effects of NO on the development of COPD might be derived from iNOS-mediated pro-inflammatory signaling [128], which is consequently (not causally) reflected by the huge amount of NO in the exhaled air of patients with COPD [129].”
From NO-Rich Diet for Lifestyle-Related Diseases (2015) · cites this paper as [129]
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Laura Mendoza, I., & Julia Guerrero, P. (2019) · Revista Hospital Clínico Universidad de Chile · doi:10.5354/2735-7996.2019.70050
Fractional Exhalation of Nitric Oxide
Hasan, A. (2025) · Springer eBooks · doi:10.1007/978-981-96-7810-5_25
Metadata
- Authors
- Brindicci, C., Ito, K., Resta, O., Pride, N. B., Barnes, P. J., & Kharitonov, S. A.
- Affiliations
- Imperial College London (GB)
- University of Bari Aldo Moro (IT)
- Corresponding author
- Kharitonov, S. A.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2005-07
- Volume
- 26
- Issue
- 1
- Pages
- 52-59
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2164167422
- Cited by
- 206
- References
- 29
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 6 · 2018: 11 · 2017: 6 · 2016: 3 · 2015: 9 · 2014: 5 · 2013: 14 · 2012: 14
- FWCI
- 11.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Physical Sciences › Engineering › Biomedical Engineering › Advanced Chemical Sensor Technologies
- Keywords
- exhaled nitric oxide, chronic obstructive pulmonary disease, alveolar nitric oxide, COPD severity, smoking, airway inflammation
- MeSH terms
- Adult, Aged, Analysis of Variance, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Nitric Oxide, Probability, Prognosis, Reference Values, Respiratory Function Tests, Sensitivity and Specificity, Severity of Illness Index, Smoking, Cohort Studies, Biomarkers, Case-Control Studies, Risk Assessment, Statistics, Nonparametric, Pulmonary Disease, Chronic Obstructive, Exhalation
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