help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by LEHTIMÄKI, L.
Right arrow Articles by MOILANEN, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by LEHTIMÄKI, L.
Right arrow Articles by MOILANEN, E.

Am. J. Respir. Crit. Care Med., Volume 163, Number 7, June 2001, 1557-1561

Extended Exhaled NO Measurement Differentiates between Alveolar and Bronchial Inflammation

LAURI LEHTIMÄKI, HANNU KANKAANRANTA, SEPPO SAARELAINEN, PAULA HAHTOLA, RITVA JÄRVENPÄÄ, TIMO KOIVULA, VÄINÖ TURJANMAA, and EEVA MOILANEN

Immunopharmacological Research Group, University of Tampere Medical School; and Departments of Clinical Chemistry, Respiratory Medicine, Radiology, and Clinical Physiology, Tampere University Hospital, Tampere, Finland

Lower respiratory tract inflammation can be detected by measuring exhaled nitric oxide (NO) concentration at a single exhalation flow rate, but this does not differentiate between alveolar and bronchial NO production. We assessed alveolar NO concentration and bronchial NO flux with an extended method of measuring exhaled NO at several exhalation flow rates in 40 patients with asthma, 17 patients with alveolitis, and 57 healthy control subjects. Bronchial NO flux was higher in asthma (2.5 ± 0.3 nl/s, p < 0.001) than in alveolitis (0.7 ± 0.1 nl/s) and healthy control subjects (0.7 ± 0.1 nl/s). Alveolar NO concentration was higher in alveolitis (4.1 ± 0.3 ppb, p < 0.001) than in asthma (1.1 ± 0.2 ppb) and healthy control subjects (1.1 ± 0.1 ppb). In asthma, bronchial NO flux correlated with serum level of eosinophil protein X (EPX) (r = 0.60, p < 0.001) and bronchial hyperresponsiveness (r = 0.55, p < 0.001). In alveolitis, alveolar NO concentration correlated inversely with pulmonary diffusing capacity (r = -0.55, p = 0.022) and pulmonary restriction. Glucocorticoid treatment or allergen avoidance normalized bronchial NO flux in asthma and decreased alveolar NO concentration toward normal in alveolitis. In conclusion, extended exhaled NO measurement can be used to separately assess alveolar and bronchial inflammation and to assess disease activity/severity in asthma and alveolitis.




This article has been cited by other articles:


Home page
 ERRHome page
P-R. Burgel, J. de Blic, P. Chanez, C. Delacourt, P. Devillier, A. Didier, J-C. Dubus, I. Frachon, G. Garcia, M. Humbert, et al.
Update on the roles of distal airways in asthma
Eur. Respir. Rev., June 1, 2009; 18(112): 80 - 95.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
A. Malinovschi, C. Janson, L. Holm, L. Nordvall, and K. Alving
Basal and induced NO formation in the pharyngo-oral tract influences estimates of alveolar NO levels
J Appl Physiol, February 1, 2009; 106(2): 513 - 519.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. Foresi, C. Leone, D. Olivieri, and G. Cremona
Alveolar-Derived Exhaled Nitric Oxide Is Reduced in Obstructive Sleep Apnea Syndrome
Chest, September 1, 2007; 132(3): 860 - 867.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. Brindicci, K. Ito, P. J. Barnes, and S. A. Kharitonov
Effect of an Inducible Nitric Oxide Synthase Inhibitor on Differential Flow-Exhaled Nitric Oxide in Asthmatic Patients and Healthy Volunteers
Chest, August 1, 2007; 132(2): 581 - 588.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
H. Lehtonen, P. Oksa, L. Lehtimaki, A. Sepponen, R. Nieminen, H. Kankaanranta, S. Saarelainen, R. Jarvenpaa, J. Uitti, and E. Moilanen
Increased alveolar nitric oxide concentration and high levels of leukotriene B4 and 8-isoprostane in exhaled breath condensate in patients with asbestosis
Thorax, July 1, 2007; 62(7): 602 - 607.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. Brindicci, K. Ito, P. J. Barnes, and S. A. Kharitonov
Differential Flow Analysis of Exhaled Nitric Oxide in Patients With Asthma of Differing Severity
Chest, May 1, 2007; 131(5): 1353 - 1362.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
P. Condorelli, H.-W. Shin, A. S. Aledia, P. E. Silkoff, and S. C. George
A simple technique to characterize proximal and peripheral nitric oxide exchange using constant flow exhalations and an axial diffusion model
J Appl Physiol, January 1, 2007; 102(1): 417 - 425.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
H.-W. Shin, C. D. Schwindt, A. S. Aledia, C. M. Rose-Gottron, J. K. Larson, R. L. Newcomb, D. M. Cooper, and S. C. George
Exercise-induced bronchoconstriction alters airway nitric oxide exchange in a pattern distinct from spirometry
Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2006; 291(6): R1741 - R1748.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. Paraskakis, C. Brindicci, L. Fleming, R. Krol, S. A. Kharitonov, N. M. Wilson, P. J. Barnes, and A. Bush
Measurement of Bronchial and Alveolar Nitric Oxide Production in Normal Children and Children with Asthma
Am. J. Respir. Crit. Care Med., August 1, 2006; 174(3): 260 - 267.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
I. van der Lee, P. Zanen, J. C. Grutters, R. J. Snijder, and J. M.M. van den Bosch
Diffusing capacity for nitric oxide and carbon monoxide in patients with diffuse parenchymal lung disease and pulmonary arterial hypertension.
Chest, February 1, 2006; 129(2): 378 - 383.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
H.-W. Shin, P. Condorelli, and S. C. George
Examining axial diffusion of nitric oxide in the lungs using heliox and breath hold
J Appl Physiol, February 1, 2006; 100(2): 623 - 630.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
ATS Workshop Proceedings: Exhaled Nitric Oxide and Nitric Oxide Oxidative Metabolism in Exhaled Breath Condensate.
Proceedings of the ATS, January 1, 2006; 3(2): 131 - 145.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
C. Brindicci, K. Ito, O. Resta, N. B. Pride, P. J. Barnes, and S. A. Kharitonov
Exhaled nitric oxide from lung periphery is increased in COPD
Eur. Respir. J., July 1, 2005; 26(1): 52 - 59.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
P. E. Silkoff
Monitoring nitric oxide: here to stay for bench and bedside
Eur. Respir. J., June 1, 2005; 25(6): 949 - 950.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
M. Berry, B. Hargadon, A. Morgan, M. Shelley, J. Richter, D. Shaw, R. H. Green, C. Brightling, A. J. Wardlaw, and I. D. Pavord
Alveolar nitric oxide in adults with asthma: evidence of distal lung inflammation in refractory asthma
Eur. Respir. J., June 1, 2005; 25(6): 986 - 991.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. Delclaux, F. Zerah-Lancner, B. Mahut, S. Ribeil, A. Dubois, C. Larger, and A. Harf
Alveolar Nitric Oxide and Effect of Deep Inspiration During Methacholine Challenge
Chest, May 1, 2005; 127(5): 1696 - 1702.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
H.-W. Shin, P. Condorelli, and S. C. George
A new and more accurate technique to characterize airway nitric oxide using different breath-hold times
J Appl Physiol, May 1, 2005; 98(5): 1869 - 1877.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
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., April 15, 2005; 171(8): 912 - 930.
[Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
S. A. Kharitonov and P. J. Barnes
Effects of Corticosteroids on Noninvasive Biomarkers of Inflammation in Asthma and Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, November 1, 2004; 1(3): 191 - 199.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. Rolla, L. Brussino, E. Scappaticci, M. Morello, R. Innarella, F. Rosina, and C. Bucca
Source of Exhaled Nitric Oxide in Primary Biliary Cirrhosis
Chest, November 1, 2004; 126(5): 1546 - 1551.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. F. Gelb, C. F. Taylor, E. Nussbaum, C. Gutierrez, A. Schein, C. M. Shinar, M. J. Schein, J. D. Epstein, and N. Zamel
Alveolar and Airway Sites of Nitric Oxide Inflammation in Treated Asthma
Am. J. Respir. Crit. Care Med., October 1, 2004; 170(7): 737 - 741.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
H.-W. Shin, P. Condorelli, C. M. Rose-Gottron, D. M. Cooper, and S. C. George
Probing the impact of axial diffusion on nitric oxide exchange dynamics with heliox
J Appl Physiol, September 1, 2004; 97(3): 874 - 882.
[Abstract] [Full Text] [PDF]

Home page
 Physiol. Rev.Home page
F. L. M. Ricciardolo, P. J. Sterk, B. Gaston, and G. Folkerts
Nitric Oxide in Health and Disease of the Respiratory System
Physiol Rev, July 1, 2004; 84(3): 731 - 765.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
P. Condorelli, H.-W. Shin, and S. C. George
Characterizing airway and alveolar nitric oxide exchange during tidal breathing using a three-compartment model
J Appl Physiol, May 1, 2004; 96(5): 1832 - 1842.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
S. C. George, M. Hogman, S. Permutt, and P. E. Silkoff
Modeling pulmonary nitric oxide exchange
J Appl Physiol, March 1, 2004; 96(3): 831 - 839.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
B. Mahut, C. Delacourt, F. Zerah-Lancner, J. De Blic, A. Harf, and C. Delclaux
Increase in Alveolar Nitric Oxide in the Presence of Symptoms in Childhood Asthma
Chest, March 1, 2004; 125(3): 1012 - 1018.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
H.-W. Shin, C. M. Rose-Gottron, D. M. Cooper, R. L. Newcomb, and S. C. George
Airway diffusing capacity of nitric oxide and steroid therapy in asthma
J Appl Physiol, January 1, 2004; 96(1): 65 - 75.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
M. Nickmilder, S. Carbonnelle, C. de Burbure, and A. Bernard
Relationship Between Ambient Ozone and Exhaled Nitric Oxide in Children
JAMA, November 19, 2003; 290(19): 2546 - 2547.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. C. Tornberg, H. Bjorne, J. O. Lundberg, and E. Weitzberg
Multiple Single-breath Measurements of Nitric Oxide in the Intubated Patient
Am. J. Respir. Crit. Care Med., November 15, 2003; 168(10): 1210 - 1215.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
H.-W. Shin and S. C. George
Impact of axial diffusion on nitric oxide exchange in the lungs
J Appl Physiol, December 1, 2002; 93(6): 2070 - 2080.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
L. Lehtimaki, H. Kankaanranta, S. Saarelainen, V. Turjanmaa, and E. Moilanen
Increased alveolar nitric oxide concentration in asthmatic patients with nocturnal symptoms
Eur. Respir. J., October 1, 2002; 20(4): 841 - 845.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. E. Girgis, M. K. Gugnani, J. Abrams, and M. D. Mayes
Partitioning of Alveolar and Conducting Airway Nitric Oxide in Scleroderma Lung Disease
Am. J. Respir. Crit. Care Med., June 15, 2002; 165(12): 1587 - 1591.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Asthma, Airway Biology, and Nasal Disorders in AJRCCM 2001
Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 598 - 618.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Tuberculosis, Lung Infections, Interstitial Lung Disease, and Socioeconomic Issues in AJRCCM 2001
Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 631 - 641.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. DELCLAUX, B. MAHUT, F. ZERAH-LANCNER, C. DELACOURT, S. LAOUD, D. CHERQUI, C. DUVOUX, A. MALLAT, and A. HARF
Increased Nitric Oxide Output from Alveolar Origin during Liver Cirrhosis versus Bronchial Source during Asthma
Am. J. Respir. Crit. Care Med., February 1, 2002; 165(3): 332 - 337.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
L. Lehtimaki, H. Kankaanranta, S. Saarelainen, V. Turjanmaa, and E. Moilanen
Inhaled fluticasone decreases bronchial but not alveolar nitric oxide output in asthma
Eur. Respir. J., October 1, 2001; 18(4): 635 - 639.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2001 American Thoracic Society 		  ATS Clinical Skills Tests