Related Experiment Video
Updated: May 28, 2026
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Subclinical Respiratory Involvement in Children with Inflammatory Bowel Disease: FeNO Elevation in Active Disease
Višnja Tokić Pivac1, Sanja Kolaček1,2, Iva Hojsak1,2,3
1Children's Hospital Zagreb, Klaićeva 16, 10000 Zagreb, Croatia.
Insights
Children with inflammatory bowel disease (IBD) show higher fractional exhaled nitric oxide (FeNO) levels, correlating with inflammation markers like CRP. However, their respiratory function remains normal, and FeNO
Area of Science:
- Pediatric Gastroenterology
- Pulmonology
- Biomarkers
Background:
- Inflammatory bowel disease (IBD) involves chronic gastrointestinal inflammation.
- Extrapulmonary manifestations, including airway inflammation, are recognized in IBD.
- Assessing airway inflammation in pediatric IBD is crucial for comprehensive management.
Purpose of the Study:
- To evaluate fractional exhaled nitric oxide (FeNO) and spirometry in pediatric IBD patients.
- To correlate FeNO and spirometry findings with IBD disease activity, duration, and treatment.
- To investigate FeNO as a potential biomarker for systemic inflammation in pediatric IBD.
Main Methods:
- Prospective case-control study involving 161 participants: active IBD (N=55), IBD in remission (N=53), and healthy controls (N=53).
- FeNO measurement using a chemiluminescent analyzer.
- Pulmonary function assessment via spirometry.
Main Results:
- Elevated FeNO levels were observed in pediatric IBD patients compared to controls (p=0.025).
- FeNO positively correlated with C-reactive protein (CRP) (ρ=0.22; p=0.027), indicating a link to systemic inflammation.
- Spirometry revealed preserved respiratory function in children with IBD, with no significant associations between respiratory parameters, disease activity, or duration.
Conclusions:
- Pediatric IBD patients exhibit increased FeNO despite normal spirometry results.
- FeNO correlates with systemic inflammation markers (CRP) in pediatric IBD.
- The clinical utility of FeNO for monitoring IBD activity or predicting relapse requires further investigation.
Abstract:
Objectives: We aimed to assess fractional exhaled nitric oxide (FeNO) and spirometry in pediatric patients with inflammatory bowel disease (IBD) and relate these parameters to disease activity, duration, and current treatment. Methods: This prospective case-control study included 161 subjects: children with newly diagnosed, active IBD (N = 55), children in clinical remission (N = 53), and healthy controls (N = 53). FeNO was measured using a chemiluminescent analyzer, and pulmonary function was assessed by spirometry. Results: FeNO was higher in patients with IBD than in controls (p = 0.025) and positively correlated with CRP (ρ = 0.22; p = 0.027). Respiratory function measured by spirometry in children with IBD was preserved. No association was found between respiratory parameters, disease activity, and duration. The correlation between FeNO and aminosalicylate treatment was of borderline significance (ρ = 0.28; p = 0.052). Conclusions: Children with IBD, although having normal pulmonary function measured by spirometry, do have increased FeNO, which is positively correlated with CRP. FeNO reflects systemic inflammation, but its role as a clinical marker of disease activity or relapse remains uncertain.
Related Concept Videos
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:13Asthma III: Clinical Manifestations
01:20Inflammatory Bowel Disease IV: Clinical Manifestations
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...