Larenas-Linnemann Désirée, Gochicoa-Rangel Laura, Macías-Weinmann Alejandra, Soto-Ramos Mario, Luna-Pech Jorge A, Elizondo-Ríos Abelardo, Del Río-Navarro Blanca E, Hernández-Colín Dante Daniel, García-Maldonado Salvador, Zepeda Benjamín, Martínez-Infante Eric A, Vázquez Juan Carlos
Fundación Clínica Médica Sur, Ciudad de México.
Rev Alerg Mex. 2020;67 Suppl 2:S1-S25. doi: 10.29262/ram.v67i0.760.
The fractional exhaled nitric oxide (FeNO) is related to the level of eosinophilic inflammation in the airways and the levels of interleukin-13, as such it could be a diagnostic and monitoring tool in asthma. A working group was convened between pulmonologists, respiratory physiology experts, and allergists to establish criteria for the use of FeNO in asthma in Mexico. Through a simplified Delphi method and group discussion, seven key points regarding the use of FeNO were agreed upon. We agree that the measurement of FeNO serves for the diagnosis of asthma in specialized clinics, both in children and adults, as well as to determine the level of corticosteroid treatment. In severe asthma, we recommend FeNO for endotyping, for detecting poor therapeutic adherence, undertreatment, and the risk of crisis. We suggest FeNO can be used to determine the level of corticosteroid treatment and to identify patients at risk of loss of lung function. We also recommend it in adults to improve the selection of biological therapy and, in this context, we only suggest it in selected cases for children.
呼出一氧化氮分数(FeNO)与气道嗜酸性粒细胞炎症水平及白细胞介素-13水平相关,因此它可能成为哮喘的一种诊断和监测工具。墨西哥的肺病专家、呼吸生理学专家和过敏症专科医生召开了一个工作组会议,以制定在墨西哥将FeNO用于哮喘的标准。通过简化的德尔菲法和小组讨论,就FeNO的使用达成了七个关键点。我们一致认为,FeNO的测量可用于专科诊所中儿童和成人哮喘的诊断,以及确定皮质类固醇治疗水平。在重度哮喘中,我们建议使用FeNO进行内型分类,检测治疗依从性差、治疗不足和危机风险。我们建议FeNO可用于确定皮质类固醇治疗水平,并识别有肺功能丧失风险的患者。我们还建议在成人中使用它来改进生物疗法的选择,在这种情况下,我们仅建议在特定儿童病例中使用。