Exhaled Nitric Oxide-1 (NOA-1) - 11.22.16

Overview | Description | Applications | Operations | Results | Publications | Imagery

ISS Science for Everyone

Science Objectives for Everyone
Inhaled dust particles can cause inflammation in the airways of humans on Earth as well as in space. To study the effects of the inhaled dust particles in space, investigators will examine the amount of the gaseous Nitric Oxide, which indicates airway inflammation, exhaled by crewmembers.
Science Results for Everyone
Is that Nitric Oxide on your breath? Inhaled dust particles can irritate and inflame our airways on Earth and in space. Aa simple way to detect inflammation is by measuring the levels of exhaled gaseous Nitric Oxide (FENO) which is produced by the body during inflammation. This investigation measured FENO exhaled by crewmembers. Measurements showed that exhaled NO is gravity dependent; FENO fell to nearly half its preflight value in flight, but was elevated in hyper-gravity. These findings suggest that gravity-induced changes in capillary gas transfer in the lungs greatly affect FENO, although there were no clear trends over time.

The following content was provided by Dag Linnarsson, and is maintained in a database by the ISS Program Science Office.
Information provided courtesy of the Erasmus Experiment Archive.
Experiment Details


Principal Investigator(s)
Dag Linnarsson, Karolinska Institute, Stockholm, Sweden

Lars E. Gustafsson, Ph.D., Karolinska Institutet, Stockholm, Sweden
Claes G. Frostell, Ph.D., M.D., Karolinska Institutet, Stockholm, Sweden
M. Carlson, Karolinska Institute, Stockholm, Sweden
J. Mann, Karolinska Institute, Stockholm, Sweden
Manuel Paiva, Ph.D., Universite Libre de Bruxelles, Brussels, Belgium
Tryggve E. Hemmingsson, Aerocrine, Solna, Sweden
Per Blom, Ph.D., M.D., Linde Gas Therapeutics, Lidingo, Sweden
Lars L. Karlsson, Ph.D., Karolinska Institutet, Stockholm, Sweden

Karolinska Institute, Stockholm, Sweden
Aerocrine, Solna, Sweden

Sponsoring Space Agency
European Space Agency (ESA)

Sponsoring Organization
Information Pending

Research Benefits
Information Pending

ISS Expedition Duration
October 2005 - April 2007; April 2008 - October 2008

Expeditions Assigned

Previous Missions
This experiment has also been known as ESANO-1.

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Experiment Description

Research Overview

  • Dust particles never settle in microgravity, therefore they are more concentrated in the environment ISS and are inhaled by crewmembers.

  • Inhalation of dust particles into the airways leading to the lungs can cause inflammation of the airways.

  • Measurements of the amount of Nitric Oxide, an exhaled gas, will be used to determine the amount of airway inflammation experienced by the ISS crewmembers.

  • This research will lead to the advancements in treatment for patients that have lung inflammation illnesses, such as asthma, and countermeasures to ensure respiratory health on long duration space missions.

Recent research has demonstrated that an elevation of expired Nitric Oxide is an early and accurate sign of airway inflammation especially in asthma but also after occupational dust inhalation. This experiment will utilize improved techniques for analysis of Nitric Oxide in expired air. This will be used to study physiological reactions in humans in microgravity.

Since dust never settles in microgravity, it is likely that there is an increased exposure of the human airways to inhaled particles in such an environment. The crewmembers will perform a simple inhalation-exhalation procedure on a bi-weekly basis during their stay on the ISS.

Elevated levels of expired Nitric Oxide compared to preflight levels would indicate airway inflammation. Data will be stored on a credit-card size memory unit. This experiment, which started during Expedition 12, is planned to be carried out over multiple Expedition Crews requiring eight subjects.

The Platon device, developed for spaceflight, has a dual use, as it is now also used to improve the treatment of asthma by allowing monitoring of patients at home. (Description provided by ESA: Astrolab Mission)

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Space Applications
Information Pending

Earth Applications
Information Pending

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Operational Requirements and Protocols
Information Pending

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Decadal Survey Recommendations

Information Pending

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Results/More Information

During orbital space flight, and in future space exploration missions, crew-members are exposed to an increased risk of airway inflammation due to inhalation of free-floating dust and particles, and inhalation of Moon dust. Analysis of exhaled nitric oxide (FENO) is a simple method to monitor inflamed airway (Karlsson et al. 2009). In preparation for possible future monitoring of lung health during long-term space missions, the effects of altered gravity per se on FENO was studied.

It was hypothesized that changes in gravity can influence FENO by altering lung gas exchange capacity and uptake of nitric oxide (NO) in the alveoli (tiny grape-like sacs in the lungs where the gas to blood exchange occurs). For this study, five healthy astronauts performed control FENO measurements on ground before space flight and then approximately every 6 weeks during their 23- to 28-wk-long stays onboard the ISS during 2005-2008. A parallel ground based study with 10 subjects was completed for hypergravity (acceleration force greater than normal gravity) in a human centrifuge.

Results show that during microgravity, FENO was significantly lower and fell to nearly half that of preflight value. In the centrifuge experiments, FENO was significantly elevated during exposure to 2, and 3 times the normal gravity. The findings of decreased exhaled NO in space and increased exhaled and estimated alveolar NO values in hypergravity suggest that gravity-induced changes in alveolar-to-lung capillary gas transfer greatly affect FENO, but there was no clear trend over time during the stays on ISS or after landing. According to current models of NO transport, NO originates from conductive airways and alveoli, each source having a different impact on the exhaled amount. Additionally NO is taken up by blood in the alveolar compartment. Thus, a change in FENO may come from an alteration of the overall balance between production and blood recapture as well as by a change in the airway production. The principal observation was that exhaled NO is gravity dependent: its values were lowered in microgravity and elevated in seated humans during hypergravity (Karlsson et al. 2009).

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Results Publications

    Karlsson LL, Kerckx Y, Gustafsson LE, Hemmingsson TE, Linnarsson D.  Microgravity Decreases and Hypergravity Increases Exhaled Nitric Oxide. Journal of Applied Physiology. 2009 November; 107(5): 1431-1437. DOI: 10.1152/japplphysiol.91081.2008. PMID: 19745185.

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Ground Based Results Publications

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ISS Patents

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Related Publications

    Verbanck S, Kerckx Y, Schuermans D, Vincken W, Paiva M, Van Muylem A.  Effect of airways constriction on exhaled nitric oxide. Journal of Applied Physiology. 2008 February 2; 104(4): 925-903. DOI: 10.1152/japplphysiol.01019.2007.

    Hemmingsson TE, Linnarsson D, Gambert R.  Novel hand-held device for exhaled nitric oxide-analysis in research and clinical applications. Journal of Clinical Monitoring and Computing. 2004 December; 18(5-6): 379-387. DOI: 10.1007/s10877-005-1158-z. PMID: 15957630.

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Related Websites
The information on this page is provided courtesy of the ESA Erasmus Experiment Archive.

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image The Platon device is used to detect Nitric Oxide in the NOA-1 experiment. Image courtesy of ESA.
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image NASA Image: ISS012E24271- The Planton Unit and Medical kits in the Zvezda Service Module (SM). The Platon unit, Nitric Oxide Analyzer (NOA), used in the European Space Agency Nitric Oxide 1 (ESANO 1) experiment is in the mid-left of the image. Image taken during Expedition 12/13 Joint Operations.
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