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Measuring nasal nitric oxide in allergic rhinitis patients

Published online by Cambridge University Press:  08 November 2016

V S Nesic ,
V Z Djordjevic ,
V Tomic-Spiric ,
Z R Dudvarski ,
I A Soldatovic  and
N A Arsovic
V S Nesic*
Affiliation:
School of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
V Z Djordjevic
Affiliation:
School of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
V Tomic-Spiric
Affiliation:
School of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Allergology and Immunology, Clinical Centre of Serbia, Belgrade, Serbia
Z R Dudvarski
Affiliation:
School of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
I A Soldatovic
Affiliation:
Institute of Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia
N A Arsovic
Affiliation:
School of Medicine, University of Belgrade, Belgrade, Serbia Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
*
Address for correspondence: Dr V S Nesic, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia. E-mail: [email protected]
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Abstract

Objective:

This study aimed to compare two sampling methods for nasal nitric oxide in healthy individuals and allergic rhinitis patients, and to examine the within-subject reliability of nasal nitric oxide measurement.

Methods:

The study included 23 allergic rhinitis patients without concomitant asthma and 10 healthy individuals. For all participants, nitric oxide levels were measured non-invasively from the lungs through the mouth (i.e. the oral fractional exhaled nitric oxide) and the nose. Nasal nitric oxide was measured by two different methods: (1) nasal aspiration via one nostril during breath holding and (2) single-breath quiet exhalation against resistance through a tight facemask (i.e. the nasal fractional exhaled nitric oxide).

Results:

Compared with healthy participants, allergic rhinitis patients had significantly higher average oral and nasal nitric oxide levels. All methods of nitric oxide measurement had excellent reliability.

Conclusion:

Nasal nitric oxide measurement is a useful and reliable clinical tool for diagnosing allergic rhinitis in patients without asthma in an out-patient setting.

Keywords

Nitric OxideNoseReproducibility of ResultsRhinitisAllergicPerennial
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 11 , November 2016 , pp. 1064 - 1071
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 American Thoracic Society; European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med 2005;171:912–30CrossRefGoogle Scholar
2 Silkoff, PE, Erzurum, SC, Lundberg, JO, George, SC, Marczin, N, Hunt, JF et al. ATS workshop proceedings: exhaled nitric oxide and nitric oxide oxidative metabolism in exhaled breath condensate. Proc Am Thorac Soc 2006;3:131–45Google Scholar
3 Scadding, G, Scadding, GK. Update on the use of nitric oxide as a noninvasive measure of airway inflammation. Rhinology 2009;47:115–20Google Scholar
4 Dweik, RA, Boggs, PB, Erzurum, SC, Irvin, CG, Leigh, MW, Lundberg, JO et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FeNO) for clinical applications. Am J Respir Crit Care Med 2011;184:602–15Google Scholar
5 Struben, VM, Wieringa, MH, Mantingh, CJ, de Jongste, JC, Feenstra, L. Nasal NO measurement by direct sampling from the nose during breathhold: aspiration flow, nasal resistance and reproducibility. Eur Arch Otorhinolaryngol 2006;263:723–8CrossRefGoogle ScholarPubMed
6 Lundberg, JO. Nitric oxide and the paranasal sinuses. Anat Rec (Hoboken) 2008;291:1479–84CrossRefGoogle ScholarPubMed
7 Kharitonov, SA, Rajakulasingam, K, O'Connor, B, Durham, SR, Barnes, PJ. Nasal nitric oxide is increased in patients with asthma and allergic rhinitis and may be modulated by nasal glucocorticoids. J Allergy Clin Immunol 1997;99:58–64 Google Scholar
8 Kharitonov, SA, Walker, L, Barnes, PJ. Repeatability of standardised nasal nitric oxide measurements in healthy and asthmatic adults and children. Respir Med 2005;99:1105–14Google Scholar
9 Silkoff, PE, Chatkin, J, Qian, W, Chakravorty, S, Gutierrez, C, Furlott, H et al. Nasal nitric oxide: a comparison of measurement techniques. Am J Rhinol 1999;13:169–78CrossRefGoogle ScholarPubMed
10 Weschta, M, Deutschle, T, Riechelmann, H. Nasal fractional exhaled nitric oxide analysis with a novel hand-held device. Rhinology 2008;46:23–7Google Scholar
11 Djupesland, PG, Chatkin, JM, Qian, W, Cole, P, Zamel, N, McClean, P et al. Aerodynamic influences on nasal nitric oxide output measurements. Acta Otolaryngol 1999;119:479–85Google Scholar
12 de Winter-de Groot, KM, van der Ent, CK. Measurement of nasal nitric oxide: evaluation of six different sampling methods. Eur J Clin Invest 2009;39:72–7CrossRefGoogle ScholarPubMed
13 Henriksen, AH, Sue-Chu, M, Lingaas, Holmen T, Langhammer, A, Bjermer, L. Exhaled and nasal NO levels in allergic rhinitis: relation to sensitization, pollen season and bronchial hyperresponsiveness. Eur Respir J 1999;13:301–6Google Scholar
14 Maniscalco, M, Sofia, M, Carratù, L, Higenbottam, T. Effect of nitric oxide inhibition on nasal airway resistance after nasal allergen challenge in allergic rhinitis. Eur J Clin Invest 2001;31:462–6Google Scholar
15 Williamson, PA, Vaidyanathan, S, Clearie, K, Stewart, M, Lipworth, BJ. Relationship between fractional exhaled nitric oxide and nasal nitric oxide in airways disease. Ann Allergy Asthma Immunol 2010;105:162–7Google Scholar
16 Lee, KJ, Cho, SH, Lee, SH, Tae, K, Yoon, HJ, Kim, SH et al. Nasal and exhaled nitric oxide in allergic rhinitis. Clin Exp Otorhinolaryngol 2012;5:228–33CrossRefGoogle ScholarPubMed
17 Djupesland, PG, Chatkin, JM, Qian, W, Cole, P, Zamel, N, McClean, P et al. Aerodynamic influences on nasal nitric oxide output measurements. Acta Otolaryngol 1999;119:479–85Google Scholar
18 Arnal, JF, Didier, A, Rami, J, M'Rini, C, Charlet, JP, Serrano, E et al. Nasal nitric oxide is increased in allergic rhinitis. Clin Exp Allergy 1997;27:358–62Google Scholar
19 Irander, K, Palm, JP, Borres, MP, Ghafouri, B. Clara cell protein in nasal lavage fluid and nasal nitric oxide – biomarkers with anti-inflammatory properties in allergic rhinitis. Clin Mol Allergy 2012;10:4 CrossRefGoogle ScholarPubMed
20 Irander, K, Borres, MP, Palm, JP. Acoustic rhinometry, spirometry and nitric oxide in relation to airway allergy and smoking habits in an adolescent cohort. Int J Pediatr Otorhinolaryngol 2011;75:177–81Google Scholar
21 Maniscalco, M, de Laurentiis, G, Weitzberg, E, Lundberg, JO, Sofia, M. Validation study of nasal nitric oxide measurements using a hand-held electrochemical analyser. Eur J Clin Invest 2008;38:197–200 Google Scholar
22 Takeno, S, Noda, N, Hirakawa, K. Measurements of nasal fractional exhaled nitric oxide with a hand-held device in patients with allergic rhinitis: relation to cedar pollen dispersion and laser surgery. Allergol Int 2012;61:93–100 Google Scholar
23 Struben, VM, Wieringa, MH, Mantingh, CJ, Bruinsma, SM, de Jongste, JC, Feenstra, L. Silent and humming nasal NO measurements in adults aged 18–70 years. Eur J Clin Invest 2005;35:653–7Google Scholar
24 Bartley, J, Fergusson, W, Moody, A, Wells, AU, Kolbe, J. Normal adult values, diurnal variation, and repeatability of nasal nitric oxide measurement. Am J Rhinol 1999;13:401–5Google Scholar
25 Marthin, JK, Nielsen, KG. Hand-held tidal breathing nasal nitric oxide measurement – a promising targeted case-finding tool for the diagnosis of primary ciliary dyskinesia. PLoS One 2013;8:e57262 Google Scholar
26 Törnberg, DC, Marteus, H, Schedin, U, Alving, K, Lundberg, JO, Weitzberg, E. Nasal and oral contribution to inhaled and exhaled nitric oxide: a study in tracheotomized patients. Eur Respir J 2002;19:859–64CrossRefGoogle ScholarPubMed
27 Montella, S, Alving, K, Maniscalco, M, Sofia, M, De Stefano, S, Raia, V et al. Measurement of nasal nitric oxide by hand-held and stationary devices. Eur J Clin Invest 2011;41:1063–70Google Scholar
28 American thoracic society guidelines for methacholine and exercise challenge testing – 1999. Am J Respir Crit Care Med 2000;161:309–29Google Scholar
29 Fleiss, J. The Design and Analysis of Clinical Experiments. New York: John Wiley & Sons, 1986.Google Scholar
30 Bozek, A, Krajewska, J, Jarzab, J. Nasal nitric oxide and other diagnostic procedures in seasonal allergic rhinitis: elderly vs juvenile patients. Am J Otolaryngol 2011;32:105–8Google Scholar