Sekuyiminyaka eminingi, ukuhlolwa kwe-Fractional Exhaled Nitric Oxide (FeNO) kube ngumngane obalulekile kuthuluzi lodokotela be-asthma, ikakhulukazi kuqondisa izinqumo zokuphatha. Isibuyekezo sika-2025 semihlahlandlela ye-Global Initiative for Asthma (GINA) sibonisa ukuvela okuphawulekayo, sandisa ngokusemthethweni indima ye-FeNO ngale kokuhlola nokuphatha ukuze manje sisekele ngenkuthalo ukuxilongwa kwe-Type 2 (T2) asthma evuvukalayo. Lokhu kulungiswa kuvuma indima ebalulekile ye-phenotyping ekunakekelweni kwe-asthma yesimanje futhi kunikeza indlela enembile kakhulu, esekelwe ezintweni eziphilayo ekuxilongweni kokuqala.
I-FeNO: Ifasitela Lokuvuvukala Komoya
I-FeNO ilinganisa ukugcwala kwe-nitric oxide emphefumulweni okhishwayo, okusebenza njenge-biomarker eqondile, engahlaseli yokuvuvukala komoya i-eosinophilic, noma i-T2. Lokhu kuvuvukala, okuqhutshwa ama-cytokine afana ne-interleukin-4, -5, kanye ne-13, kubonakala nge-IgE ephezulu, ama-eosinophil egazini kanye ne-sputum, kanye nokusabela kuma-corticosteroids. Ngokwesiko, i-FeNO ibilokhu isetshenziswa uku:
Qagela impendulo kuma-corticosteroids aphefumulayo (i-ICS): Amazinga aphezulu e-FeNO abonisa ngokuthembekile amathuba amakhulu okuzuza ekwelashweni kwe-ICS.
Qapha ukunamathela kanye nokulawula ukuvuvukala: Ukulinganisa ngokulandelana kungahlola ngokunembile ukunamathela kwesiguli ekwelashweni okulwa nokuvuvukala kanye nokucindezelwa kokuvuvukala kwe-T2 okuyisisekelo.
Ukulungiswa kokwelashwa okuqondisiwe: Izitayela ze-FeNO zinganikeza ulwazi ngezinqumo zokwenyusa noma ukwehlisa umthamo we-ICS.
Ushintsho luka-2025: I-FeNO endleleni yokuxilonga
Intuthuko ebalulekile embikweni we-GINA ka-2025 ukuqiniswa kwe-FeNO njengosizo lokuxilonga lokuhlonza i-asthma ephezulu ye-T2 lapho isethulwa. Lokhu kubaluleke kakhulu esimweni sokwethulwa kwe-asthma okuhlukahlukene.
Ukuhlukanisa Izinhlobo Ze-Asthma: Akuzona zonke izinhlobo zokuphefumula noma ukuphefumula ezibizwa ngokuthi i-T2 asthma ejwayelekile. Iziguli ezine-non-T2 noma ukuvuvukala kwe-pauci-granulocytic zingase zibe nezimpawu ezifanayo kodwa zibe namazinga aphansi e-FeNO. Izinga le-FeNO elihlala liphakeme (isb., >35-40 ppb kubantu abadala) esigulini esinezimpawu ezibonisa ukukhwehlela, ukuphefumula, ukulinganiselwa komoya okuguqukayo) manje kunikeza ubufakazi obuhle obunamandla be-endotype ephezulu ye-T2, ngisho nangaphambi kokuhlolwa kokwelashwa.
Ukusekela Ukuxilongwa Ezimweni Eziyinselele: Ezigulini ezinezimpawu ezingavamile noma lapho imiphumela ye-spirometry ingacacile noma ijwayelekile ngesikhathi sokuhlolwa, i-FeNO ephezulu ingaba ubufakazi obubalulekile obukhomba inqubo yokuvuvukala ye-T2 eyisisekelo. Kuyasiza ukuhambisa ukuxilongwa kusuka kokusekelwe kuphela kuzimpawu eziguquguqukayo kuya kokunye okuhlanganisa isiginesha sebhayoloji.
Ukwazisa Isu Lokuqala Lokwelapha: Ngokufaka i-FeNO esigabeni sokuxilonga, odokotela bangahlukanisa ukwelashwa ngokwezigaba kusukela ekuqaleni. Izinga eliphezulu le-FeNO aligcini nje ngokusekela ukuxilongwa kwe-asthma kodwa futhi libikezela ngokuqinile impendulo enhle ekwelashweni kwe-ICS kokuqala. Lokhu kwenza kube lula indlela yokwelapha eyenzelwe wena, "efanele okokuqala", okungenzeka ithuthukise ukulawulwa kwasekuqaleni kanye nemiphumela.
Imiphumela Yezokwelapha Nokuhlanganiswa
Iziqondiso zika-2025 zincoma ukuhlanganisa ukuhlolwa kwe-FeNO ekuhlolweni kokuqala kokuxilonga lapho kukhona izinsolo ze-asthma futhi ukufinyelela ekuhlolweni kuyatholakala. Ukuchazwa kulandela imodeli ehlukaniswe ngezigaba:
I-FeNO Ephakeme (>50 ppb kubantu abadala): Isekela ngokuqinile ukuxilongwa kwe-asthma ephezulu ye-T2 futhi ibikezela ukuphendula kwe-ICS.
I-FeNO ephakathi (25-50 ppb kubantu abadala): Kufanele ihunyushwe ngokomongo wezokwelapha; ingase iphakamise ukuvuvukala kwe-T2 kodwa ingathonywa yi-atopy, ukuvezwa kwe-allergen muva nje, noma ezinye izici.
I-FeNO ephansi (<25 ppb kubantu abadala): Yenza ukuvuvukala okuphezulu kwe-T2 kube kuncane, okubangela ukucatshangelwa kwezinye izifo (isb., ukungasebenzi kahle kwezwi, izinhlobo ze-asthma ezingezona eze-T2, i-COPD) noma izimbangela zezimpawu ezingezona ezokuvuvukala.
Lokhu kubuyekezwa akwenzi i-FeNO ibe ukuhlolwa kokuxilonga okuzimele kodwa kuyibeka njengesithasiselo esinamandla emlandweni wezokwelapha, amaphethini ezimpawu, kanye nokuhlolwa kwe-spirometry/ukubuyela emuva. Kunezela ungqimba lokungabi naphutha oluthuthukisa ukuzethemba kokuxilonga.
Isiphetho
Iziqondiso ze-GINA zika-2025 zimelela ushintsho olujwayelekile, oluqinisa isimo sokuhlolwa kwe-FeNO kusuka ku-adjunct yokuphatha kuya kumsekeli obalulekile wokuxilonga we-asthma yoHlobo 2. Ngokunikeza isilinganiso esisheshayo nesingenaphutha sokuvuvukala kwe-T2 okuyisisekelo, i-FeNO inika amandla odokotela ukuthi benze ukuxilongwa kwe-phenotypic okunembe kakhudlwana ekuhlanganeni kokuqala. Lokhu kuholela ekwelashweni kokuqala okuqondiswe kakhulu futhi okuphumelelayo, okuhambisana kahle nesifiso sesimanje semithi enembile ekunakekelweni kwe-asthma. Njengoba ukufinyelela kubuchwepheshe be-FeNO kukhula, indima yayo kokubili ekuxilongeni nasekuqondiseni ukwelashwa kwe-asthma ephezulu ye-T2 kulindeleke ukuthi ibe yindinganiso yokunakekelwa, ekugcineni ihlose imiphumela engcono yesiguli ngokungenelela kwangaphambi kwesikhathi nangokunembile kakhudlwana.
Uhlelo Lokuhlaziya Igesi Lokuphefumula lwe-UBREATH (BA200) luyithuluzi lezokwelapha eliklanywe futhi lakhiqizwa yi-e-LinkCare Meditech ukuze lihambisane nokuhlolwa kwe-FeNO kanye ne-FeCO ukuze kuhlinzekwe ngesilinganiso esisheshayo, esinembile, nesinobuningi ukuze kusizwe ekuxilongweni nasekuphathweni kwezifo ezifana ne-asthma kanye nezinye izifo zokuphefumula ezingamahlalakhona.
Isikhathi sokuthunyelwe: Jan-23-2026