{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:39:01Z","timestamp":1787161141135,"version":"build-2736575974"},"reference-count":46,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ersjournals.com"],"crossmark-restriction":true},"short-container-title":["Breathe"],"published-print":{"date-parts":[[2019,12]]},"abstract":"\n Exhaled nitric oxide fraction (\n F<\/jats:italic>\n ENO<\/jats:sub>\n ) values can be easily measured using portable analysers and are a surrogate marker of airway eosinophilia.\n F<\/jats:italic>\n ENO<\/jats:sub>\n may be useful in diagnosing and monitoring conditions characterised by airway eosinophilia,\n i.e.<\/jats:italic>\n asthma and possibly COPD. Many factors other than asthma and COPD affect\n F<\/jats:italic>\n ENO<\/jats:sub>\n , especially atopy, which is associated with elevated\n F<\/jats:italic>\n ENO<\/jats:sub>\n . One guideline recommends that\n F<\/jats:italic>\n ENO<\/jats:sub>\n should be used as part of the diagnostic pathway for asthma diagnosis in adults and children aged >5\u2005years. The role of\n F<\/jats:italic>\n ENO<\/jats:sub>\n in monitoring asthma is even less clear, and most guidelines do not recommend its use outside of specialist asthma clinics. Currently,\n F<\/jats:italic>\n ENO<\/jats:sub>\n is not recommended for diagnosis or monitoring of COPD. Although\n F<\/jats:italic>\n ENO<\/jats:sub>\n is starting to find a place in the management of asthma in children and adults, considerably more research is required before the potential of\n F<\/jats:italic>\n ENO<\/jats:sub>\n as an objective measurement in asthma and COPD can be realised.\n <\/jats:p>\n \n Key points<\/jats:title>\n \n \n \n For individuals aged \u226512\u2005years,\n F<\/jats:italic>\n ENO<\/jats:sub>\n is not recommended by all guidelines as a test to diagnose asthma (recommended only by the UK National Institute for Health and Care Excellence guideline for asthma symptoms, which are likely to respond to corticosteroid treatment).\n <\/jats:p>\n <\/jats:list-item>\n \n \n F<\/jats:italic>\n ENO<\/jats:sub>\n may be used in conjunction with other investigations to diagnose asthma in 5\u201316-year-olds where there is diagnostic uncertainty, but further evidence is required.\n <\/jats:p>\n <\/jats:list-item>\n \n \n F<\/jats:italic>\n ENO<\/jats:sub>\n is not recommended as a routine test to monitor all patients with asthma or to titrate asthma treatment.\n <\/jats:p>\n <\/jats:list-item>\n \n \n F<\/jats:italic>\n ENO<\/jats:sub>\n is not recommended for routine clinical testing in adults with COPD.\n <\/jats:p>\n <\/jats:list-item>\n \n \n F<\/jats:italic>\n ENO<\/jats:sub>\n may be useful to identify patients with COPD who could benefit from the use of inhaled corticosteroids (asthma\u2013COPD overlap).\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n \n Educational aims<\/jats:title>\n \n \n \n To understand what factors other than asthma and COPD affect\n F<\/jats:italic>\n ENO<\/jats:sub>\n <\/jats:p>\n <\/jats:list-item>\n \n \n To understand the current controversies in the application of\n F<\/jats:italic>\n ENO<\/jats:sub>\n to diagnosis and management of asthma in children\n <\/jats:p>\n <\/jats:list-item>\n \n \n To understand the current controversies in the application of\n F<\/jats:italic>\n ENO<\/jats:sub>\n to diagnosis and management of asthma and COPD in adults\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1183\/20734735.0268-2019","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T05:56:30Z","timestamp":1575266190000},"page":"306-316","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical utility of exhaled nitric oxide fraction in the management of asthma and\u00a0COPD"],"prefix":"10.1183","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8393-5060","authenticated-orcid":false,"given":"Steve W.","family":"Turner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian A.","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2019,12,1]]},"reference":[{"key":"2024101703462156000_15.4.306.1","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(94)90266-6"},{"key":"2024101703462156000_15.4.306.2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.9120-11ST"},{"key":"2024101703462156000_15.4.306.3","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.135574"},{"key":"2024101703462156000_15.4.306.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30879-6"},{"key":"2024101703462156000_15.4.306.5","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3389\/fped.2019.00068","article-title":"Pathophysiological mechanisms of asthma","volume":"7","author":"Bush","year":"2019","journal-title":"Front Pediatr"},{"key":"2024101703462156000_15.4.306.6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201212-2156LE"},{"key":"2024101703462156000_15.4.306.7","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-201064"},{"key":"2024101703462156000_15.4.306.8","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/02770903.2018.1439953","article-title":"Difference between two exhaled nitric oxide analyzers, NIOX VERO electrochemical hand-held analyzer and NOA280i chemiluminescence stationary analyzer","volume":"56","author":"Tanabe","year":"2019","journal-title":"J Asthma"},{"key":"2024101703462156000_15.4.306.9","unstructured":"National Institute for Health and Care Excellence. 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