title: Control maintenance can be predicted by exhaled NO monitoring in asthmatic patients.
abstract: BACKGROUND
  Fractional exhaled nitric oxide (F(E)NO) is a marker of airway inflammation in asthma. Monitoring of such inflammation is currently not included in asthma guidelines and remains controversial. The hypothesis underlying the present study was that, F(E)NO could help assessing asthma control and, therefore, improve its management, by predicting loss of control in asthmatics.
  
  
  METHODS
  A total of 90 adult asthmatics were included in the study. Asthma control was evaluated according to ACQ. All patients underwent F(E)NO by chemiluminescent (EndoNO) and hand-held (MINO) devices, followed by lung function testing.
  
  
  RESULTS
  MINO was accurate as compared to EndoNO. F(E)NO was significantly increased in uncontrolled as compared to controlled asthmatics using both devices. F(E)NO measurement was able to predict control maintenance in controlled asthmatics in the absence of any change in their treatment. Indeed, using cut-off values of 31 and 40 ppb, the negative predictive values were 95 and 97% for EndoNO and MINO, respectively. EndoNO and MINO were also able to assess asthma control, although to a lesser extent.
  
  
  CONCLUSIONS
  These findings suggest that F(E)NO can predict the persistence of asthma control in controlled patients and may now be used in asthma management since it can accurately be measured by means of hand-held devices.
authors.affiliation: Université de Bordeaux, UB2, Centre de Recherche Cardio-Thoracique, CIC 0005, F-33076 Bordeaux, France. annaig.ozier@u-bordeaux2.fr
authors.forename: Annaïg
authors.initials: A
authors.lastname: Ozier
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Girodet
authors.forename: Imane
authors.initials: I
authors.lastname: Bara
authors.forename: José-Manuel
authors.initials: JM
authors.lastname: Tunon de Lara
authors.forename: Roger
authors.initials: R
authors.lastname: Marthan
authors.forename: Patrick
authors.initials: P
authors.lastname: Berger
mesh_terms: D000328:Adult; D000420:Albuterol / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D004417:Dyspnea; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D016210:Methacholine Chloride / Q000008:administration & dosage; D009569:Nitric Oxide / Q000032:analysis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012129:Respiratory Function Tests / Q000379:methods
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D016210:Methacholine Chloride; D009569:Nitric Oxide; D000420:Albuterol