Tsawon shekaru, gwajin fractional exhaled nitric oxide (FeNO) ya kasance abokin tarayya mai mahimmanci a cikin kayan aikin likitan asma, wanda galibi ke jagorantar shawarwarin gudanarwa. Sabuntawar 2025 ga jagororin Shirin Duniya don Asma (GINA) yana nuna babban ci gaba, yana faɗaɗa rawar FeNO a hukumance fiye da kimantawa da gudanarwa don yanzu yana tallafawa sosai ga ganewar cutar asma mai kumburi ta Type 2 (T2). Wannan ingantaccen bayani ya amince da babban rawar da ake takawa a cikin kulawar asma ta zamani kuma yana ba da hanya mafi daidaito, wacce ta dogara da ilimin halitta don gano cutar asma ta farko.
FeNO: Tagar da ke haifar da kumburi a hanyar iska
FeNO yana auna yawan nitric oxide a cikin numfashin da aka fitar, wanda ke aiki a matsayin alamar cutar kai tsaye, mara cutarwa ga kumburin hanyar iska ta eosinophilic, ko T2. Wannan kumburi, wanda cytokines kamar interleukin-4, -5, da -13 ke haifarwa, ana siffanta shi da haɓakar IgE, eosinophils a cikin jini da maniyyi, da kuma amsawa ga corticosteroids. A al'ada, ana amfani da FeNO don:
Yi hasashen martanin da za a yi wa corticosteroids da aka shaƙa (ICS): Yawan matakan FeNO yana nuna yuwuwar samun fa'ida daga maganin ICS.
Kula da bin ƙa'idodi da kuma kula da kumburi: Ma'aunin gwaje-gwaje na iya tantance bin ƙa'idodin majiyyaci ga maganin hana kumburi da kuma rage kumburin T2 da ke haifar da shi.
Jagorar daidaita magani: Yanayin FeNO na iya ba da shawara kan yanke shawara kan haɓaka ko rage yawan ICS.
Canjin 2025: FeNO a cikin Hanyar Bincike
Babban ci gaba a cikin rahoton GINA na 2025 shine ƙarfafa amincewa da FeNO a matsayin taimakon gano cutar asma mai yawan T2 a lokacin da aka fara kamuwa da ita. Wannan yana da matuƙar muhimmanci musamman a cikin mahallin bayyanar cutar asma daban-daban.
Bambancin Alamomin Asma: Ba duk wani numfashi ko numfashi ba ne asma ta T2. Marasa lafiya da ke fama da kumburin da ba na T2 ba ko kuma pauci-granulocytic na iya gabatar da alamu iri ɗaya amma suna da ƙarancin matakan FeNO. Matsayin FeNO mai yawa akai-akai (misali, >35-40 ppb a cikin manya) a cikin majiyyaci da ke da alamun bayyanar cututtuka (tari, tari, ƙarancin iska mai canzawa) yanzu yana ba da tabbataccen shaida ga endotype mai yawan T2, ko da kafin a gwada magani.
Tallafawa Ganewar Cututtuka a Yanayin Matsalolin da Suka Shafi Kalubalantar Haihuwa: Ga marasa lafiya da ke da alamun da ba su da alaƙa ko kuma inda sakamakon spirometry ba su da tabbas ko kuma al'ada a lokacin gwaji, ƙaruwar FeNO na iya zama muhimmin abin shaida da ke nuna cewa akwai wani tsari na kumburi na T2. Yana taimakawa wajen motsa ganewar asali daga wanda ya dogara ne kawai akan alamun da ba su da alaƙa da juna zuwa wanda ya haɗa da sa hannun halitta.
Sanarwa kan Dabarun Maganin Farko: Ta hanyar haɗa FeNO a matakin ganewar asali, likitoci za su iya rarraba maganin cikin hikima tun daga farko. Babban matakin FeNO ba wai kawai yana tallafawa ganewar asma ba, har ma yana annabta kyakkyawan martani ga maganin ICS na farko. Wannan yana sauƙaƙa hanyar magani ta musamman, wacce ke iya inganta sarrafawa da sakamako da wuri.
Tasirin Asibiti da Haɗakarwa
Ka'idojin 2025 sun ba da shawarar haɗa gwajin FeNO cikin aikin farko na ganewar asali idan akwai zargin asma kuma akwai damar yin gwajin. Fassarar ta bi tsarin da aka raba:
Babban FeNO (>50 ppb a cikin manya): Yana ƙarfafa ganewar cutar asma mai yawan T2 kuma yana annabta amsawar ICS.
Matsakaicin FeNO (25-50 ppb a cikin manya): Ya kamata a fassara shi a cikin mahallin asibiti; yana iya nuna kumburin T2 amma yana iya shafar atopy, fallasawar allergen kwanan nan, ko wasu dalilai.
Ƙarancin FeNO (<25 ppb a cikin manya): Yana rage yiwuwar kamuwa da kumburi mai yawan T2, wanda ke haifar da la'akari da wasu cututtukan da ba su da kumburi (misali, matsalar toshewar murya, yanayin asma mara T2, COPD) ko kuma abubuwan da ba su da kumburi na alamun.
Wannan sabuntawa bai sanya FeNO gwajin ganewar asali ba, amma ya sanya shi a matsayin wani ƙarin ƙarfi ga tarihin asibiti, yanayin alamun, da gwajin spirometry/reversibility. Yana ƙara wani matakin gaskiya wanda ke inganta kwarin gwiwar ganewar asali.
Kammalawa
Jagororin GINA na 2025 suna wakiltar wani canji na tsari, wanda ke ƙarfafa matsayin gwajin FeNO daga wani ƙarin magani na kulawa zuwa wani babban mai tallafawa ganewar asali na asma ta nau'in 2. Ta hanyar samar da ma'auni nan take, na ainihin kumburin T2, FeNO yana ba wa likitoci damar yin ingantattun ganewar asali a farkon haɗuwa. Wannan yana haifar da ƙarin magani na farko mai inganci, wanda ya dace da burin zamani na maganin daidaito a cikin kula da asma. Yayin da samun damar amfani da fasahar FeNO ke faɗaɗa, rawar da take takawa wajen gano cutar asma mai yawan T2 za ta zama mizanin kulawa, a ƙarshe tana nufin samun sakamako mafi kyau ga marasa lafiya ta hanyar shiga tsakani da wuri da kuma daidai.
Tsarin Binciken Iskar Gas na UBREATH (BA200) na'urar likita ce da e-LinkCare Meditech ta tsara kuma ta ƙera don haɗawa da gwajin FeNO da FeCO don samar da ma'auni cikin sauri, daidai, da ƙima don taimakawa wajen gano cutar da kuma kula da ita kamar asma da sauran kumburin hanyoyin iska na yau da kullun.
Lokacin Saƙo: Janairu-23-2026