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Related Experiment Videos

Changes in exhaled nitric oxide levels with immunotherapy.

Chitra Dinakar1, Thomas J Van Osdol, Charles S Barnes

  • 1Section of Allergy/Asthma/Immunology, Children's Mercy Hospital, Kansas City, Missouri 64108, USA. cdinakar@cmh.edu

Allergy and Asthma Proceedings
|May 27, 2006
PubMed
Summary

Rush immunotherapy (IT) in children with allergic airway disorders causes a rapid rise in exhaled nitric oxide (eNO) levels, a marker of inflammation. These levels then decrease, indicating immunomodulatory changes during treatment.

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Area of Science:

  • Allergy and Immunology
  • Respiratory Medicine
  • Biomarkers

Background:

  • Immunotherapy (IT) modulates allergic airway responses, but mechanisms remain unclear.
  • Exhaled nitric oxide (eNO) is a sensitive marker for airway inflammation in allergic respiratory disorders.

Purpose of the Study:

  • To characterize eNO patterns in children receiving traditional IT (TradIT) versus rush IT (RushIT).
  • To investigate eNO as a potential barometer of immunomodulatory changes during IT.

Main Methods:

  • Off-line eNO measurements were taken in children undergoing TradIT or RushIT.
  • eNO levels were recorded before IT initiation and at 2, 4, 6, 8, and 12 weeks post-initiation.
  • Nine children received TradIT, and 10 received RushIT.

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Main Results:

  • RushIT group showed an initial rise in eNO (12.6 to 17.7 ppb by week 2), peaking by week 8, then dropping below baseline by week 12 (p=0.038).
  • TradIT group did not exhibit similar eNO changes.
  • The difference in eNO levels between groups was significant at 4 weeks (p=0.014).

Conclusions:

  • Initiation of IT induces significant immunomodulatory changes, reflected by alterations in eNO levels.
  • These immunomodulatory changes appear accelerated with RushIT compared to TradIT.
  • eNO levels return to baseline as maintenance IT levels are achieved.