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Metabolic Dysregulation in Idiopathic Pulmonary Fibrosis
Review

Extended Exhaled Nitric Oxide Analysis in Interstitial Lung Diseases: A Systematic Review

1
Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
2
Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(17), 6187; https://doi.org/10.3390/ijms21176187
Received: 3 August 2020 / Revised: 20 August 2020 / Accepted: 24 August 2020 / Published: 27 August 2020
(This article belongs to the Special Issue Molecular Pathology of Idiopathic Pulmonary Fibrosis)
Fractional exhaled nitric oxide (FeNO) is a well-known and widely accepted biomarker of airways inflammation that can be useful in the therapeutic management, and adherence to inhalation therapy control, in asthmatic patients. However, the multiple-flows assessment of FeNO can provide a reliable measurement of bronchial and alveolar production of NO, supporting its potential value as biomarker also in peripheral lung diseases, such as interstitial lung diseases (ILD). In this review, we first discuss the role of NO in the pathobiology of lung fibrosis and the technique currently approved for the measurement of maximum bronchial flux of NO (J’awNO) and alveolar concentration of NO (CaNO). We systematically report the published evidence regarding extended FeNO analysis in the management of patients with different ILDs, focusing on its potential role in differential diagnosis, prognostic evaluation and severity assessment of disease. The few available data concerning extended FeNO analysis, and the most common comorbidities of ILD, are explored too. In conclusion, multiple-flows FeNO analysis, and CaNO in particular, appears to be a promising tool to be implemented in the diagnostic and prognostic pathways of patients affected with ILDs. View Full-Text
Keywords: idiopathic pulmonary fibrosis; interstitial lung disease; biomarker; exhaled breath; nitric oxide; oxidative stress; review idiopathic pulmonary fibrosis; interstitial lung disease; biomarker; exhaled breath; nitric oxide; oxidative stress; review
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MDPI and ACS Style

Cameli, P.; Bargagli, E.; Bergantini, L.; d’Alessandro, M.; Pieroni, M.; Fontana, G.A.; Sestini, P.; Refini, R.M. Extended Exhaled Nitric Oxide Analysis in Interstitial Lung Diseases: A Systematic Review. Int. J. Mol. Sci. 2020, 21, 6187. https://doi.org/10.3390/ijms21176187

AMA Style

Cameli P, Bargagli E, Bergantini L, d’Alessandro M, Pieroni M, Fontana GA, Sestini P, Refini RM. Extended Exhaled Nitric Oxide Analysis in Interstitial Lung Diseases: A Systematic Review. International Journal of Molecular Sciences. 2020; 21(17):6187. https://doi.org/10.3390/ijms21176187

Chicago/Turabian Style

Cameli, Paolo, Elena Bargagli, Laura Bergantini, Miriana d’Alessandro, Maria Pieroni, Giovanni A. Fontana, Piersante Sestini, and Rosa M. Refini. 2020. "Extended Exhaled Nitric Oxide Analysis in Interstitial Lung Diseases: A Systematic Review" International Journal of Molecular Sciences 21, no. 17: 6187. https://doi.org/10.3390/ijms21176187

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