Beyond blue inhaler: Doctor explains how FeNO testing could unlock biologic treatment for severe Asthma

FeNO testing is changing severe asthma care by helping doctors identify Type 2 airway inflammation and assess which patients may respond to targeted biologic therapies when standard inhalers fail to adequately control symptoms and exacerbations.

New Delhi: For millions living with asthma, the familiar blue reliever inhaler can feel like a lifeline. But when breathlessness, wheezing and repeated asthma attacks continue despite intensive inhaled treatment, simply reaching for another inhaler may no longer be the answer. Talking to News9 Live, Dr Rajiv Kovil, Diabetes and Obesity Specialist at Zandra Healthcare, Mumbai, highlights the growing role of biomarker-driven care in identifying the biology behind difficult-to-control asthma. One of the tools increasingly used in this assessment is Fractional Exhaled Nitric Oxide, or FeNO, a quick, non-invasive breath test that can provide clues about Type 2 airway inflammation.

“The future of asthma care lies not merely in relieving symptoms but in understanding the biology behind them.” explains Dr Rajiv Kovil

The shift matters because asthma is not one uniform disease. Modern respiratory medicine increasingly recognises different inflammatory patterns, or phenotypes, that can sit behind apparently similar symptoms. In some patients, Type 2 inflammation – involving pathways associated with cytokines such as IL-4, IL-5 and IL-13 – plays a major role. These patients may be candidates for targeted biological therapies when asthma remains uncontrolled despite optimised standard treatment.

What exactly does a FeNO test measure

FeNO measures the concentration of nitric oxide in a person’s exhaled breath. Nitric oxide is produced in the airways, and elevated FeNO can be associated with Type 2 airway inflammation, particularly inflammation involving IL-13 signalling.

The test is remarkably straightforward: the patient breathes into a specialised analyser according to the device’s instructions, allowing........

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