Related Experiment Video

Updated: Aug 19, 2026

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
05:31

Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels

Published on: August 7, 2017

Exhaled nitric oxide in 4-year-old children: relationship with asthma and atopy

J E Brussee1, H A Smit, M Kerkhof

  • 1National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.

The European Respiratory Journal
|March 2, 2005
PubMed

Insights

Elevated exhaled nitric oxide levels in 4-year-olds indicate airway inflammation, suggesting potential for early asthma detection. This marker is associated with asthma and atopy, but not wheezing or eosinophilia.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Epidemiology

Background:

  • Airway inflammation is an early indicator of asthma, making early detection crucial for therapeutic impact.
  • Exhaled nitric oxide (eNO) serves as a noninvasive biomarker for assessing airway inflammation.
  • Understanding eNO in young children can aid in early asthma diagnosis and management.

Purpose of the Study:

  • To investigate the association between exhaled nitric oxide levels and asthma, wheezing phenotypes, atopy, and blood eosinophilia in 4-year-old children.
  • To determine if eNO can serve as a reliable marker for identifying airway inflammation in early childhood.
  • To contribute to the epidemiological understanding of eNO in a general population of young children.

Main Methods:

  • A large-scale birth cohort study involving 429 children aged 4 years from the Netherlands.
  • Measurement of exhaled nitric oxide levels in all participating children.
  • Analysis of associations between eNO levels and doctor's diagnosed asthma, atopy, wheezing phenotypes, and blood eosinophilia.

Main Results:

  • Children with doctor's diagnosed asthma or atopy exhibited higher geometric mean exhaled nitric oxide levels (9.4 ppb and 10.0 ppb) compared to those without (7.7 ppb and 7.9 ppb).
  • The highest eNO values were observed in atopic children experiencing asthma symptoms.
  • No significant association was found between exhaled nitric oxide levels and wheezing phenotypes or blood eosinophilia.

Conclusions:

  • Higher exhaled nitric oxide levels in 4-year-olds are associated with asthma and atopy, highlighting its potential as an early marker of airway inflammation.
  • eNO measurement can be a valuable noninvasive tool for identifying children at risk for or with early signs of asthma.
  • Further research can explore the longitudinal impact of eNO levels on asthma development and progression in children.

More Related Videos

Methodology for Sputum Induction and Laboratory Processing13:28

Methodology for Sputum Induction and Laboratory Processing

Published on: December 17, 2017

Related Concept Videos

Asthma I: Introduction01:28

Asthma I: Introduction

Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...
Asthma-I: Introduction01:29

Asthma-I: Introduction

Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...
Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Asthma-II: Pathophysiology and Classification01:26

Asthma-II: Pathophysiology and Classification

Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma: Pathogenesis and Management01:20

Asthma: Pathogenesis and Management

Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma III: Clinical Manifestations01:13

Asthma III: Clinical Manifestations

Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...