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Relations between exhaled nitric oxide and measures of disease activity among children with mild-to-moderate asthma

Ronina A Covar1, Stanley J Szefler, Richard J Martin

  • 1Ira J. and Jacqueline Neimark Laboratory of Clinical Pharmacology and the Division of Allergy-Clinical Immunology, Department of Pediatrics, Denver, Colorado, USA. covarr@njc.org

The Journal of Pediatrics
|May 21, 2003
PubMed

Insights

Budesonide significantly reduced exhaled nitric oxide (FeNO) in children with asthma, but this effect was not sustained after treatment cessation. FeNO monitoring can aid in assessing asthma control and medication response.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Asthma management in children requires effective long-term strategies.
  • Inhaled corticosteroids are a cornerstone of persistent asthma treatment.
  • Exhaled nitric oxide (FeNO) is a non-invasive biomarker of airway inflammation.

Purpose of the Study:

  • To evaluate the effect of long-term budesonide, nedocromil, or albuterol treatment on FeNO in children with asthma.
  • To assess the sustainability of FeNO reduction after treatment discontinuation.
  • To explore correlations between FeNO and other asthma control markers.

Main Methods:

  • 118 children with asthma were treated for 4-6 years with budesonide, nedocromil, or albuterol.
  • FeNO, spirometry, eosinophil counts, and serum eosinophil cationic protein were measured.
  • Measurements were taken upon treatment completion and after a 2-4 month washout period.

Main Results:

  • Budesonide significantly reduced FeNO and eosinophil cationic protein compared to placebo.
  • No significant differences in FeNO were observed between nedocromil and placebo groups.
  • FeNO levels correlated with bronchial hyperresponsiveness, bronchodilator reversibility, allergen sensitivity, IgE, eosinophil counts, nocturnal symptoms, and beta-agonist use.

Conclusions:

  • Budesonide was more effective than nedocromil in reducing FeNO during treatment.
  • The anti-inflammatory effects of budesonide on FeNO were not sustained after discontinuation.
  • FeNO may serve as a valuable complementary tool for monitoring asthma control and treatment response.
Abstract

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