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Exhaled nitric oxide levels in non-allergic and allergic mono- or polysensitised children with asthma
M Silvestri1, F Sabatini, D Spallarossa
1Pulmonary Division, G. Gaslini Institute, Largo G Gaslini 5, 16148 Genoa, Italy.
Insights
Allergic children with mild asthma exhibit higher blood eosinophilia and fractional exhaled nitric oxide (FENO) levels, indicating increased inflammation compared to non-allergic asthmatics. These markers suggest a greater inflammatory component in allergic asthma, even with similar lung function.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Immunology
Background:
- Allergic children with mild asthma often show elevated fractional exhaled nitric oxide (FENO) and blood eosinophilia, reflecting disease intensity.
- The study aimed to compare FENO levels and blood eosinophilia between allergic and non-allergic asthmatic children.
Purpose of the Study:
- To investigate differences in FENO levels and blood eosinophilia intensity in allergic versus non-allergic asthmatic children.
- To correlate these inflammatory markers with asthma severity and sensitization status.
Main Methods:
- 112 children with mild intermittent asthma underwent methacholine bronchial challenge.
- Participants were categorized into non-sensitized (n=56) and allergic (n=56) groups based on skin prick tests and RAST.
- A control group of 19 healthy children was included for comparison.
Main Results:
- Allergic asthmatic children showed significantly higher blood eosinophilia (p=0.0001) and FENO levels (p=0.0001) compared to non-allergic asthmatics.
- Lung function (FEV1, FVC, FEF25-75%) and bronchial reactivity were similar across groups.
- Significant correlations between blood eosinophilia and FENO were observed in allergic and polysensitized children.
Conclusions:
- Children with mild asthma have a higher inflammatory component if they are allergic compared to non-allergic subjects.
- FENO and blood eosinophilia serve as valuable biomarkers for assessing allergic inflammation in pediatric asthma.
Background:
Increased fractional exhaled NO concentrations (FENO) and blood/tissue eosinophilia are frequently reported in allergic children with mild asthma and are thought to reflect the intensity of the inflammation characterising the disease. The aim of this study was to investigate possible differences in FENO levels or in the intensity of the blood eosinophilia in allergic and non-allergic asthmatic children.
Methods:
112 children with stable, mild, intermittent asthma with a positive bronchial challenge to methacholine were consecutively enrolled in the study; 56 were skin prick test and RAST negative (non-sensitised) while 56 were sensitised to house dust mites (23 only to house dust mites (monosensitised) and 33 were sensitised to mites and at least another class of allergens (pollens, pet danders, or moulds)). Nineteen sex and age matched healthy children formed a control group.
Results:
Compared with non-allergic patients, allergic children had a significantly higher rate of blood eosinophilia (p=0.0001) with no differences between mono- and polysensitised individuals. Forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), forced expiratory flow at 25-75% of vital capacity (FEF(25-75%)), and the degree of bronchial reactivity to methacholine were similar in non-atopic and atopic children, with no differences between mono- and polysensitised individuals. FENO levels measured by chemiluminescence analyser were higher in asthmatic children (15.9 (14.3) ppb) than in the control group (7.6 (1.6) ppb, p=0.04) and higher in allergic patients (23.9 (2.1) ppb) than in non-allergic patients (7.9 (0.8) ppb, p=0.0001), but there were no differences between mono- and polysensitised individuals (p>0.1). Significant correlations between blood eosinophilia and FENO levels were seen only in allergic (r=0.35, p<0.01) and in polysensitised individuals (r=0.45, p<0.05).
Conclusions:
In children with mild asthma, a similar degree of functional disease severity may be associated with a higher inflammatory component in allergic than in non-allergic subjects.
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