Section: 
Reviews
ReviewsNasal nitric oxide as a biomarker in diseases of nose and paranasal sinuses
A. Yu. Ovchinnikov (1), M. A. Edzhe (2), T. Yu. Sokaeva (3)
(1), (2), (3) Russian University of Medicine, Moscow, 111398, Russian Federation
UDK: 616.211-002:516.172.6-31:578.52
DOI: https://doi.org/10.18692/1810-4800-2026-4-106-114
ABSTRACT
Abstract. Nitric oxide (NO) plays an important role in the physiology of the body, including circulation, immune functions, and inflammatory processes. Enzymatic systems facilitate the production of NO in the body, including three isoforms of NO synthases: neuronal (nNOS), inducible (iNOS), and endothelial (eNOS). These enzymes are localized in various tissues and cells, with functions ranging from participation in intercellular signaling to protect the body from infections. Research has confirmed the significance of NO as a marker of inflammation, particularly in the lower respiratory tract, where its measurement is actively used for the diagnosis and monitoring of bronchial asthma. Objective. To analyze current literature on the production, measurement methods, and clinical significance of nasal nitric oxide (nNO) as a potential non-invasive biomarker in diseases of the nasal cavity and paranasal sinuses. In recent years, researchers have increasingly focused on the role of nasal NO (nNO) in upper respiratory tract diseases, including rhinosinusitis and allergic rhinitis. Studies indicate that nNO levels can decrease with inflammation of the mucosa and obstruction of sinus ostia. Specifically, patients with chronic rhinosinusitis exhibit reduced nNO levels, which are associated with both mechanical obstruction and decreased NO synthesis because of tissue damage. The use of intranasal glucocorticosteroids also reduces nNO levels by suppressing iNOS activity. Modern methods for measuring nNO, including chemiluminescent and electrochemical analyzers, provide accurate data; however, the standardization of these methods remains a challenge. Despite the proven efficacy of nNO in diagnostics, particularly for primary ciliary dyskinesia, studies in rhinosinusitis remain insufficient. This highlights the need for further research, especially in the Russian Federation, where clinical data on this topic are almost absent. The most promising application of nNO is the noninvasive assessment of inflammatory changes and the functional state of the paranasal sinuses. An objective and accessible method for assessing nNO may be used in the diagnosis and management of inflammatory diseases of the nasal cavity and paranasal sinuses, providing a non-invasive approach to patient monitoring.
Publication date:
08.08.2026
Keywords:
nasal nitric oxide, rhinosinusitis, biomarker For citation:
Ovchinnikov A. Yu., Edzhe M. A., Sokaeva T. Yu. Nasal nitric oxide as a biomarker in diseases of nose and paranasal sinuses. Russian Otorhinolaryngology . 2026;25(4):106-114. (In Russ.) https://doi.org/10.18692/1810-4800-2026-4-106-114