{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T02:26:09Z","timestamp":1791167169045,"version":"4.1.0"},"reference-count":41,"publisher":"European Respiratory Society (ERS)","issue":"6","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/publications.ersnet.org\/user-licence"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UM1 TR004399"],"award-info":[{"award-number":["UM1 TR004399"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL071798"],"award-info":[{"award-number":["R01HL071798"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U54HL096458"],"award-info":[{"award-number":["U54HL096458"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2025,12,27]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nasal nitric oxide (nNO) measurement during velum closure is a useful test for primary ciliary dyskinesia (PCD) but is not feasible in young children. Measurement during tidal breathing is an alternative approach. Our objectives were to define a protocol with age-specific cut-off nNO values during tidal breathing and evaluate this method as an adjunctive test for PCD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A standardised method for nNO measurement during tidal breathing was developed and tested at the University of North Carolina in children aged &lt;6\u2005years with PCD, asthma, cystic fibrosis and healthy controls. Normative curves were generated as a function of age and generalised estimating equations were used to define age-specific cut-off values. The protocol was subsequently validated in 107 children undergoing evaluation for PCD at eight additional sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In healthy controls, tidal breathing nNO values increased from birth to age 6\u2005years, but remained low for children with PCD. With sensitivity set at 0.98, cut-off values of nNO increased from 13.9\u2005nL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      at 2\u2005months to 47.7\u2005nL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      at 5\u2005years of age. Receiver operating characteristic curves had high areas under each curve for nNO cut-offs, ranging from 0.98 to 0.99 across the ages represented in the study. Validation testing at participating sites showed tidal breathing nNO accurately identified 93% of the 60 children aged &lt;6\u2005years with PCD confirmed by ultrastructural ciliary analysis or genetic testing, with high specificity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tidal breathing nNO measurement is a useful adjunctive test to distinguish young children with PCD from healthy controls as young as 2\u2005months using age-specific cut-off nNO values.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.01540-2025","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T15:20:14Z","timestamp":1769700014000},"page":"2501540","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Tidal breathing nasal nitric oxide measurement as a 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