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Published on: August 7, 2017
Surrogate markers of airway inflammation: inflammometry in paediatric respiratory medicine
1Department of Paediatrics/Respiratory Medicine, Erasmus University and University Hospital/Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Assessing pediatric airway inflammation non-invasively is now possible. Exhaled nitric oxide is a promising marker for diagnosing and monitoring childhood inflammatory airway diseases.
Area of Science:
- Pediatric Pulmonology
- Biomarker Discovery
Background:
- Non-invasive assessment of pediatric airway inflammation has been lacking.
- Surrogate markers are crucial for diagnosing and monitoring pediatric inflammatory airway diseases.
Purpose of the Study:
- To review the potential of various non-invasive surrogate markers for assessing airway inflammation in children.
- To highlight exhaled nitric oxide as a particularly well-studied marker.
Main Methods:
- Review of current research on surrogate markers for airway inflammation in pediatric populations.
- Focus on characteristics of ideal markers: validity, non-invasiveness, speed, reproducibility, cost-effectiveness.
- Evaluation of marker utility for specific conditions like asthma, cystic fibrosis, infections, and ciliary dyskinesia.
Main Results:
- Numerous substances in blood, urine, exhaled air, and induced sputum are under investigation.
- Exhaled nitric oxide (eNO) has the most extensive research and shows clinical potential.
- No single marker fulfills all ideal requirements; specificity for different inflammation types is key.
Conclusions:
- 'Inflammometry' using surrogate markers represents a significant advancement in pediatric respiratory medicine.
- Further cost-benefit analyses are needed before widespread clinical adoption.
- These markers will aid in differentiating airway diseases and optimizing treatment strategies.
Abstract:
Until recently, there has not been any practical way to assess airway inflammation non-invasively in paediatrics. Surrogate markers of airway inflammation are potentially of great importance in the diagnosis and monitoring of inflammatory airways disease in children. A large number of substances in blood, urine and exhaled air or induced sputum are currently under study to evaluate their possible usefulness as markers of airway inflammation. To be useful, a marker should be valid, preferably non-invasive, quick, reproducible, repeatable and cheap. In addition, markers should be studied in relation to their specific purpose because different markers may be useful for different types of airway inflammation. Few, if any, markers will fulfill all these requirements. Most research has focused on applications of markers in asthma, some data refer to cystic fibrosis, infections and ciliary dyskinesia. Of all surrogate markers, exhaled nitric oxide has been studied the most and seems to offer information that should be evaluated for its relevance to clinical practice. Before introducing markers of inflammation into daily practice, analysis of benefits and costs are needed. There is little doubt that 'inflammometry' will be a major step forward and will be useful in differentiating airways diseases and improving treatment.
