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Exhaled nitric oxide in children with allergic rhinitis and/or asthma: a relationship with bronchial hyperreactivity

Giorgio Ciprandi1, Maria Angela Tosca, Michele Capasso

  • 1Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino-University of Genoa, Genoa, Italy. gio.cip@libero.it

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|October 19, 2010
PubMed

Insights

Fractional exhaled nitric oxide (FeNO) can predict bronchial hyperreactivity (BHR) in allergic children. A FeNO level of 32 ppb or higher indicates a higher likelihood of BHR, linking upper and lower airway inflammation.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Clinical Diagnostics

Background:

  • Fractional exhaled nitric oxide (FeNO) is an established non-invasive marker for assessing airway inflammation in clinical settings.
  • International consensus supports FeNO measurement methodology for routine use.
  • The relationship between FeNO and bronchial hyperreactivity (BHR) in pediatric allergic conditions requires further elucidation.

Purpose of the Study:

  • To investigate the predictive value of FeNO measurements for BHR in children diagnosed with allergic rhinitis, asthma, or both conditions.
  • To explore the correlation between FeNO levels and BHR severity in this pediatric population.

Main Methods:

  • A cohort of 280 children with allergic rhinitis, asthma, or co-existing conditions underwent assessment.
  • Evaluated parameters included spirometry (FEV1, FEF25-75), BHR via methacholine challenge, FeNO levels, and allergic sensitization status.

Main Results:

  • Significant differences in bronchial function, BHR, and FeNO levels were observed across the three patient groups (p < .001).
  • A robust inverse correlation was identified between FeNO and BHR in children with asthma (r = -0.63) and those with both asthma and rhinitis (r = -0.61).
  • An FeNO cutoff value of 32 ppb demonstrated predictive capability for the presence of BHR.

Conclusions:

  • FeNO measurement emerges as a valuable potential biomarker for identifying BHR in pediatric patients with allergic diseases.
  • The findings underscore the significant association between upper (allergic rhinitis) and lower (asthma) airway inflammation.
Abstract

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