Szefler SJ, Mitchell H, Sorkness CA, Gergen PJ, O'Connor GT, Morgan WJ, Kattan M, Pongracic JA, Teach SJ, Bloomberg GR, Eggleston PA, Gruchalla RS, Kercsmar CM, Liu AH, Wildfire JJ, Curry MD, Busse WW.
Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults: a randomised controlled trial. Lancet. 2008 Sep 20;372(9643):1065-72.
"After all, does anyone seriously advocate treating hypertension without measuring the blood pressure, or kidney disease without knowing the glomerular filtration rate? Neither seems to me to be any dafter than using anti-inflammatory medications without measuring inflammation."
Comment by Professor Andrew Bush (Royal Brompton Hospital, UK) to the Lancet publication in the Factulty of 1000 Medicine, posted on November 13, 2008.
"Szefler and colleagues did not reduce inhaled corticosteroids when FENO was low in symptomatic patients. Why not? Their approach would be justified only if "asthma" symptoms were exclusively due to steroid-responsive airway inflammation. This is not true: there are many other causes-eg, anxiety-overlay. A low FENO permits steroid unresponsive symptoms to be differentiated from those due to steroid-responsive inflammation."
Correspondance "Clinical use of exhaled nitric oxide" by
Professor D Robin Taylor (Dunedin School of Medicine, University of Otago, Dunedin, New Zealand) and Professor Andrew Bush (Royal Brompton Hospital, UK) in Lancet. 2009 January 31;373:382.