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Expired nitric oxide and airway reactivity in infants at risk for asthma

Robert S Tepper1, Conrado J Llapur2, Marcus H Jones3

  • 1Department of Pediatrics, Indiana University Medical Center, James Whitcomb Riley Hospital for Children, Wells Center for Pediatric Research, Indianapolis, Ind.

The Journal of Allergy and Clinical Immunology
|September 2, 2008
PubMed

Insights

Atopic infants, even without wheezing, show altered airway function. Specific food sensitization is linked to lower airflow and increased airway reactivity, suggesting early airway involvement in atopy.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Neonatal Asthma Research

Background:

  • Family history of atopy, atopic dermatitis, and food allergies are known infant asthma risk factors.
  • Atopic sensitization is implicated in asthma development, but early airway involvement remains unclear.

Purpose of the Study:

  • To investigate if atopic infants without prior wheezing exhibit elevated expired nitric oxide (eNO) and heightened airway reactivity.
  • To explore the relationship between infant atopy and early airway physiological changes.

Main Methods:

  • Recruited infants with eczema; defined atopic status via specific IgE and total IgE levels.
  • Measured eNO, forced expiratory flow at 75% exhaled volume (FEF75), and methacholine airway reactivity in sedated infants.
  • Quantified airway reactivity using the provocative concentration to decrease FEF75 by 30% (PC30).

Main Results:

  • Infants sensitized to egg/milk showed lower FEF75 and PC30 compared to non-sensitized infants.
  • Higher total serum IgE levels (>20 IU/mL) correlated with increased eNO levels.
  • No significant differences in eNO were found between food-sensitized and non-sensitized infants.

Conclusions:

  • Atopic characteristics in infants may significantly influence airway physiology, including forced expiratory flows and reactivity.
  • Findings suggest early airway involvement in the atopic process, even before wheezing occurs.
  • eNO levels appear linked to overall atopic burden (total IgE) rather than specific food sensitization.
Abstract

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