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The role of exhaled nitric oxide assessment in children with bronchial asthma
Sorana Staticescu1, Paraschiva Chereches Panta1, Simona Tatar1
1Pediatric Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Insights
Exhaled nitric oxide (eNO) levels can indicate bronchial inflammation in children with asthma. Higher eNO values are more common in uncontrolled asthma, suggesting eNO is a useful marker for assessing disease status and treatment response.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Exhaled nitric oxide (eNO) is a non-invasive marker for airway inflammation.
- Bronchial asthma (BA) in children often involves significant bronchial inflammation.
Purpose of the Study:
- To evaluate the utility of eNO assessment in diagnosing and monitoring bronchial inflammation in children with asthma.
- To correlate eNO levels with asthma control, atopic status, and treatment.
Main Methods:
- 110 children (5-18 years) with BA underwent clinical assessment, spirometry, induced sputum analysis, and eNO measurement.
- Patients were categorized by asthma control (controlled, partially controlled, uncontrolled) and atopic status.
Main Results:
- Elevated eNO levels were observed in a majority of children with non-atopic (72.72%) and atopic (54.54%) asthma.
- Significant differences in eNO levels were found between asthma control groups (p=0.003).
- Normal eNO was more frequent in patients on inhaled glucocorticoids (IGC) and those with low sputum eosinophils.
Conclusions:
- eNO measurement is a valuable tool for assessing airway inflammation in pediatric asthma.
- eNO levels can help determine disease responsiveness and guide therapy adjustments.
Background:
Exhaled nitric oxide (eNO) assessment in children with bronchial asthma (BA) is an easy and non-invasive test that provides informations on the presence of bronchial inflammation.
Methods:
The study included 110 children aged between 5-18 years with a diagnosis of BA. The patients were assessed clinically (objective examination, questionnaire regarding the disease control) and by medical tests (exhaled breath analysis for nitric oxide, induced sputum, spirometry).
Results:
Of the 33 patients with non-atopic BA, 9 (27.27%) presented normal eNO values, and 24 (72.72%) had higher than normal levels. There were 26 patients with controlled BA, 59 with partially controlled BA and 25 with uncontrolled BA, the levels of eNO demonstrating the existence of the statistically significant differences between the mean values of the variables obtained in the studied groups (p=0.003). Increased individual values were more frequently noted in patients with an exacerbation of asthma in the last month (70% vs 56.6%), but the differences were not statistically significant. Of the 77 patients with atopic BA, 35 (45.45%) had normal eNO, while 42 (54.54%) had increased values. The normal values of the eNO were most frequently noted in patients undergoing treatment with inhaled glucocorticoids (IGC). Patients with low percent of eosinophils in sputum had increased eNO values (p=0.03).
Conclusions:
The investigation of the airways by measuring the eNO levels is a useful method of assessing bronchial inflammation in children with bronchial asthma, in order to establish the disease responsiveness and therapy.
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