The History of FeNO into Global Guidelines
The Fractional exhaled nitric oxide (FeNO) has evolved from a promising research biomarker into a widely recognized clinical tool in respiratory medicine. Over the past decades, its role in assessing airway inflammation, particularly eosinophilic inflammation associated with asthma, has been increasingly validated through clinical studies and real-world practice. This progression has paved the way for its integration into major international respiratory guidelines, supporting more precise diagnosis, treatment decisions, and disease monitoring.
The inclusion of FeNO in guidelines from leading organizations such as the Global Initiative for Asthma (GINA) and the American Thoracic Society (ATS) reflects a growing consensus on its value in personalized respiratory care. As understanding of airway inflammation has advanced, FeNO testing has become an important complement to traditional lung function tests, offering clinicians a non-invasive, rapid method for evaluating inflammatory status.
Nowadays, FeNO continues to gain global acceptance as part of comprehensive asthma management strategies. Its adoption into clinical pathways highlights the shift toward precision medicine, where objective biomarkers guide tailored therapies and improve patient outcomes. The historical development of FeNO into global guidelines underscores its importance as a bridge between scientific discovery and everyday clinical application in respiratory care. This evolution continues to shape future respiratory diagnostics worldwide.
1+2 Standards and Guidelines
Timeline:
2008:
The "1" Guideline:
NIOX MINO, FeNO50
2011:
The "1" Guideline:
ATS Clinical Guidelines, FeNO50
2013:
The "1+2" Guidelines:
Sunvou-CA2122, FeNO50 + FeNO200 + CaNO + FnNO10
2017:
The "1+2" Standard:
ERS Technical Standard, FeNO50 + CaNO + FnNO10
2021:
The "1+2" Guidelines:
Chinese Expert Consensus of Adults and Children, FeNO50 + FeNO200 + CaNO + FnNO10