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[Related factors for asthmatic children's responses to long-term treatment]
Xiao-Ying Liu1, Jing Wang, Qun Wang
1Allergy Department, Beijing Children's Hospital, Capital Medical University, 100045 Beijing, China. drxiangli@163.com.
Insights
Monitoring pulmonary function and fractional exhaled nitric oxide (FeNO) helps assess treatment response in children with asthma. Stable responders showed better lung function and FeNO levels compared to unstable responders.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Biomarkers in Asthma
Context:
- Asthma management in children requires effective monitoring of treatment efficacy.
- Individual responses to asthma control therapies can vary significantly.
- Fractional exhaled nitric oxide (FeNO) and pulmonary function tests are key indicators of airway inflammation and obstruction.
Purpose:
- To investigate changes in pulmonary function and FeNO in pediatric asthma patients with differing treatment responses.
- To compare lung function parameters (FEV1/FVC, MMEF%) and FeNO levels between stable and unstable asthmatic children.
- To evaluate the utility of continuous monitoring of these parameters for early treatment response assessment.
Summary:
- A 9-month study followed 52 children with asthma on regular treatment.
- Children with a stable treatment response required lower-level controller medications and demonstrated significantly better FEV1/FVC and MMEF% compared to unstable responders.
- Stable responders also showed higher FeNO levels at initial evaluation and 3 months, suggesting FeNO's role in early assessment.
Impact:
- Continuous monitoring of FEV1/FVC, MMEF%, and FeNO aids in the early identification of treatment response in pediatric asthma.
- These findings can inform personalized asthma management strategies.
- Improved monitoring may lead to timely adjustments in therapy, enhancing asthma control and patient outcomes.
Objective:
To study the changes in pulmonary function and fractional exhaled nitric oxide in exhaled breath (FeNO) in asthmatic children who have different responses to regular treatment.
Methods:
A total of 52 asthmatic children who had a good compliance with regular stepped control treatment were selected as subjects. They were followed up every three months to evaluate the asthma control level, pulmonary ventilation function, and FeNO for 9 months. Besides, medications for asthma control were recorded.
Results:
At three follow-up points (months 3, 6, and 9), the percentage of asthmatic children who used the first or the second level of control treatment in the stable group (with stable response to the treatment) was significantly higher than in the unstable group (with unstable response to the treatment) (P<0.05), while the percentage of asthmatic children who used the third level of control treatment in the stable group was significantly lower than in the unstable group (P<0.05). At the three follow-up points, the stable group had a significantly higher ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) than the unstable group (P<0.05); at the 3-month and 9-month follow-up points, the stable group had a significantly higher percentage of predicted maximum mid-expiratory flow (MMEF%) than the unstable group (P<0.05); at the initial evaluation and 3-month follow-up point, the stable group had a significantly higher FeNO than the unstable group (P<0.05).
Conclusions:
Continuously monitoring FEV1/FVC, MMEF% and FeNO is useful in the early evaluation of the responses to treatment in children with asthma.
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