Use of nitric oxide with airway diseases.

It is clear that NO in the lung has a major role beyond the modulation of pulmonary vasculature. NO appears to be involved in both the acute and chronic inflammatory response of many pulmonary cell types, as well as being partly responsible for modulating bronchial tone via the nonadrengeric noncholinergic system. Although the application of inhaled NO for the treatment of acute alternations of bronchial tone appears promising from animal data, the use of inhaled NO in patients has failed to reverse increased bronchial tone to a clinically significant level. Albuterol has better bronchodilating properties than inhaled NO. Monitoring exhaled NO, however, can provide an indicator of both acute and chronic lung inflammation. Much more work needs to be done before the monitoring of exhaled NO in pulmonary inflammatory disease can be recommended, but the preliminary data do indicate, as proposed by others, that exhaled NO may be a useful noninvasive measure of pulmonary inflammation and disease severity.