Exhaled Nitric Oxide During Exercise in Primary Pulmonary Hypertension and Pulmonary Fibrosis

Riley, M.; Pórszász, János; Miranda, J F de; Engelen, M.P.; Brundage, Bruce H.; Wasserman, Karlman

doi:10.1378/chest.111.1.44

Cited by 65 publications

(54 citation statements)

References 25 publications

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“…It comes primarily from airway epithelial cells with a component from the pulmonary vasculature [61]. Exhaled NO (eNO) has been shown to be lower in patients with IPAH [62][63][64], although there are conflicting studies that show either no difference in eNO compared with controls [65,66] or an increased level [67]. These divergent results could be explained by methodological differences.…”

Section: Nitric Oxidementioning

confidence: 99%

Biomarkers in pulmonary hypertension

Warwick

Thomas²,

Yates³

2008

Eur Respir J

140

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There have been significant recent advances in the understanding of the pathophysiology of pulmonary hypertension, and a growing number of therapeutic agents have become available to the treating physician. Traditional methods of diagnosing and monitoring this condition have comprised echocardiography and right heart catheterisation, in addition to functional measures, such as estimation of functional class and the 6-min walk test. An increasing number of biomarkers have been described that are elevated in pulmonary hypertension and which may assist the clinician in diagnosis and in the assessment of disease severity and response to treatment.The present article details the more important biomarkers, their potential applications and the evidence supporting their use.

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Section: Nitric Oxidementioning

confidence: 99%

Biomarkers in pulmonary hypertension

Warwick

Thomas²,

Yates³

2008

Eur Respir J

140

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show abstract

“…Most studies of NO in PAH patients have measured exhaled NO levels from the lungs in order to assess possible changes in NO synthesis in PAH [284][285][286][287][288][289][290]. NO is relatively stable in the gas phase, allowing for such measurements, whereas the instability of NO in biological �uids means that estimates of NO synthesis from blood measurements are usually done via nitrate/nitrite products derived from NO.…”

Section: No Elevation?mentioning

confidence: 99%

“…e majority of studies on exhaled NO in PAH patients report lowered levels when compared with controls [284][285][286][287]289], but two such studies report apparent elevated levels, with one reporting a nonsigni�cant trend [288] and the other signi�cant elevation [290]. Consequently, there appears to be substantial variation in these studies.…”

Section: No Elevation?mentioning

confidence: 99%

Pulmonary Hypertension Is a Probable NO/ONOO⁻Cycle Disease: A Review

Pall

2013

ISRN Hypertension

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e NO/ONOO − cycle is a primarily local biochemical/physiological vicious cycle that appears to cause a series of chronic in�ammatory diseases. is paper focuses on whether the cycle causes pulmonary arterial hypertension (PAH) when located in the pulmonary arteries. e cycle involves 12 elements, including superoxide, peroxynitrite (ONOO − ), nitric oxide (NO), oxidative stress, NF-B, in�ammatory cytokines, iNOS, mitochondrial dysfunction, intracellular calcium, tetrahydrobiopterin depletion, NMDA activity, and TRP receptor activity. 10 of the 12 are elevated in PAH (NMDA?, NO?) and 11 have documented causal roles in PAH. Each stressor that initiates cases of PAH acts to raise cycle elements, and may, therefore, initiate the cycle in this way. PAH involves a primarily local mechanism as required by the cycle and the symptoms and signs of PAH are generated by elements of the cycle. Endothelin-1, which acts as a causal factor in PAH, acts as part of the cycle; its synthesis is stimulated by cycle elements, and it, in turn, increases each element of the cycle. is extraordinary �t to the principles of the NO/ONOO − cycle allows one to conclude that PAH is a NO/ONOO − cycle disease, and this �t supports the cycle as a ma�or paradigm of chronic in�ammatory disease.

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“…where VE is the minute ventilation, 0.826 is the gases universal constant (Riley et al, 1997), and [NO] exh is the exhaled NO concentration. To obtain NO released from the lower airways (pulmonary endothelium), we calculated the plateau seen in [NO] exh , as previously described in other studies (Kharitonov et al, 1996(Kharitonov et al, , 1997Rutgers et al, 1998).…”

Section: No In Exhaled Breath Measurementmentioning

confidence: 99%

Pulmonary and Systemic Nitric Oxide Measurements During CCK-5-Induced Panic Attacks

Lara

Chrapko

Archer

et al. 2003

Neuropsychopharmacol

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Nitric oxide (NO) plays a major role in cardiopulmonary regulation as illustrated by the alterations of the NO system described in cardiopulmonary illnesses. Recent studies have found an association between panic disorder and cardiovascular death and illness, as well as pulmonary diseases. Our objective was to investigate whether pulmonary or systemic NO production was altered during induced panic attacks (PAs). We used a double-blind placebo-controlled crossover design with randomization of the order of an injection of placebo and pentagastrin, a cholecystokinin-B receptor agonist that induces PAs in healthy volunteers (HVs). A total of 17 HVs experienced a PA after pentagastrin challenge. Exhaled NO and NO metabolites were measured by chemiluminescence. During pentagastrin-induced PAs, HVs displayed significant decreases in plateau concentrations of NO exhaled, which were associated with proportional increases in minute ventilation. There were no significant changes in pulmonary or systemic NO production. These results suggest that the decrease in exhaled NO concentration observed during pentagastrin-induced PAs is related to the associated hyperventilation, rather than to any change in lung NO production. This study is the first to evaluate changes in NO measurements during acute anxiety.

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Exhaled Nitric Oxide During Exercise in Primary Pulmonary Hypertension and Pulmonary Fibrosis

Cited by 65 publications

References 25 publications

Biomarkers in pulmonary hypertension

Biomarkers in pulmonary hypertension

Pulmonary Hypertension Is a Probable NO/ONOO⁻Cycle Disease: A Review

Pulmonary and Systemic Nitric Oxide Measurements During CCK-5-Induced Panic Attacks

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Exhaled Nitric Oxide During Exercise in Primary Pulmonary Hypertension and Pulmonary Fibrosis

Cited by 65 publications

References 25 publications

Biomarkers in pulmonary hypertension

Biomarkers in pulmonary hypertension

Pulmonary Hypertension Is a Probable NO/ONOO−Cycle Disease: A Review

Pulmonary and Systemic Nitric Oxide Measurements During CCK-5-Induced Panic Attacks

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Product

Resources

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Pulmonary Hypertension Is a Probable NO/ONOO⁻Cycle Disease: A Review