{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:45:02Z","timestamp":1791881102324,"version":"4.3.4"},"reference-count":23,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of type 2 airway inflammation, but its role in non-cystic fibrosis bronchiectasis remains uncertain. This study explored the associations of FeNO with peripheral blood eosinophils, pulmonary function, high-resolution computed tomography (HRCT)-defined morphology, and short-term post-treatment change in adults with non-cystic fibrosis bronchiectasis. We conducted an exploratory prospective observational study including 152 adults with clinically and HRCT-confirmed non-cystic fibrosis bronchiectasis admitted to a national tertiary pulmonary center. FeNO was measured using a standardized single-flow technique. Pulmonary function testing, blood eosinophil assessment, and HRCT evaluation were performed. Descriptive statistics, between-group comparisons, correlation analyses, and exploratory multivariable linear regression were used. A subgroup underwent repeat FeNO assessment after antibiotic treatment. Mean FeNO was 12.1\u00b17.9 ppb. FeNO correlated positively with blood eosinophil percentage (r=0.41, p&lt;0.001) and MEF50% predicted (r=0.48, p&lt;0.001) and inversely with total lung capacity % predicted (r=\u22120.39, p&lt;0.001). FeNO distributions differed across ventilatory patterns (overall Kruskal-Wallis p=0.030) and HRCT morphology groups (overall Kruskal\u2013Wallis p=0.040); the exploratory cylindrical versus cystic\/saccular comparison yielded p=0.023 (unadjusted). In exploratory multivariable regression, blood eosinophil percentage remained associated with FeNO (\u03b2=1.12, 95% confidence interval: 0.29-1.95; p=0.009). Among 55 reassessed patients, FeNO decreased from 12.1\u00b16.8 to 7.0\u00b13.1 ppb after antibiotic treatment (p=0.010). FeNO was generally low in adults with non-cystic fibrosis bronchiectasis but showed exploratory associations with eosinophilic inflammation, selected pulmonary function parameters, HRCT morphology, and short-term post-treatment change. Larger longitudinal studies with standardized severity classification, microbiological characterization, and predefined outcomes are needed before FeNO can be recommended for routine clinical use.<\/jats:p>","DOI":"10.4081\/monaldi.2026.3873","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:51:43Z","timestamp":1791877903000},"source":"Crossref","is-referenced-by-count":0,"title":["Fractional exhaled nitric oxide in non-cystic fibrosis bronchiectasis: an exploratory prospective observational study"],"prefix":"10.4081","author":[{"given":"Eugerta","family":"Dilka","sequence":"first","affiliation":[{"name":"University Hospital \u201cShefqet Ndroqi\u201d, Tirana; University of Medicine, Tirana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7507-6307","authenticated-orcid":false,"given":"Eva","family":"Duraku","sequence":"additional","affiliation":[{"name":"University \u201cLady of Good Counsel\u201d, Tirana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artan","family":"Simaku","sequence":"additional","affiliation":[{"name":"Public Health Institute, Tirana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perlat","family":"Kapisyzi","sequence":"additional","affiliation":[{"name":"University Hospital \u201cShefqet Ndroqi\u201d, Tirana; University of Medicine, Tirana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"88768","doi-asserted-by":"crossref","unstructured":"Polverino E, Goeminne PC, McDonnell MJ, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J 2017;50:1700629.","DOI":"10.1183\/13993003.00629-2017"},{"key":"88769","doi-asserted-by":"crossref","unstructured":"Chalmers JD, Chang AB, Chotirmall SH, et al. Bronchiectasis. Nat Rev Dis Primers 2018;4:45.","DOI":"10.1038\/s41572-018-0042-3"},{"key":"88770","doi-asserted-by":"crossref","unstructured":"Choi H, McShane PJ, Aliberti S, Chalmers JD. Bronchiectasis management in adults: state of the art and future directions. Eur Respir J 2024;63:2400518.","DOI":"10.1183\/13993003.00518-2024"},{"key":"88771","doi-asserted-by":"crossref","unstructured":"Aliberti S, Lonni S, Dore S, et al. Clinical phenotypes in adult patients with bronchiectasis. Eur Respir J 2016;47:1113-22.","DOI":"10.1183\/13993003.01899-2015"},{"key":"88772","doi-asserted-by":"crossref","unstructured":"Dweik RA, Boggs PB, Erzurum SC, et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med 2011;184:602-15.","DOI":"10.1164\/rccm.9120-11ST"},{"key":"88773","doi-asserted-by":"crossref","unstructured":"Horvath I, Barnes PJ, Loukides S, et al. A European Respiratory Society technical standard: exhaled biomarkers in lung disease. Eur Respir J 2017;49:1600965.","DOI":"10.1183\/13993003.00965-2016"},{"key":"88774","doi-asserted-by":"crossref","unstructured":"Chen YF, Hou HH, Chien N, et al. Type 2 biomarkers and their clinical implications in bronchiectasis: a prospective cohort study. Lung 2024;202:695-709.","DOI":"10.1007\/s00408-024-00707-0"},{"key":"88775","doi-asserted-by":"crossref","unstructured":"Campisi R, Nolasco S, Mancuso M, et al. Eosinophilic bronchiectasis: prevalence, severity, and associated features\u2014a cohort study. J Clin Med 2024;13:4932.","DOI":"10.3390\/jcm13164932"},{"key":"88776","doi-asserted-by":"crossref","unstructured":"Shoemark A, Shteinberg M, De Soyza A, et al. Characterization of eosinophilic bronchiectasis: a European multicohort study. Am J Respir Crit Care Med 2022;205:894-902.","DOI":"10.1164\/rccm.202108-1889OC"},{"key":"88777","doi-asserted-by":"crossref","unstructured":"Martinez-Garcia MA, Mendez R, Olveira C, et al. The U-shaped relationship between eosinophil count and bronchiectasis severity: the effect of inhaled corticosteroids. Chest 2023;164:606-13.","DOI":"10.1016\/j.chest.2023.04.029"},{"key":"88778","doi-asserted-by":"crossref","unstructured":"Kharitonov SA, Wells AU, O'Connor BJ, et al. Elevated levels of exhaled nitric oxide in bronchiectasis. Am J Respir Crit Care Med 1995;15:1889-93.","DOI":"10.1164\/ajrccm.151.6.7767536"},{"key":"88779","doi-asserted-by":"crossref","unstructured":"Shoemark A, Devaraj A, Meister M, et al. Elevated peripheral airway nitric oxide in bronchiectasis reflects disease severity. Respir Med 2011;105:885-91.","DOI":"10.1016\/j.rmed.2011.01.015"},{"key":"88780","doi-asserted-by":"crossref","unstructured":"Tsikrika S, Dimakou K, Papaioannou AI, et al. The role of non-invasive modalities for assessing inflammation in patients with non-cystic fibrosis bronchiectasis. Cytokine 2017;99:281-6.","DOI":"10.1016\/j.cyto.2017.08.005"},{"key":"88781","doi-asserted-by":"crossref","unstructured":"Hill AT, Sullivan AL, Chalmers JD, et al. British Thoracic Society guideline for bronchiectasis in adults. Thorax 2019;74:1-69.","DOI":"10.1136\/thoraxjnl-2018-212463"},{"key":"88782","doi-asserted-by":"crossref","unstructured":"Stanojevic S, Kaminsky DA, Miller MR, et al. ERS\/ATS technical standard on interpretive strategies for routine lung function tests. 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Chron Respir Dis 2023;20:14799731231210559.","DOI":"10.1177\/14799731231210559"},{"key":"88789","doi-asserted-by":"crossref","unstructured":"Aliberti S, Sotgiu G, Blasi F, et al. Blood eosinophils predict inhaled fluticasone response in bronchiectasis. Eur Respir J 2020;56:2000453.","DOI":"10.1183\/13993003.00453-2020"},{"key":"88790","doi-asserted-by":"crossref","unstructured":"Chalmers JD, Polverino E, Crichton ML, et al. Bronchiectasis in Europe: data on disease characteristics from the European Bronchiectasis registry (EMBARC). Lancet Respir Med 2023;11:637-49.","DOI":"10.1016\/S2213-2600(23)00093-0"}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3873\/2294","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3873\/2295","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3873\/2294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:51:52Z","timestamp":1791877912000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/view\/3873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":23,"URL":"https:\/\/doi.org\/10.4081\/monaldi.2026.3873","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,13]]}}}