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Exhaled nitric oxide in symptomatic children at preschool age predicts later asthma

F Singer1, I Luchsinger, D Inci

  • 1Division of Respiratory Medicine, University Children's Hospital Bern, University of Bern, Bern, Switzerland.

Allergy
|February 19, 2013
PubMed

Insights

Fraction of exhaled nitric oxide (FeNO) can help predict asthma in preschool children. Elevated FeNO levels are linked to a higher risk of developing asthma by school age, offering a non-invasive predictive tool.

Area of Science:

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

Background:

  • Predicting childhood asthma is challenging due to a lack of objective clinical measures.
  • Fraction of exhaled nitric oxide (FeNO) is a biomarker for airway inflammation.

Purpose of the Study:

  • To assess if FeNO levels in preschool children with respiratory symptoms are associated with asthma at school age.
  • To develop and evaluate a new asthma predictive index (API) incorporating FeNO.

Main Methods:

  • A prospective study of 391 preschool children (3-47 months) with lower airway symptoms.
  • Measured blood IgE, eosinophils, and offline FeNO at baseline.
  • Developed an API with high FeNO as a major criterion; asthma diagnosed via standardized interviews at school age (n=166).

Main Results:

  • FeNO was significantly higher in children who developed asthma (median 10.5 ppb) compared to those who did not (median 7.4 ppb).
  • Each 5 ppb increase in FeNO raised asthma odds by 2.44 (95% CI: 1.61-3.70), even after adjusting for confounders.
  • The new FeNO-based API showed a 58.0% probability for later asthma in at-risk children, with a 78.2% negative predictive value.

Conclusions:

  • Elevated FeNO in high-risk preschool children is associated with an increased risk of school-age asthma.
  • The novel API, incorporating FeNO, effectively identifies children at risk for later asthma.
  • This FeNO-based API offers a non-invasive alternative to traditional methods, avoiding blood sampling.
Abstract

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