Fractional Exhaled Nitric Oxide (FENO) in the management of asthma: a position paper of the Italian Respiratory Society (SIP/IRS) and Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC)

  • Enrico Heffler Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy. https://orcid.org/0000-0002-0492-5663
  • Giovanna Elisiana Carpagnano Department of Medical and Surgical Sciences, University of Foggia; Section of Respiratory Diseases, Hospital d'Avanzo, Foggia, Italy. https://orcid.org/0000-0001-7931-4704
  • Elisabetta Favero Department of Medicine-DIMED, Immunological and Respiratory Rare Disease, Allergologic Clinic Ca’ Foncello Hospital, Treviso, Italy.
  • Giuseppe Guida Allergy and Pneumology Unit, A.O. S.Croce e Carle, Cuneo, Italy.
  • Mauro Maniscalco Respiratory Rehabilitation Unit, Institute of Telese Terme IRCCS, ICS Maugeri, Italy. https://orcid.org/0000-0001-6751-9921
  • Andrea Motta Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy.
  • Giovanni Paoletti Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
  • Giovanni Rolla Allergy and Clinical Immunology, University of Turin and AO Mauriziano, Italy. https://orcid.org/0000-0001-5997-7172
  • Eugenio Baraldi Department of Woman's and Child's Health, University Hospital of Padua, Italy. https://orcid.org/0000-0002-1829-3652
  • Vincenza Pezzella Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
  • Giorgio Piacentini Paediatric Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Italy.
  • Stefano G. Nardini | snardini.pneumologo@gmail.com Italian Respiratory Society-Società Italiana di Pneumologia, Milan, Italy.

Abstract

Asthma prevalence in Italy is on the rise and is estimated to be over 6% of the general population. The diagnosis of asthma can be challenging and elusive, especially in children and the last two decades has brought evidences that asthma is not a single disease but consists of various phenotypes. Symptoms can be underestimated by the patient or underreported to the clinician and physical signs can be scanty. Usual objective measures, like spirometry, are necessary but sometimes not significant. Despite proper treatment asthma can be a very severe condition (even leading to death) however new drugs have recently become available which can be very effective in its control. Since asthma is currently thought to be caused by inflammation, a direct measure of the latter can be of paramount importance.  For this purpose, the measurement of Fractional Exhaled Nitric Oxide (FENO) has been used since the early years of the current century as a non-invasive, easy-to-assess tool useful for diagnosing and managing asthma. This SIP-IRS/SIAAIC Position Paper is a narrative review which summarizes the evidence behind the usefulness of FENO in the diagnosis, management and phenotypization of asthma.

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Published
2020-02-19
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Section
Position Papers
Keywords:
Asthma diagnosis, Asthma management, Fractional Exhaled Nitric Oxide (FENO)
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How to Cite
Heffler, E., Carpagnano, G. E., Favero, E., Guida, G., Maniscalco, M., Motta, A., Paoletti, G., Rolla, G., Baraldi, E., Pezzella, V., Piacentini, G., & Nardini, S. G. (2020). Fractional Exhaled Nitric Oxide (FENO) in the management of asthma: a position paper of the Italian Respiratory Society (SIP/IRS) and Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC). Multidisciplinary Respiratory Medicine, 15. https://doi.org/10.4081/mrm.2020.36