Rolla Giovanni, Heffler Enrico, Bommarito Luisa, Bergia Roberta, Ferrero Nicoletta
Allergologia e Immunologia Clinica dell'Università, Ospedale Mauriziano Umberto I, Torino.
Recenti Prog Med. 2005 Dec;96(12):634-40.
Recently a method to measure nitric oxide (NO) concentration in exhaled air has been developed. The method is non-invasive and easy to perform and it provides information on a fascinating molecule, with such extensive respiratory functions, ranging from bronchial and vascular dilation to ciliary motion and antibacterial defense. Nasal and sinus cavities are the site of major NO production, followed by airway and alveolar compartment. A very low nasal NO production is associated with ciliary dyskinesia, a disease characterized by severe chronic sinusitis and bronchiectasis. An increased concentration of NO in exhaled air has been reported in airway diseases, characterized by airway inflammation, such as bronchial asthma, where its concentration is related to bronchial hyperresponsiveness and sputum eosinophilia. Exhaled NO concentration in asthma is a sensitive marker of airway inflammation that reacts rapidly in response to treatment or exacerbation of disease. Clinical application of exhaled NO measurement include monitoring compliance and response to treatment, disease activity, diagnosis of asthma, and the prediction of acute exacerbations. Exhaled NO concentration may be increased also in other diseases, as COPD, bronchiectasis and some connective tissue diseases (SLE and systemic sclerosis). An increased NO production from alveolar source has been shown to be involved in oxygenation impairment of patients with liver disease, particularly in case of hepato-pulmonary syndrome.
最近，一种测量呼出气体中一氧化氮（NO）浓度的方法已被开发出来。该方法是非侵入性的，易于操作，它提供了关于一种迷人分子的信息，这种分子具有广泛的呼吸功能，从支气管和血管扩张到纤毛运动和抗菌防御。鼻腔和鼻窦腔是主要的NO产生部位，其次是气道和肺泡腔。鼻腔NO产生量极低与纤毛运动障碍有关，纤毛运动障碍是一种以严重慢性鼻窦炎和支气管扩张为特征的疾病。在以气道炎症为特征的气道疾病中，如支气管哮喘，呼出气体中NO浓度升高，其浓度与支气管高反应性和痰液嗜酸性粒细胞增多有关。哮喘患者呼出的NO浓度是气道炎症的敏感标志物，对治疗或疾病加重反应迅速。呼出NO测量的临床应用包括监测治疗依从性和反应、疾病活动度、哮喘诊断以及急性加重的预测。在其他疾病中，如慢性阻塞性肺疾病（COPD）、支气管扩张和一些结缔组织疾病（系统性红斑狼疮和系统性硬化症），呼出NO浓度也可能升高。已表明肺泡来源的NO产生增加与肝病患者的氧合障碍有关，尤其是在肝肺综合征的情况下。
