title: Exhaled nitric oxide levels correlate with measures of disease control in asthma.
abstract: BACKGROUND
  Asthma guidelines emphasize maintaining disease control. However, objective measures of asthma disease control are lacking.
  
  
  OBJECTIVE
  We sought to examine the relationship between exhaled nitric oxide (NO) levels and measures of asthma disease control versus asthma disease severity.
  
  
  METHODS
  We performed a cross-sectional study of 100 patients (age range, 7-80 years) with asthma. We administered a questionnaire to identify characteristics of asthma, performed spirometric testing before and after administration of a bronchodilator, and measured exhaled NO levels in all participants.
  
  
  RESULTS
  Exhaled NO was significantly correlated with the following markers of asthma disease control: asthma symptoms within the past 2 weeks (P =.02), dyspnea score (P =. 02), daily use of rescue medications (P =.01), and reversibility of airflow obstruction (P =.02). Exhaled NO levels were not correlated with the following markers of asthma disease severity: history of respiratory failure (P =.20), health care use (P =.08), fixed airflow obstruction (P =.91), or a validated asthma severity score (P =.19). Markers with relevance to both disease control and severity showed either a weak correlation (FEV(1) and FEV(1) percent predicted) or no correlation (controller drug use) with exhaled NO.
  
  
  CONCLUSIONS
  We conclude that exhaled NO levels are correlated predominantly with markers of asthma control rather than asthma severity. Monitoring of exhaled NO may be useful in outpatient asthma management.
authors.affiliation: Pulmonary and Critical Care Section, Portland Veterans Administration Medical Center, Portland, OR, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Sippel
authors.forename: W E
authors.initials: WE
authors.lastname: Holden
authors.forename: S A
authors.initials: SA
authors.lastname: Tilles
authors.forename: M
authors.initials: M
authors.lastname: O'Hollaren
authors.forename: J
authors.initials: J
authors.lastname: Cook
authors.forename: N
authors.initials: N
authors.lastname: Thukkani
authors.forename: J
authors.initials: J
authors.lastname: Priest
authors.forename: B
authors.initials: B
authors.lastname: Nelson
authors.forename: M L
authors.initials: ML
authors.lastname: Osborne
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000378:metabolism* / Q000517:prevention & control*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism / Q000502:physiology*; D012119:Respiration; D012720:Severity of Illness Index
chemical_list: D009569:Nitric Oxide