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Exhaled nitric oxide and asthma: complex interactions between atopy, airway responsiveness, and symptoms in a

P J Franklin1, S W Turner, P N Le Souëf

  • 1Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia.

Thorax
|December 4, 2003
PubMed

Insights

In children, raised exhaled nitric oxide (FE(NO)) is linked to atopy and airway responsiveness (AR), not necessarily asthma symptoms. This suggests a mechanism connecting these factors in pediatric respiratory health.

Area of Science:

  • Pediatric Respiratory Medicine
  • Allergy and Immunology
  • Pulmonary Function Testing

Background:

  • Elevated exhaled nitric oxide (FE(NO)) is observed in asthmatic children.
  • Inconsistencies exist regarding FE(NO)'s relationship with asthma characteristics like atopy, airway responsiveness (AR), and inflammation.
  • Understanding these relationships is crucial for accurate pediatric asthma diagnosis and management.

Purpose of the Study:

  • To investigate the association between FE(NO) and asthma, atopy, and increased AR in children.
  • To clarify the role of FE(NO) as a biomarker in pediatric respiratory conditions.
  • To explore potential underlying mechanisms linking FE(NO) to asthma phenotypes.

Main Methods:

  • 155 children (mean age 11.5 years) underwent FE(NO) measurements, spirometry, histamine challenge, and skin prick testing.
  • Blood eosinophil counts and asthma-like symptoms via questionnaire were also assessed.
  • Multiple linear regression analyses were employed to determine associations.

Main Results:

  • FE(NO) significantly correlated with atopy (p<0.001), AR (p=0.005), blood eosinophil count (p=0.007), and height (p=0.002).
  • These associations were primarily observed in atopic children.
  • Elevated FE(NO) was found in children with combined atopy and increased AR, irrespective of respiratory symptoms.

Conclusions:

  • Raised FE(NO) in children appears linked to an underlying mechanism connecting atopy and AR.
  • FE(NO) may serve as a marker for this specific pathophysiological pathway, rather than general respiratory symptoms.
  • Further research is warranted to elucidate the precise role of FE(NO) in pediatric airway diseases.
Abstract

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