Nitric Oxide Accumulation in the Nonventilated Nasal Cavity
Chatkin et al.,
Nitric Oxide Accumulation in the Nonventilated Nasal Cavity,
Archives of Otolaryngology–Head & Neck Surgery, doi:10.1001/archotol.125.6.682
Analysis of nitric oxide concentrations in the nonventilated nasal cavity, showing increasing levels with time. Results indicate that nitric oxide levels can be increased with breathing techniques.
Chatkin et al., 1 Jun 1999, peer-reviewed, 6 authors.
Contact:
jose.chatkin@utoronto.ca.
Abstract: ORIGINAL ARTICLE
Nitric Oxide Accumulation
in the Nonventilated Nasal Cavity
Jose Miguel Chatkin, MD; Wei Qian, MD; Patricia A. McClean, MSc;
Noe Zamel, MD; James Haight, MD; Phillip Silkoff, MD
Background: Nasal nitric oxide is present in high con-
centrations in the upper airway relative to the lower respiratory tract.
Objective: To explore the rate of nitric oxide accumu-
lation in the nonventilated nasal cavity.
Methods: In 9 healthy subjects previously trained to close
the soft palate, steady-state plateau nitric oxide levels were
recorded while air was aspirated through the nasal airway in series at a constant flow rate. Nitric oxide was then
allowed to accumulate in the nasal cavity by occluding
both nares and keeping the velum closed. After varying
occlusion times, peak nitric oxide levels and a second plateau were ascertained.
On opening to the analyzer after the accumulation period, the peak nitric oxide level was several times higher
than the initial plateau (range, 2810-19 008 ppb) and then
slowly returned to previous plateau levels. There was no
significant difference between initial and second plateau nitric oxide levels for any period. The accumulated
nitric oxide peak increased in direct proportion to the
accumulation time (P,.001).
Conclusions: Nitric oxide concentrations accumulate
in the nonventilated nasal cavity in proportion to the time
of nonventilation. Peak nasal nitric oxide values after accumulation are similar to published sinus nitric oxide measurements obtained by direct puncture. These results suggest an important alternative source of nitric oxide in
humans.
Results: While the subjects aspirated air at a constant
flow, there was a slow rise to a first nitric oxide plateau.
N
From the Catholic University
of Rio Grande do Sul, Porto
Alegre, Brazil (Dr Chatkin);
Zhenjiang First People’s
Hospital, Jiangsu, China
(Dr Qian); the Divisions of
Respiratory Medicine
(Drs Chatkin, Zamel, and
Silkoff and Ms McClean) and
Otolaryngology (Drs Qian and
Haight), The Toronto Hospital,
University of Toronto, Toronto,
Ontario; and the National
Jewish Medical and Research
Center, Denver, Colo
(Dr Silkoff).
Arch Otolaryngol Head Neck Surg. 1999;125:682-685
ITRIC OXIDE (NO) is present in the human airway, 1 and high nasal
concentrations of nitric
oxide were first detected
by Alving et al.2 The source of high nitric
oxide levels in the nose is still uncertain,
but there is evidence that the upper airways (ie, paranasal sinuses, nasal cavities, or nasopharynx) could be the main
source of this gas in exhaled air.3,4
Nasal nitric oxide may subserve
physiological functions in the upper airway. This chemical may represent the very
first line of defense in the airways, possibly acting on pathogens even before they
reach the nasal mucosa.3 Its concentration in upper airways is several times
higher than that required for bacteriostasis5 and antiviral effect.6 It also acts as a
mediator of mucociliary activity7 and mucus secretion.8 Autoinhalation may also
provide another endogenous function for
nitric oxide, regulating the ventilationperfusion ratio.9 Nitric oxide has also been
shown to play a role in neurally mediated
bronchodilation10 and in the modulation
of airway reactivity.11
Nitric oxide may also be involved in
the pathophysiology of several diseases.
High nitric oxide levels are found in patients with noninfectious inflammations,
such as allergic rhinitis.12 Conversely, nasal nitric oxide levels are substantially..
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