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Biomed Res Int. 2014;2014:271918. doi: 10.1155/2014/271918. Epub 2014 Feb 27.

Exhaled nitric oxide as a biomarker in COPD and related comorbidities.

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Department of Internal Medicine, University of Brescia and Civil Hospital of Brescia, Piazza Spedali Civili 1, 25100 Brescia, Italy.
Department of Dermatology, Civil Hospital of Brescia, Piazza Spedali Civili 1, 25100 Brescia, Italy.
Department of Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Largo Francesco Vito 1, 00198 Rome, Italy.
Department of Clinical and Biological Sciences, University of Torino, San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Italy.


Chronic Obstructive Pulmonary Disease (COPD) is defined as a disease characterized by persistent, progressive airflow limitation. Recent studies have underlined that COPD is correlated to many systemic manifestations, probably due to an underlying pattern of systemic inflammation. In COPD fractional exhaled Nitric Oxide (FeNO) levels are related to smoking habits and disease severity, showing a positive relationship with respiratory functional parameters. Moreover FeNO is increased in patients with COPD exacerbation, compared with stable ones. In alpha-1 antitrypsin deficiency, a possible cause of COPD, FeNO levels may be monitored to early detect a disease progression. FeNO measurements may be useful in clinical setting to identify the level of airway inflammation, per se and in relation to comorbidities, such as pulmonary arterial hypertension and cardiovascular diseases, either in basal conditions or during treatment. Finally, some systemic inflammatory diseases, such as psoriasis, have been associated with higher FeNO levels and potentially with an increased risk of developing COPD. In these systemic inflammatory diseases, FeNO monitoring may be a useful biomarker for early diagnosis of COPD development.

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