Measurement of lung inflammation in asthmatics. Reason for optimism

It is recognized that bronchial asthma is an inflammatory disease. However, aggressive anti-inflammatory therapy is not guided by the degree of lung inflammation. This is of particular concern in children in whom over-aggressive therapy with corticosteroid may lead to growth retardation. Analysis of breath exhaled nitric oxide levels may be an indirect measurement of lung inflammation. Since exhaled nitric oxide levels and inflammation decrease after steroid therapy, measurement of exhaled nitric oxide levels may provide a rationale for optimization of steroid therapy and possible reduction of side effects. Measurement of exhaled nitric oxide levels is not available for routine use but may be so in the near future. This will likely herald a new dawn in the management of asthma, a disease with increasing frequency, mortality and morbidity.