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Single high flow exhaled nitric oxide is an imperfect proxy for distal nitric oxide
  1. Sandrah P Eckel,
  2. Muhammad T Salam
  1. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  1. Correspondence to Dr Sandrah P Eckel, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, MC-9234, Los Angeles, CA 90089, USA; eckel{at}usc.edu

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The fractional concentration of exhaled nitric oxide (FeNO) has been used as a non-invasive biomarker of airway response to inhaled toxic exposures in both population-based and occupational studies. Results have been mixed, but a compelling finding is the 60% decrease (95% CI 54 to 66) and subsequent 130% increase (95% CI 63 to 225) in FeNO observed in a quasi-experimental study of FeNO in a group of healthy young adult volunteers before, during and after the 2008 Beijing Olympic games air pollution control measures.1 Methodological developments now allow for the assessment of NO from proximal and distal airway compartment sources. The ability to non-invasively differentiate inflammation in two lower respiratory tract compartments may provide a practical method to gain insights into the effects of inhaled toxins. Using this approach, …

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