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Nitric oxide (NO), an inorganic gas, acts as a potent second messenger in most animal and plant tissues. NO diffuses out of the cells that produce it and enters the neighboring cells to generate a downstream response. NO synthase (NOS) catalyzes NO production by the deamination of the amino acid arginine. There are three isoforms of NOS. Endothelial cells have endothelial NOS (eNOS), nerve and muscle cells have neuronal NOS (nNOS), and macrophages produce inducible NOS (iNOS) upon exposure...
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Assessing Nasal Nitric Oxide in Allergic Rhinitis: A Controversial Biomarker.

Natalia Louca1, Despina Damianou1, Nektaria Kostea1

  • 1Medical School, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus.

Medicina (Kaunas, Lithuania)
|March 27, 2025
PubMed
Summary

Nasal nitric oxide (nNO) levels were evaluated for diagnosing allergic rhinitis (AR). Researchers found nNO is not a reliable independent biomarker for differentiating AR from nonallergic rhinitis (NAR).

Keywords:
allergensallergic rhinitisatopynasal NOnonallergic rhinitis

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Area of Science:

  • Allergology
  • Pulmonology
  • Biomarker Research

Background:

  • Elevated nitric oxide (NO) is linked to inflammatory conditions like allergic asthma.
  • Fractional exhaled NO is a known biomarker for type 2 inflammation in asthma.
  • The diagnostic utility of nasal NO (nNO) for allergic rhinitis (AR) remains less explored.

Purpose of the Study:

  • To investigate nNO as a potential biomarker for distinguishing AR from nonallergic rhinitis (NAR).

Main Methods:

  • A cohort of medical students with rhinitis symptoms underwent questionnaires, medical history review, clinical examination, skin-prick tests (SPTs), and nNO measurements.
  • nNO levels were measured using the NIOX VERO portable nitric oxide analyzer.
  • SPTs were conducted for 14 regional allergens during the pollen season.

Main Results:

  • Out of 122 volunteers, 62 reported rhinitis symptoms; 39 had SPT-confirmed AR and 23 were classified as NAR.
  • Mean nNO concentrations were 830 ± 247 ppb in the AR group and 851 ± 373 ppb in the NAR group.
  • No statistically significant difference in mean nNO concentrations was observed between the AR and NAR groups.

Conclusions:

  • nNO is not a reliable independent biomarker for the diagnosis of allergic rhinitis.
  • Further research may be needed to explore other potential roles or combinations of biomarkers for AR diagnosis.