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Breath Collection from Children for Disease Biomarker Discovery
Published on: February 14, 2019
Urinary and exhaled biomarkers of exercise-induced bronchoconstriction in atopic asthmatic children
Mario Barreto1, Matilde Capi2, Luana Lionetto2
1Pediatric Unit Sant'Andrea Hospital, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.
Insights
Noninvasive biomarkers like fractional exhaled nitric oxide (FeNO) and urinary adenosine can help assess exercise-induced bronchoconstriction (EIB) in children with asthma. These markers show promise for monitoring asthma control in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Asthma Research
- Biomarker Discovery
Background:
- Exercise-induced bronchoconstriction (EIB) is a key indicator of poor asthma control in children.
- Noninvasive biomarkers are needed for effective monitoring of pediatric asthma patients.
Purpose of the Study:
- To evaluate exhaled and urinary biomarkers for assessing EIB in atopic asthmatic children.
- To identify reliable indicators of EIB in pediatric asthma.
Main Methods:
- Measured fractional exhaled nitric oxide (FeNO) components (CaNO, J'awNO, TMAD), urinary adenosine, 8-OxodG, blood eosinophils, IgE, and spirometry before and after exercise challenge in 45 atopic asthmatic children.
- Included 40 healthy controls for baseline comparisons.
Main Results:
- Patients with EIB showed higher CaNO TMAD and urinary adenosine levels post-exercise compared to those without EIB.
- CaNO TMAD and urinary adenosine were significant predictors of FEV1 decline, while CaNO TMAD also predicted FEF25-75 decline.
- Higher FeNO and urinary adenosine were observed in asthmatic patients compared to controls.
Conclusions:
- Peripheral airway nitric oxide (NO) and urinary adenosine are complementary biomarkers for assessing EIB in pediatric asthma.
- These biomarkers show potential as tools for monitoring asthma control in atopic children.
Background:
Exercise-induced bronchoconstriction (EIB) reflects poor asthma control. Assessing noninvasive biomarkers associated with EIB could help to monitor patients in the pediatric age.
Aims:
To test exhaled and urinary biomarkers for assessing EIB in atopic asthmatic children.
Methods:
In 45 atopic patients (11.1 ± 1.8 years, 25 males) we measured the fractional exhaled nitric oxide (FENO ), its alveolar (CaNO), and bronchial (J'awNO) components corrected for the trumpet shape of the airways and axial NO diffusion (TMAD), concentrations of urinary adenosine and 8-hydroxy-2'-deoxyguanosine (8-OxodG), blood eosinophils count, total immunoglobulin E , skin prick tests, and baseline spirometry before a treadmill exercise challenge. Forty healthy control subjects participated solely to baseline measurements.
Results:
Patients yielded higher FENO and urinary adenosine concentrations than healthy controls. After the challenge, 18 patients (40%) had EIB; these patients had higher levels of CaNO, CaNO TMAD, and urinary adenosine than patients without EIB. Baseline spirometry, FE NO , JawNO, JawNO TMAD, urinary 8-OxodG, allergy, and blood eosinophil counts were found similar in both groups. In multiple linear regression, the fall in FEV 1 was explained by CaNO TMAD, urinary adenosine and blood eosinophil count, whereas the fall in FEF 25-75 was explained by CaNO TMAD and blood eosinophil count. Both CaNO TMAD ≥10.5 ppb and urinary adenosine ≥406 nmol/mmol Cr predicted a fall in FEV 1 ≥10%, while only CaNO TMAD ≥10.5 ppb predicted a fall in FEF 25-75 ≥26%.
Conclusion:
Concentrations of peripheral airway NO are complementary with urinary adenosine for assessing EIB and promising tools of asthma control in pediatric patients with the atopic phenotype.
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