Skip to main content

Exhaled Nitric Oxide in Specific Inhalation Challenge

  • Chapter
  • First Online:
Book cover Neurobiology of Respiration

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 788))

Abstract

Exhaled nitric oxide (eNO) is a biological mediator in human lungs and can be measured easily in exhaled air. Increasing eNO concentrations after specific inhalation testing (SIT) have been described for subjects with occupational asthma. Nevertheless, interpreting eNO concentrations after SIT is still a challenge because eNO concentrations depend on various confounding factors. In this study, 24 women and 43 men with suspected occupational asthma were examined by a questionnaire, physical examination, routine laboratory testing, skin prick testing (atopy: at least one wheal reaction >3 mm), lung function including methacholine testing, and SIT with various occupational allergens. Exhaled NO was measured before SIT (t0), 2 h (t1) and 20–22 h (t2) afterwards (NIOX Flex, Aerocrine, Sweden). At baseline we observed significantly lower eNO concentrations in smokers than in non-smokers and in non-atopics than in atopics (significant only in SIT non-responders). In the SIT non-responders (n = 45), eNO concentrations showed no change after SIT (t0: 16.0, t1: 12.3, t2: 16.0 ppb). In the SIT responders (n = 22), eNO was elevated significantly at t2 (t0: 22.9, t1: 19.9, t2: 42.0 ppb). In addition to positive responder status and measuring time, missing atopy and exposure to isocyanates were the essential factors leading to increased eNO concentrations. We conclude that the measurements of eNO after SIT may provide valuable information concerning the allergenic status of a patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Allmers, H., Chen, Z., Barbinova, L., Marczynski, B., Kirschmann, V., & Baur, X. (2000). Challenge from methacholine, natural rubber latex, or 4,4´-diphenylmethane diisocyanate in workers with suspected sensitization affects exhaled nitric oxide [change in exhaled NO levels after allergen challenges]. International Archives of Occupational and Environmental Health, 39, 181–186.

    Article  Google Scholar 

  • Barbinova, L., & Baur, X. (2006). Increase of exhaled nitric oxide (eNO) after work-related isocyanate exposure. International Archives of Occupational and Environmental Health, 79, 387–395.

    Article  PubMed  CAS  Google Scholar 

  • Baur, X., & Barbinova, L. (2005). Latex allergen exposure increase exhaled nitric oxide in symptomatic healthcare workers. European Respiratory Journal, 25, 309–316.

    Article  PubMed  CAS  Google Scholar 

  • Baur, X., Hubert, H., Degens, P., Allmers, H., & Ammon, J. (1998). Relation between occupational asthma case history, bronchial methacholine challenge, and specific test in patients with suspected occupational asthma. American Journal of Industrial Medicine, 33, 114–122.

    Article  PubMed  CAS  Google Scholar 

  • Cruz, M. J., & Munoz, X. (2012). The current diagnostic role of the specific occupational laboratory challenge test. Current Opinion in Allergy and Clinical Immunology, 12, 119–125.

    Article  PubMed  CAS  Google Scholar 

  • Dweik, R. A., Boggs, P. B., Erzurum, S. C., Irvin, C. G., Leigh, M. W., Lundberg, J. O., Olin, A. C., Plummer, A. L., & Taylor, D. R. (2011). An official ATS clinical practice guideline: Interpretation of exhaled nitric oxide levels (FeNO) for clinical applications. American Journal of Respiratory and Critical Care Medicine, 184, 602–615.

    Article  PubMed  CAS  Google Scholar 

  • Gonsior, E., Henzgen, M., Jörres, R. A., Kroidl, R. F., Merget, R., Riffelmann, F. W., & Wallenstein, G. (2002). Leitlinie für die Durchführung bronchialer Provokationstests mit Allergenen. Pneumologie, 56, 187–198.

    Article  PubMed  CAS  Google Scholar 

  • Lemiere, C., D’Alpaos, V., Chaboillze, S., Cesar, M., Watthiez, M., Chiry, S., & Vandenplas, O. (2012). Investigation of occupational asthma. Chest, 137, 617–622.

    Article  Google Scholar 

  • Niimi, A., Amitani, R., Yamada, K., Tanaka, K., & Kuze, F. (1996). Late respiratory response and associated eosinophilic inflammation induced by repeated exposure to toluene diisocyanate in guinea pigs. The Journal of Allergy and Clinical Immunology, 97, 1308–1319.

    Article  PubMed  CAS  Google Scholar 

  • Pedrosa, M., Barranco, P., Lopez-Carrasco, V., & Quirce, S. (2012). Changes in exhaled nitric oxide levels after bronchial allergen challenge. Lung, 190, 209–214.

    Article  PubMed  CAS  Google Scholar 

  • Quirce, S., Lemière, C., De Blay, F., Del Pozo, V., Gerth van Wijk, R., Maestrelli, P., Pauli, G., Pignatti, P., Raulf-Heimsoth, M., Sastre, J., Storaas, T., & Moscato, G. (2010). Noninvasive methods for assessment of airway inflammation in occupational settings. Allergy, 65, 445–458.

    Article  PubMed  CAS  Google Scholar 

  • Szefler, S. J., Wenzel, S., Brown, R., Erzurum, S. C., Fahy, J. V., Hamilton, R. G., Hunt, J. F., Kita, H., Liu, A. H., Panetterii, R. A., Schleimer, R. P., & Minnocozzi, M. (2012). Asthma outcomes: Biomarker. The Journal of Allergy and Clinical Immunology, 129, S9–S23.

    Article  PubMed  Google Scholar 

Download references

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to O. Hagemeyer .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Ewald-Kleimeier, S., Lotz, A., Merget, R., Brüning, T., Hagemeyer, O. (2013). Exhaled Nitric Oxide in Specific Inhalation Challenge. In: Pokorski, M. (eds) Neurobiology of Respiration. Advances in Experimental Medicine and Biology, vol 788. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6627-3_36

Download citation

Publish with us

Policies and ethics