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[Exhale nitric oxide (NO) and respiratory function measured with body plethysmography in children]
1Service de Médecine Néonatale, CHRU, Hôpital Jeanne-de-Flandre, Lille, France.
Insights
Exhaled nitric oxide (NO) levels are elevated in infants with cystic fibrosis and bronchopulmonary dysplasia, indicating airway inflammation. Lung distention influences NO production in young children.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Biomarkers of Inflammation
Context:
- Exhaled nitric oxide (NO) is a potential marker for airway inflammation.
- Limited research exists on exhaled NO in children under three years old.
- Factors influencing NO levels in adults are well-documented, but less so in infants.
Purpose:
- To determine endogenous NO levels in infants with various respiratory diseases.
- To investigate the relationship between NO production and lung function parameters in young children.
- To compare NO levels in infants with and without respiratory conditions.
Summary:
- Exhaled NO levels were significantly higher in infants with bronchopulmonary dysplasia and cystic fibrosis compared to healthy controls.
- Asthma also showed increased NO levels, while recurrent respiratory tract infections did not significantly alter NO production.
- Exhaled NO correlated with trapped lung volume, suggesting a link to dynamic pulmonary hyperinflation.
Impact:
- Establishes exhaled NO as a relevant biomarker for specific respiratory diseases in infants.
- Provides insights into the physiological mechanisms influencing NO production in pediatric lung conditions.
- Highlights the potential for using exhaled NO measurements in diagnosing and monitoring airway inflammation in very young children.
Background:
Exhaled nitric oxide (NO) may be a marker of airway inflammation. Previous studies in adults have shown that the level of NO in exhaled air is influenced by several factors (breath holding, exercise, etc), or by several disease (asthma, congestive heart failure, diseases of the upper respiratory tract, cystic fibrosis, etc). However, few studies have been performed in children less than 3 years of age. The aim of this study was to determine endogenous NO levels in children with various diseases during lung volume measurements.
Patients And Methods:
Fifty-two children aged 18.3 +/- 9.5 months were studied. The population was divided in two groups, according to the underlying disease: a group of 39 children with cystic fibrosis (n = 7), bronchopulmonary dysplasia (n = 17), asthma (n = 7) or recurrent respiratory tract infections (n = 8) and a second group of 13 children without respiratory disease. Lung function was measured by whole body plethysmography and several respiratory parameters were calculated (functional residual capacity [FRC], compliance and resistances of the respiratory system, trapped volume). NO production was measured on a chemiluminescence analyzer from mixed exhaled air collected into a bag, over a period of 5 minutes.
Results:
NO production was related to disease: exhaled NO levels were three times higher in bronchopulmonary dysplasia and cystic fibrosis, compared to NO levels in children without respiratory disease. They were higher in asthma. They were not altered in recurrent respiratory tract infections. No correlation was found between respiratory parameters and NO production. However, exhaled NO levels were correlated to trapped volume, which defined dynamic part of pulmonary hyperinflation.
Conclusion:
Levels of endogenous NO in infants were similar to those measured in adults with and without inflammatory respiratory disease. Lung distention influenced exhaled NO production.