Az utóbbi 10 évben ugrásszerűen megnőtt az érdeklődés a kilégzett levegő és ezen keresztül a légúti gyulladás vizsgálata iránt a különböző tüdőbetegségekben. A gyulladás monitorozása segíthet e kórképek differenciáldiagnózisában, súlyosságuk megítélésében és a megfelelő terápia beállításában. Az új, noninvazív vizsgálómódszerek közül legismertebb a kilégzett levegő nitrogén-monoxid-koncentrációjának mérése, amely napjainkban nemzetközileg elfogadott ajánlások alapján a kereskedelmi forgalomban is kapható mérőműszerek segítségével történik. Az asztmás betegekben a kilégzett nitrogén-monoxid-koncentráció jelentősen emelkedett, és szoros összefüggést mutat a légutak eozinofilsejtes gyulladásával, a légúti hiperreaktivitás mértékével és a beteg panaszaival. E betegekben a kilégzett nitrogén-monoxid mérésén alapuló gyógyszeres beállítás a klasszikus kezelési stratégiákhoz képest jobb asztmakontrollt eredményezhet. Más tüdőbetegségekben, így például a krónikus obstruktív pulmonalis megbetegedésben a kilégzett nitrogén-monoxid mérése a szteroidra való válaszkészség megjósolásában segítheti a klinikust, míg tüdőtranszplantált betegekben rejtett infekciók vagy kilökődési reakciók indikátora lehet.
Alving K., Weitzberg E., Lundberg J. M.: Increased amount of nitric oxide in exhaled air of asthmatics. Eur. Respir. J., 1993, 6 , 1368–1370.
Lundberg J. M. , 'Increased amount of nitric oxide in exhaled air of asthmatics ' (1993 ) 6 Eur. Respir. J. : 1368 -1370 .
Antuni J. D., Kharitonov S. A., Hughes D. és mtsai: Increase in exhaled carbon monoxide during exacerbations of cystic fibrosis. Thorax, 2000, 55 , 138–142.
Hughes D. , 'Increase in exhaled carbon monoxide during exacerbations of cystic fibrosis ' (2000 ) 55 Thorax : 138 -142 .
Antus B., Csiszer E., Czebe K. és mtsa: Pulmonary infections increase exhaled nitric oxide in lung transplant recipients: a longitudinal study. Clin. Transplant., 2005, 19 , 377–382.
Czebe K. , 'Pulmonary infections increase exhaled nitric oxide in lung transplant recipients: a longitudinal study ' (2005 ) 19 Clin. Transplant. : 377 -382 .
Antus B., Csiszer E., Horvath I.: Antibiotic treatment decreases exhaled nitric oxide levels in cystic fibrosis patients. Eur. Respir. J., 2004, 24 , 382S.
Horvath I. , 'Antibiotic treatment decreases exhaled nitric oxide levels in cystic fibrosis patients ' (2004 ) 24 Eur. Respir. J. : 382S -.
Antus B., Fillinger J., Csiszer E. és mtsai: Bronchiolitis obliterans szindróma a tüdőtranszplantáción átesett betegekben. Orv. Hetil., 2005, 146 , 953–958.
Csiszer E. , 'Bronchiolitis obliterans szindróma a tüdőtranszplantáción átesett betegekben ' (2005 ) 146 Orv. Hetil. : 953 -958 .
Antus B., Horváth I.: A nitrogén-monoxid szerepe a pulmonalis rendszerben. Med. Thorac., 1996, 48 , 162–166.
Horváth I. , 'A nitrogén-monoxid szerepe a pulmonalis rendszerben ' (1996 ) 48 Med. Thorac. : 162 -166 .
ATS/ERS Recommendations for Standardized Procedures for the Online and Offline Measurement of Exhaled Lower Respiratory Nitric Oxide and Nasal Nitric Oxide, 2005. Am. J. Respir. Crit. Care Med., 2005, 171, 912–930.
Balint B., Kharitonov, S. A., Hanazawa, T. és mtsai: Increased nitrotyrosine in exhaled breath condensate in cystic fibrosis. Eur. Respir. J., 2001, 17 , 1201–1207.
Hanazawa T. , 'Increased nitrotyrosine in exhaled breath condensate in cystic fibrosis ' (2001 ) 17 Eur. Respir. J. : 1201 -1207 .
Baraldi, E., de Jongste, J. C.: European Respiratory Society; American Thoracic Society. Measurement of exhaled nitric oxide in children, 2001. Eur. Respir. J., 2002, 20 , 223–237.
Jongste J. C. , 'Measurement of exhaled nitric oxide in children, 2001 ' (2002 ) 20 Eur. Respir. J. : 223 -237 .
Brugiere, O., Thabut, G., Mal, H. és mtsai: Exhaled NO may predict the decline in lung function in bronchiolitis obliterans syndrome. Eur. Respir. J., 2005, 25 , 813–819.
Mal H. , 'Exhaled NO may predict the decline in lung function in bronchiolitis obliterans syndrome ' (2005 ) 25 Eur. Respir. J. : 813 -819 .
Busse, W. W., Vrtis, R. F., Dick, E. C.: The role of viral infections in intrinsic asthma: activation of neutrophil inflammation. Agents Actions Suppl., 1989, 28 , 41–56.
Dick E. C. , 'The role of viral infections in intrinsic asthma: activation of neutrophil inflammation ' (1989 ) 28 Agents Actions Suppl. : 41 -56 .
Gabbay, E., Walters, E. H., Orsida, B. és mtsai: Post-lung transplant bronchiolitis obliterans syndrome (BOS) is characterized by increased exhaled nitric oxide levels and epithelial inducible nitric oxide synthase. Am. J. Respir. Crit. Care Med., 2000, 162 , 2182–2187.
Orsida B. , 'Post-lung transplant bronchiolitis obliterans syndrome (BOS) is characterized by increased exhaled nitric oxide levels and epithelial inducible nitric oxide synthase ' (2000 ) 162 Am. J. Respir. Crit. Care Med. : 2182 -2187 .
Gratziou, C., Lignos, M., Dassiou, M. és mtsa: Influence of atopy on exhaled nitric oxide in patients with stable asthma and rhinitis. Eur. Respir. J., 1999, 14 , 897–901.
Dassiou M. , 'Influence of atopy on exhaled nitric oxide in patients with stable asthma and rhinitis ' (1999 ) 14 Eur. Respir. J. : 897 -901 .
Green, R. H., Brightling, C. E., McKenna, S. és mtsai: Comparison of asthma treatment given in addition to inhaled corticosteroids on airway inflammation and responsiveness. Eur. Respir. J., 2006, 27 , 1144–1151.
McKenna S. , 'Comparison of asthma treatment given in addition to inhaled corticosteroids on airway inflammation and responsiveness ' (2006 ) 27 Eur. Respir. J. : 1144 -1151 .
Gustafsson, L. E., Leone, A. M., Persson, M. G. és mtsai: Endogenous nitric oxide is present in the exhaled air of rabbits, guinea pigs and humans. Biochem. Biophys. Res. Commun., 1991, 181 , 852–857.
Persson M. G. , 'Endogenous nitric oxide is present in the exhaled air of rabbits, guinea pigs and humans ' (1991 ) 181 Biochem. Biophys. Res. Commun. : 852 -857 .
Ho, L. P., Innes, J. A., Greening, A. P.: Nitrite levels in breath condensate of patients with cystic fibrosis is elevated in contrast to exhaled nitric oxide. Thorax, 1998, 53 , 680–684.
Greening A. P. , 'Nitrite levels in breath condensate of patients with cystic fibrosis is elevated in contrast to exhaled nitric oxide ' (1998 ) 53 Thorax : 680 -684 .
Horvath I., Barnes, P. J.: Exhaled monoxides in asymptomatic atopic subjects. Clin. Exp. Allergy, 1999, 29 , 1276–1280.
Barnes P. J. , 'Exhaled monoxides in asymptomatic atopic subjects ' (1999 ) 29 Clin. Exp. Allergy : 1276 -1280 .
Horvath I., Donnelly, L. E., Kiss, A. és mtsai: Combined use of exhaled hydrogen peroxide and nitric oxide in monitoring asthma. Am. J. Respir. Crit. Care Med., 1998, 158 , 1042–1046.
Kiss A. , 'Combined use of exhaled hydrogen peroxide and nitric oxide in monitoring asthma ' (1998 ) 158 Am. J. Respir. Crit. Care Med. : 1042 -1046 .
Horvath I., Loukides, S., Wodehouse, T. és mtsai: Comparison of exhaled and nasal nitric oxide and exhaled carbon monoxide levels in bronchiectatic patients with and without primary ciliary dyskinesia. Thorax, 2003, 58 , 68–72.
Wodehouse T. , 'Comparison of exhaled and nasal nitric oxide and exhaled carbon monoxide levels in bronchiectatic patients with and without primary ciliary dyskinesia ' (2003 ) 58 Thorax : 68 -72 .
Horváth I.: Nitrogén-monoxid a pulmonológiai diagnosztikában és terápiában. Med. Thorac., 1997, 50 , 51–59.
Horváth I. , 'Nitrogén-monoxid a pulmonológiai diagnosztikában és terápiában ' (1997 ) 50 Med. Thorac. : 51 -59 .
Hutchison, S. J., Sievers, R. E., Zhu, B. Q. és mtsai: Secondhand tobacco smoke impairs rabbit pulmonary artery endothelium-dependent relaxation. Chest, 2001, 120 , 2004–2012.
Zhu B. Q. , 'Secondhand tobacco smoke impairs rabbit pulmonary artery endothelium-dependent relaxation ' (2001 ) 120 Chest : 2004 -2012 .
Ichinose, M., Sugiura, H., Yamagata, S. és mtsai: Increase in reactive nitrogen species production in chronic obstructive pulmonary disease airways. Am. J. Respir. Crit. Care Med., 2000, 162 , 701–706.
Yamagata S. , 'Increase in reactive nitrogen species production in chronic obstructive pulmonary disease airways ' (2000 ) 162 Am. J. Respir. Crit. Care Med. : 701 -706 .
Jatakanon, A., Lim, S., Kharitonov, S. A. és mtsai: Correlation between exhaled nitric oxide, sputum eosinophils, and methacholine responsiveness in patients with mild asthma. Thorax, 1998, 53 , 91–95.
Kharitonov S. A. , 'Correlation between exhaled nitric oxide, sputum eosinophils, and methacholine responsiveness in patients with mild asthma ' (1998 ) 53 Thorax : 91 -95 .
Jones K. L., Bryan T. W., Jinkins P. A. és mtsai: Superoxide released from neutrophils causes a reduction in nitric oxide gas. Am. J. Physiol., 1998, 275 , L1120–L1126.
Jinkins P. A. , 'Superoxide released from neutrophils causes a reduction in nitric oxide gas ' (1998 ) 275 Am. J. Physiol. : L1120 -L1126 .
Katsara, M., Donnelly, D., Iqbal, S. és mtsai: Relationship between exhaled nitric oxide levels and compliance with inhaled corticosteroids in asthmatic children. Respir. Med., 2006, 100 , 1512–1517.
Iqbal S. , 'Relationship between exhaled nitric oxide levels and compliance with inhaled corticosteroids in asthmatic children ' (2006 ) 100 Respir. Med. : 1512 -1517 .
Kharitonov, S., Alving, K., Barnes, P. J.: Exhaled and nasal nitric oxide measurements: recommendations. The European Respiratory Society Task Force. Eur. Respir. J., 1997, 10 , 1683–1693.
Barnes P. J. , 'Exhaled and nasal nitric oxide measurements: recommendations. The European Respiratory Society Task Force ' (1997 ) 10 Eur. Respir. J. : 1683 -1693 .
Kharitonov, S. A., Gonio, F., Kelly, C. és mtsai: Reproducibility of exhaled nitric oxide measurements in healthy and asthmatic adults and children. Eur. Respir. J., 2003, 21 , 43–438.
Kelly C. , 'Reproducibility of exhaled nitric oxide measurements in healthy and asthmatic adults and children ' (2003 ) 21 Eur. Respir. J. : 43 -438 .
Kharitonov, S. A., Rajakulasingam, K., O’Connor, B. és mtsai: Nasal nitric oxide is increased in patients with asthma and allergic rhinitis and may be modulated by nasal glucocorticoids. J. Allergy Clin. Immunol., 1997, 99 , 58–64.
O’Connor B. , 'Nasal nitric oxide is increased in patients with asthma and allergic rhinitis and may be modulated by nasal glucocorticoids ' (1997 ) 99 J. Allergy Clin. Immunol. : 58 -64 .
Kharitonov, S. A., Yates, D., Barnes, P. J.: Increased nitric oxide in exhaled air of normal human subjects with upper respiratory tract infections. Eur. Respir. J., 1995, 8 , 295–297.
Barnes P. J. , 'Increased nitric oxide in exhaled air of normal human subjects with upper respiratory tract infections ' (1995 ) 8 Eur. Respir. J. : 295 -297 .
Kharitonov, S. A., Yates, D., Robbins, R. A. és mtsai: Increased nitric oxide in exhaled air of asthmatic patients. Lancet, 1994, 343 , 133–135.
Robbins R. A. , 'Increased nitric oxide in exhaled air of asthmatic patients ' (1994 ) 343 Lancet : 133 -135 .
Kharitonov, S. A.: Exhaled markers of inflammatory lung diseases: ready for routine monitoring? Swiss Med Wkly, 2004, 134 , 175–192.
Kharitonov S. A. , 'Exhaled markers of inflammatory lung diseases: ready for routine monitoring? ' (2004 ) 134 Swiss Med Wkly : 175 -192 .
Lundberg, J. O., Farkas-Szallasi T., Weitzberg, E. és mtsai: High nitric oxide production in human paranasal sinuses. Nat. Med., 1995, 1 , 370–373.
Weitzberg E. , 'High nitric oxide production in human paranasal sinuses ' (1995 ) 1 Nat. Med. : 370 -373 .
Malmberg, L. P., Pelkonen, A. S., Haahtela, T. és mtsai: Exhaled nitric oxide rather than lung function distinguishes preschool children with probable asthma. Thorax, 2003, 58 , 494–499.
Haahtela T. , 'Exhaled nitric oxide rather than lung function distinguishes preschool children with probable asthma ' (2003 ) 58 Thorax : 494 -499 .
Martin, U., Bryden, K., Devoy, M. és mtsai: Increased levels of exhaled nitric oxide during nasal and oral breathing in subjects with seasonal rhinitis. J. Allergy. Clin. Immunol., 1996, 97 , 768–772.
Devoy M. , 'Increased levels of exhaled nitric oxide during nasal and oral breathing in subjects with seasonal rhinitis ' (1996 ) 97 J. Allergy. Clin. Immunol. : 768 -772 .
Maziak, W., Loukides, S., Culpitt, S. és mtsai: Exhaled nitric oxide in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med., 1998, 157 , 998–1002.
Culpitt S. , 'Exhaled nitric oxide in chronic obstructive pulmonary disease ' (1998 ) 157 Am. J. Respir. Crit. Care Med. : 998 -1002 .
Meijer, R. J., Postma, D. S., Kauffman, H. F. és mtsai: Accuracy of eosinophils and eosinophil cationic protein to predict steroid improvement in asthma. Clin. Exp. Allergy, 2002, 32 , 1096–1103.
Kauffman H. F. , 'Accuracy of eosinophils and eosinophil cationic protein to predict steroid improvement in asthma ' (2002 ) 32 Clin. Exp. Allergy : 1096 -1103 .
Meng, Q. H., Springall, D. R., Bishop, A. E. és mtsai: Lack of inducible nitric oxide synthase in bronchial epithelium: a possible mechanism of susceptibility to infection in cystic fibrosis. J. Pathol., 1998, 184 , 323–331.
Bishop A. E. , 'Lack of inducible nitric oxide synthase in bronchial epithelium: a possible mechanism of susceptibility to infection in cystic fibrosis ' (1998 ) 184 J. Pathol. : 323 -331 .
Moncada, S., Palmer, R. M., Higgs, E. A.: Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol. Rev., 1991, 43 , 109–142.
Higgs E. A. , 'Nitric oxide: physiology, pathophysiology, and pharmacology ' (1991 ) 43 Pharmacol. Rev. : 109 -142 .
Nogami, H., Shoji, S., Nishima, S.: Exhaled nitric oxide as a simple assessment of airway hyperresponsiveness in bronchial asthma and chronic cough patients. J. Asthma, 2003, 40 , 653–659.
Nishima S. , 'Exhaled nitric oxide as a simple assessment of airway hyperresponsiveness in bronchial asthma and chronic cough patients ' (2003 ) 40 J. Asthma : 653 -659 .
Papi, A., Romagnoli, M., Baraldo, S. és mtsai: Partial reversibility of airflow limitation and increased exhaled NO and sputum eosinophilia in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med., 2000, 162 , 1773–1777.
Baraldo S. , 'Partial reversibility of airflow limitation and increased exhaled NO and sputum eosinophilia in chronic obstructive pulmonary disease ' (2000 ) 162 Am. J. Respir. Crit. Care Med. : 1773 -1777 .
Parameswaran, K., Allen, C. J., Kamada, D. és mtsai: Sputum cell counts and exhaled nitric oxide in patients with gastroesophageal reflux, and cough or asthma. Can. Respir. J., 2001, 8 , 239–244.
Kamada D. , 'Sputum cell counts and exhaled nitric oxide in patients with gastroesophageal reflux, and cough or asthma ' (2001 ) 8 Can. Respir. J. : 239 -244 .
Paredi, P., Kharitonov, S. A., Barnes, P. J.: Analysis of expired air for oxidation products. Am. J. Respir. Crit. Care Med., 2002, 166 , S31–37.
Barnes P. J. , 'Analysis of expired air for oxidation products ' (2002 ) 166 Am. J. Respir. Crit. Care Med. : S31 -37 .
Persson, M. G., Zetterstrom, O., Agrenius, V. és mtsa: Single-breath nitric oxide measurements in asthmatic patients and smokers. Lancet, 1994, 343 , 146–147.
Agrenius V. , 'Single-breath nitric oxide measurements in asthmatic patients and smokers ' (1994 ) 343 Lancet : 146 -147 .
Pijnenburg, M. W., Hofhuis, W., Hop, W. C. és mtsa: Exhaled nitric oxide predicts asthma relapse in children with clinical asthma remission. Thorax, 2005, 60 , 215–218.
Hop W. C. , 'Exhaled nitric oxide predicts asthma relapse in children with clinical asthma remission ' (2005 ) 60 Thorax : 215 -218 .
Silkoff, P. E., Caramori, M., Tremblay, L. és mtsai: Exhaled nitric oxide in human lung transplantation. A noninvasive marker of acute rejection. Am. J. Respir. Crit. Care Med., 1998, 157 , 1822–1828.
Tremblay L. , 'Exhaled nitric oxide in human lung transplantation. A noninvasive marker of acute rejection ' (1998 ) 157 Am. J. Respir. Crit. Care Med. : 1822 -1828 .
Silkoff, P. E., Carlson, M., Bourke, T. és mtsai: The Aerocrine exhaled nitric oxide monitoring system NIOX is cleared by the US Food and Drug Administration for monitoring therapy in asthma. J. Allergy Clin. Immunol., 2004, 114 , 1241–1256.
Bourke T. , 'The Aerocrine exhaled nitric oxide monitoring system NIOX is cleared by the US Food and Drug Administration for monitoring therapy in asthma ' (2004 ) 114 J. Allergy Clin. Immunol. : 1241 -1256 .
Smith, A. D., Cowan, J. O., Filsell, S. és mtsai: Diagnosing asthma: comparisons between exhaled nitric oxide measurements and conventional tests. Am. J. Respir. Crit. Care Med., 2004, 169 , 473–478.
Filsell S. , 'Diagnosing asthma: comparisons between exhaled nitric oxide measurements and conventional tests ' (2004 ) 169 Am. J. Respir. Crit. Care Med. : 473 -478 .
Steerenberg, P. A., Janssen, N. A., de Meer, G. és mtsai: Relationship between exhaled NO, respiratory symptoms, lung function, bronchial hyperresponsiveness, and blood eosinophilia in school children. Thorax, 2003, 58 , 242–245.
Meer G. , 'Relationship between exhaled NO, respiratory symptoms, lung function, bronchial hyperresponsiveness, and blood eosinophilia in school children ' (2003 ) 58 Thorax : 242 -245 .
Stuehr, D. J., Griffith, O. W.: Mammalian nitric oxide synthases. Adv. Enzymol. Relat. Areas Mol. Biol., 1992, 65 , 287–346.
Griffith O. W. , 'Mammalian nitric oxide synthases ' (1992 ) 65 Adv. Enzymol. Relat. Areas Mol. Biol. : 287 -346 .
Thomas, S. R., Kharitonov, S. A., Scott, S. F. és mtsai: Nasal and exhaled nitric oxide is reduced in adult patients with cystic fibrosis and does not correlate with cystic fibrosis genotype. Chest, 2000, 117 , 1085–1089.
Scott S. F. , 'Nasal and exhaled nitric oxide is reduced in adult patients with cystic fibrosis and does not correlate with cystic fibrosis genotype ' (2000 ) 117 Chest : 1085 -1089 .