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Fractional Exhaled Nitric Oxide for Identification of Uncontrolled Asthma in Children

Raj Kumar Meena1, Dinesh Raj, Rakesh Lodha

  • 1Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Correspondence to: Professor SK Kabra, Division of Pulmonology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029, India. skkabra@hotmail.com.

Indian Pediatrics
|May 10, 2016
PubMed

Insights

Fractional Exhaled Nitric Oxide (FENO) testing did not effectively identify uncontrolled asthma in children undergoing therapy. Specific FENO cut-off values lacked the sensitivity and specificity needed to reliably assess asthma control.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Respiratory Medicine

Background:

  • Asthma is a common chronic respiratory disease in children, requiring ongoing management and monitoring.
  • Assessing asthma control is crucial for effective treatment and preventing exacerbations.
  • Fractional Exhaled Nitric Oxide (FENO) is a biomarker used in asthma management, but its utility in identifying uncontrolled asthma in children on therapy needs further evaluation.

Purpose of the Study:

  • To evaluate the effectiveness of Fractional Exhaled Nitric Oxide (FENO) in identifying uncontrolled asthma among pediatric patients receiving treatment.
  • To determine an optimal FENO cut-off value for differentiating between controlled and uncontrolled asthma in this population.

Main Methods:

  • A cohort of 207 children (aged 5-15 years) with physician-diagnosed asthma on therapy were enrolled with a minimum 12-month follow-up.
  • Spirometry and FENO measurements were conducted, and asthma control was assessed according to GINA guidelines.
  • The sensitivity and specificity of various FENO cut-off values (15, 20, 25, 30 ppb) were calculated to assess their discriminatory power.

Main Results:

  • The majority of children (75%, n=156) had uncontrolled or partly controlled asthma, while 51 children had controlled asthma.
  • Median FENO levels were similar between children with controlled (16 ppb) and uncontrolled asthma (13 ppb), with no statistically significant difference (P=0.26).
  • No tested FENO cut-off value demonstrated a satisfactory balance of sensitivity and specificity for distinguishing between controlled and uncontrolled asthma.

Conclusions:

  • Fractional Exhaled Nitric Oxide (FENO) alone does not possess sufficient discriminatory value for assessing asthma control status in children undergoing asthma therapy.
  • Further research may be needed to explore the role of FENO in conjunction with other clinical parameters for improved asthma management in pediatric populations.
Abstract

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