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Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE

Daan Caudri1, Alet H Wijga, Maarten O Hoekstra

  • 1Department of Pediatrics/Respiratory Medicine, Erasmus University, Rotterdam, The Netherlands.

Thorax
|September 1, 2010
PubMed

Insights

Fraction of exhaled nitric oxide (FeNO) and specific immunoglobulin E (IgE) tests in 4-year-olds can predict childhood asthma. These objective measures improve prediction beyond clinical history, aiding early diagnosis and management.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Biomarkers in Respiratory Disease

Background:

  • Predicting childhood asthma from preschool symptoms is challenging for clinicians.
  • Early identification of children at risk for persistent asthma is crucial for timely intervention.

Purpose of the Study:

  • To evaluate if FeNO, interrupter resistance (Rint), or specific IgE levels at age 4 predict asthma up to age 8.
  • To determine the added predictive value of these biomarkers alongside clinical history.

Main Methods:

  • Children from the PIAMA birth cohort with asthma-suggestive symptoms at ages 3-4 were assessed at age 4.
  • Measurements included FeNO, Rint, and specific IgE.
  • Repeated measures analyses assessed associations with wheezing and asthma from ages 5-8.

Main Results:

  • FeNO and specific IgE at age 4 predicted wheezing and asthma at age 8.
  • These biomarkers remained significant predictors independently of clinical history.
  • Rint predicted wheezing at age 6 but not later childhood.

Conclusions:

  • FeNO and specific IgE measured in preschool children are valuable predictors of later childhood asthma.
  • These objective tests enhance asthma prediction beyond traditional clinical assessments.
  • Rint is less effective for predicting persistent asthma in this age group.
Abstract

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