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Asthma and FeNO

Asthma – a worldwide health problem

Bronchial asthma is a chronic inflammatory disease of the airways that according to the Global Asthma Report 2018 is estimated to affect as many as 339 people worldwide.1 The World Health Organization (WHO)2 and Global Initiative for Asthma (GINA)3 currently put the figure at 235 and 300 million, respectively. Asthma is a worldwide health problem affecting people in low- and middle-income countries as well as in western high-income countries. In fact, asthma is the most prevalent of all chronic diseases diagnosed in children.

The big challenge with asthma is that it is often not properly diagnosed and not treated effectively enough.4,5 According to the European Lung Foundation (ELF) and the European Respiratory Society (ERS), despite the increased use of asthma drugs in asthma control, Europe still has a lot of catching up to do. Around 10% of adult asthmatics suffer from severe asthma, which is difficult to treat.6

Although there is so far no cure for asthma, appropriate management can control the disease and enable people to enjoy a good quality of life. However, this requires reliable diagnosis, appropriate therapy, and educating patients to adopt adequate behavior (such as allergen avoidance, good inhalation technique, and therapy adherence).

FeNO as a solution for improved quality of life with asthma

Woman with cough - asthma

Asthmatics and their families are often affected by severe lifestyle limitations and reduced quality of life in general. In order to prevent exacerbations and asthma attacks, it is essential to understand the causes of asthma.

Within the scope of asthma diagnosis and follow-up, various pulmonary function tests are performed, but these do not allow any direct conclusion to be drawn about the extent of the underlying inflammation. The latter, however, is the goal of a guideline-based anti-inflammatory therapy for asthmatics. One measure of respiratory tract inflammation is the amount of nitric oxide (NO) in exhaled breath (FeNO). The NO concentration in exhaled breath is particularly high in allergic asthma.

FeNO alone is not the solution to the asthma problem. However, FeNO measurement at a doctor’s practice or in the patient’s home is a worthwhile supplement to an asthma diagnosis and therapy monitoring, from which both physicians and patients equally benefit.

Standardized measurement for determining bronchial NO

Respiratory system
  • To obtain a sample of NO produced in the bronchial tubes, the exhaled breath has to be fractionated.
  • The measurement of fractional exhaled NO (FeNO) has been standardized for clinical measurement and is therefore a reliable way of monitoring allergic airway inflammation.7,8
  • FeNO is measured during slow, controlled exhalation through a mouthpiece. The soft palate (velum) must be closed to prevent contamination with NO from the upper respiratory tract.
  • FeNO measurement is quick and easy to perform and is non-invasive and stress-free for the patient.

NO - The way through the respiratory tract into Vivatmo

Animation - NO - The way through the respiratory tract into Vivatmo

1 The Global Asthma Network: Global Asthma Report 2018 http://www.globalasthmareport.org/Global%20Asthma%20Report%202018.pdf

2 WHO Fact sheet asthma (August 2017) https://www.who.int/en/news-room/fact-sheets/detail/asthma

3 Global Burden of Asthma Report, 2004. https://ginasthma.org

4 Aarin et al. JAMA. 2017;317(3):269-279

5 Looijmans-van den Akker et al. Br J Gen Pract 2016; 66 (644)

6 Lunge und Gesundheit in Europa- Fakten und Zahlen https://www.erswhitebook.org/

7 ATS/ERS Am J Respir Crit Care Med 2005;171:912-30

8 Horváth et al. Eur Respir J 2017;49:1600965