Nitric Oxide and Biological Mediators in Pediatric Chronic Rhinosinusitis and Asthma

Abstract

Background: In the context of the so-called unified airway theory, chronic rhinosinusitis (CRS) and asthma may coexist. The inflammation underlying these conditions can be studied through the aid of biomarkers. Main body: We described the main biological mediators that have been studied in pediatric CRS and asthma, and, according to the available literature, we reported their potential role in the diagnosis and management of these conditions. As for CRS, we discussed the studies that investigated nasal nitric oxide (nNO), pendrin, and periostin. As for asthma, we discussed the role of fractional exhaled nitric oxide (feNO), the role of periostin, and that of biological mediators measured in exhaled breath condensate (EBC) and exhaled air (volatile organic compounds, VOCs). Conclusion: Among non-invasive biomarkers, nNO seems the most informative in CRS and feNO in asthma. Other biological mediators seem promising, but further studies are needed before they can be applied in clinical practice.

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

“… 13 The possible role of this biomarker has been also studied in chronic rhinosinusitis; a recent review of several studies, conducted mainly in adults, pointed out that inflammation of sino-nasal mucosa, especially if associated with polyps, prevents NO to flow from sinuses to the nasal lumen so that reduced nFeNO levels are measured in these conditions. 28 …”

“…13 The possible role of this biomarker has been also studied in chronic rhinosinusitis; a recent review of several studies, conducted mainly in adults, pointed out that inflammation of sino-nasal mucosa, especially if associated with polyps, prevents NO to flow from sinuses to the nasal lumen so that reduced nFeNO levels are measured in these conditions. 28 Despite the need to further define the measurement of this biomarker, it could be of great help in AR to distinguish the inflammatory or mechanical etiology of rhinitis and to assess the response to nasal treatments. 29 So far, there are no pediatric studies that have evaluated both inflammatory and functional parameters in children with AR and/or asthma.…”

Nasal Nitric Oxide as a Biomarker in the Diagnosis and Treatment of Sinonasal Inflammatory Diseases: A Review of the Literature

“…Although systematic reviews have been performed on each of these pathologies singly, a general overview of nNO in sinonasal pathologies has yet to be published. [22][23][24][25] A synthesis of the literature will help direct further research needs on the role of nNO as a biomarker for upper airway diseases.…”

Cardiovascular bioimaging of nitric oxide: Achievements, challenges, and the future

“…[17][18][19] Furthermore, chemical, genetically encoded and nanoscale NO biosensor studies have focused on different fluorescent sensors targeting NO or NO derivatives only in acellular or in vitro models, 20,21 with few in vivo studies. 22 Reports related to cardiovascular biology discuss the latest mechanistic understanding of NO function in endothelial cells, 23,24 applications of NO in exhaled air as a marker of airway inflammation, 25 function of NO as a neurotransmitter, 26 and detection of NO in cardiomyocytes. 27 However, there are no reviews that have focused specifically on the imaging and quantification of NO in cardiovascular disease despite its critical importance.…”