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during the testing procedure. I had demonstrated that it was possible to measure exhaled NO
in children, both healthy controls and asthmatics. In fact in some of the control children, they
found the exhaled NO measurements an easier task than completing lung function testing to
ATS criteria standards. I had demonstrated significantly higher levels of exhaled NO was
found in children with asthma on bronchodilator therapy only when compared to healthy
children and asthmatics on regular IHCS therapy, with no difference between the latter two
groups. Finally I had also demonstrated in a small group of asthmatic children the exhaled NO
levels reduced significantly following two weeks of IHCS treatment' These findings
contributed to the evolving literature to suggest that NO was a marker for ainvay
inflammation in asthma. I was invited with other research groups working in this area to
present this data to a European Society Task Force (ESTF) meeting in Stockholm in
September 1996 as a satellite working party to the European Respiratory Society Annual
Conference where the first discussion regarding standardisation procedures took place. This
later became the basis for the first publication setting out the best standard practices based on
the data available (Kharitonov, Alving et al. 1997)'
In the following chapter I will review how research in exhaled No and nasal No
measurement has progressed. I will review the findings on factors that altered No results in
both healthy groups and those with respiratory diseases. I will show how the standardisation
procedure for testing has continued to evolve to the present day. I will then review the
findings in the literature across adults, children and infants with a variety of conditions. I will
end with an opinion as to the best use of exhaled and nasal NO testing is at the current time'
The work in this chapterformed the basis of the publications:
o Dinarevic S, Byrnes CA, Bush A, Shinebourne EA' Measurement of expired nitric
oxide levels in child.ren. Pediatric Pulmonology 1996; 22: 396-401
. Byrnes CA, Dinarevic s, shineboume EA, Barnes PJ, Bush A' ExhAled No
measurements in normal and asthmatic child,ren. Pediatric Pulmonology 1997; 24:
312-318
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