Related Experiment Video

Updated: Jul 20, 2026

A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
05:46

A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects

Published on: May 4, 2021

Exhaled nitric oxide differentiates airway diseases in the first two years of life

Carmelo Gabriele1, Eveline M Nieuwhof, Els C Van Der Wiel

  • 1Department of Pediatric Respiratory Medicine, Erasmus Medical Centre/Sophia Children's Hospital, Rotterdam, 3000 CB, the Netherlands.

Pediatric Research
|August 31, 2006
PubMed

Insights

Fractional exhaled nitric oxide (FE(NO)) can help distinguish airway diseases in infants. This study found distinct FE(NO) levels in infants with recurrent wheezing, bronchopulmonary dysplasia, and cystic fibrosis, aiding early diagnosis.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Biomarker Research

Background:

  • Fractional exhaled nitric oxide (FE(NO)) is elevated in asthma but reduced in cystic fibrosis (CF) and primary ciliary dyskinesia.
  • Distinguishing between infant airway diseases can be challenging due to overlapping symptoms.
  • FE(NO) as a non-invasive biomarker for early detection of pediatric respiratory conditions requires further investigation.

Purpose of the Study:

  • To evaluate the utility of FE(NO) measurements in differentiating airway diseases in infants under two years old.
  • To compare FE(NO) levels across different infant respiratory conditions including recurrent wheezing (RW), bronchopulmonary dysplasia (BPD), and CF.
  • To assess FE(NO) levels in healthy infants as a control group for comparison.

Main Methods:

  • FE(NO) was measured in 118 infants (4.6-25.2 months) with RW (n=74), BPD (n=24), and CF (n=20).
  • FE(NO) was also measured in 100 healthy control infants (1.1-7.7 months).
  • Statistical analysis was performed to compare FE(NO) values between groups.

Main Results:

  • FE(NO) levels were significantly higher in infants with RW (18.6 ppb) compared to healthy controls (10.4 ppb), BPD (11.7 ppb), and CF (5.9 ppb).
  • Infants with CF showed significantly lower FE(NO) than healthy controls and BPD infants.
  • FE(NO) levels in BPD infants were not significantly different from healthy controls. Atopic wheezers had higher FE(NO) than nonatopic wheezers.

Conclusions:

  • FE(NO) measurements are valuable in differentiating between various airway diseases in infants younger than two years.
  • Distinct FE(NO) profiles observed can aid in the early diagnosis and management of pediatric respiratory conditions.
  • FE(NO) serves as a useful, non-invasive tool for distinguishing RW, BPD, and CF in early childhood.

Related Concept Videos

Breathing01:05

Breathing

The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
Asthma I: Introduction01:28

Asthma I: Introduction

Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...
Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features01:24

Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features

Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
Asthma-II: Pathophysiology and Classification01:26

Asthma-II: Pathophysiology and Classification

Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Chronic Obstructive Pulmonary Disease I: Introduction01:23

Chronic Obstructive Pulmonary Disease I: Introduction

Chronic obstructive pulmonary disease is a common, preventable, and treatable respiratory disorder characterized by persistent symptoms and progressive airflow limitation. This limitation results from a combination of small-airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), both driven by chronic inflammation from exposure to harmful particles or gases.The disease includes two main pathological entities: emphysema, marked by destruction of alveolar walls and...