The authors have no funding, financial relationships, or conflicts of interest to disclose.
Nasal nitric oxide is dependent on sinus obstruction in allergic rhinitis
Version of Record online: 10 FEB 2014
© 2014 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 6, pages E213–E218, June 2014
How to Cite
Suojalehto, H., Vehmas, T., Lindström, I., Kennedy, D. W., Kilpeläinen, M., Plosila, T., Savukoski, S., Sipilä, J., Varpula, M., Wolff, H., Alenius, H. and Toskala, E. (2014), Nasal nitric oxide is dependent on sinus obstruction in allergic rhinitis. The Laryngoscope, 124: E213–E218. doi: 10.1002/lary.24590
- Issue online: 27 MAY 2014
- Version of Record online: 10 FEB 2014
- Accepted manuscript online: 10 JAN 2014 01:35AM EST
- Manuscript Accepted: 7 JAN 2014
- Manuscript Revised: 29 NOV 2013
- Manuscript Received: 4 JUL 2013
- Nasal nitric oxide;
- exhaled nitric oxide;
- computed tomography;
The aim of this study was to evaluate the associations between nasal nitric oxide and nasal symptoms, sinus opacification, and markers of allergic inflammation in allergic and in nonallergic rhinitis while taking into account the effect of sinus obstruction.
We studied 175 young adult subjects divided into three groups: 1) allergic rhinitis, 2) nonallergic rhinitis, and 3) controls.
We measured nasal nitric oxide using the breath-holding method and exhaled nitric oxide and scored semiquantitatively nasal computed tomography scans for opacification and obstruction. We also assessed the visual analogue scores of nasal symptoms, eosinophil count, and interleukin-13 mRNA levels in nasal biopsies.
The level of nasal nitric oxide correlated with exhaled nitric oxide (r = 0.377, P < .001). In allergic rhinitis, nasal nitric oxide was elevated when compared to the controls, and an inverse correlation existed between the nasal nitric oxide level and sinus ostial obstruction (r = −0.272, P = .013). In nonallergic rhinitis, the level of nasal nitric oxide was similar to that of the controls. In allergic rhinitis, nasal nitric oxide correlated positively with the opacification score (r = 0.250, P = .033) and the nasal eosinophil count (r = 0.293, P = .030) of patients without a marked sinus ostial obstruction.
Sinus ostial obstruction lowers the level of nasal nitric oxide and reduces its value as an indicator of allergic mucosal inflammation. A high nasal nitric oxide level may be a useful marker of eosinophilic inflammation in the nasal cavity and indicate the absence of marked sinus ostial obstruction.
Level of Evidence
3b. Laryngoscope, 124:E213–E218, 2014