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Exhaled nitric oxide corresponds with office evaluation of asthma control
Isabelle Meyts1, Marijke Proesmans, Kris De Boeck
1Pediatric Pulmonology Department, University Hospital Gasthuisberg Leuven, Herestraat 49, 3000 Leuven, Belgium.
Insights
Exhaled nitric oxide (ENO) levels in children with asthma varied significantly based on disease control. Higher ENO levels correlated with poorer asthma control, suggesting ENO as a useful monitoring tool.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Biomarkers
Background:
- Exhaled nitric oxide (ENO) is a noninvasive marker for airway inflammation.
- ENO levels are elevated in asthma patients.
- The utility of ENO in assessing asthma control in children requires further investigation.
Purpose of the Study:
- To determine if exhaled nitric oxide (ENO) measurements differ among pediatric asthma patients with varying degrees of disease control.
- To compare ENO levels with clinical assessments of asthma control.
Main Methods:
- Seventy-three children (5-18 years) with asthma were enrolled.
- Exhaled nitric oxide (ENO) was measured during a slow vital capacity maneuver.
- Asthma control was assessed using clinical parameters and spirometry, including bronchodilator reversibility.
Main Results:
- ENO levels were significantly different across three groups: good (11 ppb), acceptable (15 ppb), and insufficient (28 ppb) asthma control.
- A significant difference in ENO was observed between poorly controlled and well-controlled asthma groups.
- ENO levels correlated with clinical indicators of asthma control and reversibility testing.
Conclusions:
- Exhaled nitric oxide (ENO) levels differ significantly between pediatric asthma patients with insufficient versus good/acceptable disease control.
- ENO measurements show potential as a valuable tool for monitoring asthma control in children.
- This study supports the use of ENO as an objective measure in pediatric asthma management.
Abstract:
Exhaled NO (ENO) has been studied as a noninvasive marker of airway inflammation, and has been shown to be elevated in asthma patients. The aim of this study was to investigate whether ENO measurements differ significantly between groups of asthmatic children with different disease control and to compare ENO measurements with the clinical assessment of asthma control. Seventy-three children between 5-18 years old with a diagnosis of asthma were recruited. ENO was measured online during a slow vital capacity maneuver. The mean of three plateau NO levels was used for analysis. Baseline and postbronchodilator spirometry were performed. The assessment of disease control was based on the frequency of use of beta2-agonists, occurrence of day- and nighttime asthma symptoms, and spirometry results. Twenty-one children (group 1) had good asthma control. In 31 patients (group 2), asthma control was acceptable. In 21 patients (group 3), asthma was insufficiently controlled. ENO levels were (median (quartiles)): group 1, 11 ppb (9-21); group 2, 15 ppb (11-26); and group 3, 28 ppb (19-33). Measurements were significantly different between all three groups (P = 0.009, Kruskal-Wallis), between groups 1 and 3 (P = 0.01, Mann-Whitney U test), and between groups 2 and 3 (P = 0.01, Mann-Whitney-U test). The same was true for reversibility testing. We found significantly different ENO levels between a group of pediatric asthma patients with insufficient and good/sufficient control, as defined by clinical assessment. These results suggest that ENO measurements may be useful for monitoring asthma patients.