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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
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Factors associated with elevated exhaled nitric oxide fraction in infants with recurrent respiratory symptoms

Anne Kotaniemi-Syrjänen1, L Pekka Malmberg, Kristiina Malmström

  • 1Dept of Allergology, Helsinki University Central Hospital, Helsinki, Finland.

The European Respiratory Journal
|June 30, 2012
PubMed

Insights

Fraction of exhaled nitric oxide (FeNO) in infants with recurrent respiratory symptoms is linked to maternal asthma history and increased airway responsiveness. This finding helps understand FeNO

Area of Science:

  • Pediatric Respiratory Medicine
  • Allergy and Immunology
  • Pulmonary Physiology

Background:

  • Fraction of exhaled nitric oxide (FeNO) is a proposed noninvasive marker for eosinophilic airway inflammation and corticosteroid therapy response in asthma.
  • Factors influencing FeNO require further investigation, particularly in early childhood respiratory disorders.
  • The role of FeNO in infants with recurrent lower respiratory tract symptoms needs clarification.

Purpose of the Study:

  • To investigate the association between FeNO levels and clinical factors in infants with recurrent lower respiratory tract symptoms.
  • To determine if FeNO is associated with maternal asthma history, atopy, blood eosinophilia, lung function, or airway responsiveness in this cohort.
  • To establish the clinical utility of FeNO measurement in young children.

Main Methods:

  • A cohort of 136 infants (median age 16.4 months) with recurrent lower respiratory tract symptoms underwent FeNO measurement, lung function tests, and dosimetric methacholine challenge tests.
  • FeNO levels were analyzed in relation to maternal asthma history, atopy, blood eosinophilia, and airway responsiveness.
  • Elevated FeNO was defined as the highest quartile (≥ 27 ppb).

Main Results:

  • The median FeNO level was 19.3 ppb.
  • Elevated FeNO was significantly associated with a maternal history of asthma (adjusted OR 3.2) and increased airway responsiveness (adjusted OR 4.1).
  • No significant association was found between elevated FeNO and atopy, blood eosinophilia, or standard lung function parameters.

Conclusions:

  • Maternal history of asthma and increased airway responsiveness are key factors associated with elevated FeNO in infants presenting with recurrent lower respiratory tract symptoms.
  • FeNO may serve as a valuable indicator of underlying airway inflammation and hyperresponsiveness in this population.
  • Further research is warranted to elucidate the predictive value of FeNO in early childhood respiratory conditions.

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