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Correlation Between Fractional Exhaled Nitric Oxide Levels and Efficacy of Inhaled Corticosteroids in Children With
Si-Ju Gao1, Yun-Peng Ge, Chun-Juan Zhang
1Department of Pediatrics, Linyi People's Hospital, Linyi, China.
Insights
Fractional exhaled nitric oxide (FeNO) levels may indicate how well inhaled corticosteroids work for children with asthma. Lower FeNO levels correlated with better treatment outcomes and asthma control in the study.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Bronchial asthma is a common chronic respiratory disease in children.
- Inhaled corticosteroids (ICS) are a cornerstone of asthma management.
- Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation.
Purpose of the Study:
- To investigate the correlation between FeNO levels and the efficacy of ICS in pediatric patients with bronchial asthma.
- To assess the impact of ICS treatment on FeNO levels and other asthma control parameters.
- To explore the relationship between FeNO and markers of inflammation and asthma control.
Main Methods:
- A randomized controlled trial involving 133 children with bronchial asthma, divided into ICS (Seretide/Pulmicort) and non-ICS groups.
- A control group of 72 healthy children was included for comparison.
- Measurements included FeNO, spirometry (FEV1/pred, FEV1/FVC), induced sputum eosinophils (EOS%), total serum IgE, and Childhood Asthma Control Test (C-ACT) scores, assessed at baseline and 3 and 6 months post-treatment.
Main Results:
- ICS treatment significantly improved FeNO levels, lung function (FEV1/pred, FEV1/FVC), sputum EOS%, serum IgE, and C-ACT scores compared to baseline.
- The ICS group showed significantly lower FeNO levels, sputum EOS%, and serum IgE, and higher C-ACT scores compared to the non-ICS group.
- In the ICS group, FeNO levels positively correlated with sputum EOS% and total serum IgE, and negatively correlated with C-ACT scores.
Conclusions:
- FeNO levels may serve as a useful biomarker for monitoring the efficacy of inhaled corticosteroids in children with bronchial asthma.
- Lower FeNO levels are associated with reduced airway inflammation and improved asthma control following ICS therapy.
- FeNO measurement can aid in assessing treatment response and guiding asthma management in pediatric populations.
Abstract:
To investigate correlation between fractional exhaled nitric oxide (FeNO) levels and efficacy of inhaled corticosteroids in children with bronchial asthma. Between October 2013 and December 2014, 133 cases of children with bronchial asthma were randomly divided into the glucocorticoid group (n = 67; inhaled with Seretide/Pulmicort) and the nonglucocorticoid group (n = 66; inhaled with short-acting β2 receptor agonist if needed); and alternatively 72 cases of healthy children were regarded as the control group. FeNO, forced expiratory volume in 1 second to predicted value, forced expiratory volume in 1 second/forced vital capacity, induced sputum eosinophils (EOS)%, and total serum immunoglobulin (Ig) E and serum EOS% were detected and childhood asthma control test (C-ACT) scale was investigated pretreatment and 3 and 6 months posttreatment, respectively. FeNO levels, induced sputum EOS%, total serum IgE, and serum EOS% were significantly lower, whereas forced expiratory volume in 1 second to predicted value, forced expiratory volume in 1 second/forced vital capacity, and C-ACT scores were obviously improved in the glucocorticoid group 6 months posttreatment compared with those of pretreatment (all P < 0.05). FeNO levels, induced sputum EOS%, and total serum IgE were significantly lower, whereas C-ACT scores were significantly higher in the glucocorticoid group compared with those of the nonglucocorticoid group (all P < 0.05). In the glucocorticoid group, induced sputum EOS% and total serum IgE showed significantly positive correlations with FeNO levels (r = 0.73, P < 0.01; r = 0.56, P < 0.01), whereas C-ACT scores were negatively correlated with FeNO levels (r = -0.67, P < 0.01). FeNO levels might be correlated with efficacy of inhaled corticosteroids in children with bronchial asthma.
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