title: Exhaled nitric oxide in relation to asthma control: A real-life survey.
abstract: BACKGROUND
  Asthma is characterised by chronic airway inflammation, a complex cascade of events, mostly sustained by eosinophil recruitment and activation. Fractional exhaled nitric oxide (FeNO) is a surrogate marker of airway inflammation closely associated with bronchial eosinophilia. FeNO is used to define asthma phenotype, to assess eosinophilic inflammatory severity and to predict corticosteroid responsiveness.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether FeNO may be associated with some clinical and functional factors in asthmatics evaluated in a real life setting.
  
  
  METHODS
  Globally 363 patients (150 males, mean age 46.3 years) with asthma were consecutively evaluated. The following parameters were assessed: history, including comorbidities, physical examination, body mass index (BMI), lung function, asthma control grade, asthma control test (ACT), and FeNO.
  
  
  RESULTS
  FeNO values were significantly higher in patients with poorly controlled asthma (p<0.01), asthma symptoms (p=0.015), wheezing (p<0.001), rhinitis diagnosis, (p=0.049) and rhinitis symptoms (p=0.019), but lower in patients with GERD (p=0.024) and pneumonia history (p=0.048). FeNO values increased in patients with the lowest corticosteroid dose (p=0.031). FeNO values>25ppb were associated with poorly controlled asthma (OR 3.71), asthma signs (OR 3.5) and symptoms (OR 1.79). A FeNO value cut-off of 29.9ppb was fairly predictive of (AUC 0.7) poorly controlled asthma.
  
  
  CONCLUSIONS
  FeNO assessment in clinical practice may be a useful tool for monitoring asthmatics as it is associated with several clinical factors, including asthma control.
authors.affiliation: Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
authors.forename: F L M
authors.initials: FL
authors.lastname: Ricciardolo
authors.affiliation: Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Sorbello
authors.affiliation: Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Bellezza Fontana
authors.affiliation: Department of Health, University of Genoa, Genoa, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Schiavetti
authors.affiliation: Department of Medicine, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy. Electronic address: gio.cip@libero.it.
authors.forename: G
authors.initials: G
authors.lastname: Ciprandi
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy*; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D004802:Eosinophilia / Q000175:diagnosis*; D045853:Exhalation; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D009569:Nitric Oxide
keywords: Asthma; Asthma control; Asthma control test; Exhaled nitric oxide; Rhinitis