When airways get inflamed, the inner walls of the airway swell, so there is less space for a smooth flow of air. Inflammation of the airways leads symptoms such as shortness of breath, wheezing and coughing. The primary focus of asthma treatment is to reduce inflammation. Unfortunately, current methods of testing lung function do not measure inflammation. Therefore, you have to correlate symptoms to disease severity when prescribing or adjusting medication.

1. Asthma and Exhaled Nitric Oxide (eNO)
A Simple, New Breath Test to Help Manage Asthma
Asthma is characterized by airway
inflammation
When airways get inflamed, the inner walls of the airway swell,
so there is less space for a smooth flow of air. Inflammation of
the airways leads symptoms such as shortness of breath,
wheezing and coughing.
The primary focus of asthma treatment is to reduce
inflammation. Unfortunately, current methods of testing lung
function do not measure inflammation. Therefore, you have to
correlate symptoms to disease severity when prescribing or
adjusting medication.
By courtesy of Encyclopaedia Britannica, Inc.,
copyright 2001; used with permission
As airway
inflammation increases,
Exhaled nitric oxide (eNO) provides a new way to eNO increases.
measure inflammation
Inflamed airways produce nitric oxide which becomes part of your breath.
Exhaled nitric oxide has been studied well over the last 10 years. These
studies have shown a strong relation between eNO and airway inflammation.
Exhaled nitric oxide (eNO) increases as inflammation increases, and it
higher
decreases as inflammation decreases.
high
low
Simple breath tests are now available to measure eNO levels. Your patients
simply breathe out steadily into a breath tube that is connected to the test
device. The test itself takes just about 10 seconds. The results are available (Level of Exhaled Nitric Oxide)
within one minute.
Regular monitoring of eNO provides a more complete
picture of your asthma
eNO
Adding eNO tests to other standard clinical
measures gives you a better picture of
your patients’ airway inflammation. This
Patient has high Inflammation drops can help improve asthma control. By
inflammation over time after
treatment is adjusted regularly monitoring your eNO levels,
Time
you can treat your patients’ asthma
Illustration of therapy showing a
more precisely.
reduction in inflammation by precise
adjustment of medication

2. Answers to frequently asked questions
Is eNO prescribed by specialists like pulmonologists and allergists?
Exhaled nitric oxide (eNO) has been studied since 1991 when it was first reported in exhaled breath. There are numerous publications
on eNO and its role in airway inflammation. It is currently being prescribed across the nation by physicians that specialize in respiratory
care. The Insight™ eNO System has been commercially available since April 2008.
Has eNO been studied in children?
Exhaled nitric oxide has been used as an endpoint and as an asthma assessment tool in numerous pediatric asthma studies. Its
relationship to airway inflammation (the cause of asthma symptoms) has been established in both adults and children.
How is it different from a spirometer?
A spirometer is an effective way to measure lung function, which correlates with symptoms being experienced at the time of testing.
Exhaled nitric oxide is a marker of airway inflammation and reflects changes in disease state regardless of outward symptoms. Exhaled
nitric oxide is the only non-invasive, practical and cost-effective way to regularly monitor patients’ degree of airway inflammation.
It provides greater insight into their response to anti-inflammatory therapies like inhaled corticosteroids. And, unlike a spirometer
measurement, an eNO result does not depend on patients’ “best effort” .
Spirometry eNO Testing
Measures lung function Measures airway inflammation
Involves forced exhalation by the child in a very short duration Involves steady exhalation by the child over a slightly longer
of time duration of time
Test result is a complex waveform Test result is a numerical value that has a direct correlation to
the degree of inflammation of the airways
Is it an easy test for children to do?
The Insight™ eNO test is short and easy – about 10 seconds – and requires only a small volume of exhaled air. Measurement of eNO
provides reliable results that indicate a child’s degree of airway inflammation. It does not involve a high rate of energy expenditure from
the child and it is an easy test to administer in the physician’s office.
Is eNO right for my practice?
The Insight eNO System has received clearance from the FDA for use in clinic or a physician’s office to measure exhaled nitric oxide in
children 8 years and older. Exhaled nitric oxide is a great addition to any practice that is looking to improve the management of asthma.
Symptoms do not always accurately reflect the degree of inflammation in patients’ airways. Exhaled nitric oxide provides a clearer
picture of your patients’ asthma by providing quantitative evidence for the degree of inflammation - information that was not available
before. By knowing your patients’ degree of airway inflammation, you can now see how well they are responding to anti-inflammatory
medication; whether they are adhering to the prescribed medication plan; and overall, improve the precision of your therapy.
Does eNO testing replace spirometry?
No, measurement of exhaled nitric oxide is intended and approved to be used as an adjunct to current techniques for assessment of
asthma. It is not intended to replace spirometry. Spirometry and eNO testing measure two different aspects of asthma.
How can I order a system?
Call Apieron at 1-866-550-4eNO (1-866-550-4366) to arrange for a demonstration or to purchase or finance an Insight eNO System.
www.apieron.com
© 2008 Apieron, Inc.
Managing asthma is a breath away™
Insight™ is a trademark of Apieron, Inc.
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