Factors associated with exhaled nitric oxide in children with asthma and allergic rhinitis

Clin Respir J. 2020 Jan;14(1):9-15. doi: 10.1111/crj.13093. Epub 2019 Oct 23.

Abstract

Background: Factors attributable to the level of fraction of exhaled nitric oxide (FeNO) in different age groups of asthmatic children are still lack of report.

Objective: To evaluate factors associated with FeNO and the response of FeNO to inhaled steroid in different age groups of asthmatic children with allergic rhinitis.

Methods: Asthmatic children aged 5 to 12 years were recruited. FeNO, lung function and bronchial hyperresponsiveness (BHR) to methacholine, skin prick testing to a panel of aeroallergens, total immunoglobulin E (T-IgE) in serum and eosinophils in blood were tested. Correlations between FeNO and the measured parameters were assessed. FeNO was measured again after the treatment of combined inhaled corticosteroid and long-acting beta-agonist (ICS/LABA) for 4 weeks. Changes in FeNO between different age groups were compared.

Results: A total of 121 eligible subjects were enrolled in and completed this study. Asthmatic children aged 10 to 12 years old had significantly higher FeNO than those between 8 and 9 years and 5 to 7 years of children (both P < 0.01). Greater height/age (P < 0.01) and higher level of total allergen IgE (P < 0.01) are associated with a higher value of FeNO. After 4 weeks of treatment with ICS/LABA, asthma control test scores were significantly increased in all age groups (P < 0.01), while the level of FeNO significantly decreased in the elder age group only (P < 0.01).

Conclusions: Height and T-IgE are well correlated with FeNO in asthmatic children aged 5 to 12 years. Measurement of FeNO is more suitable for evaluating the efficacy of ICS/LABA in elder asthmatic children.

Keywords: allergy; asthma; children; fraction of exhaled nitric oxide (FeNO).

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-Agonists / administration & dosage
  • Adrenergic beta-Agonists / therapeutic use
  • Asthma / drug therapy
  • Asthma / physiopathology*
  • Bronchial Hyperreactivity / immunology
  • Case-Control Studies
  • Child
  • Child, Preschool
  • China / epidemiology
  • Drug Therapy, Combination
  • Eosinophils / immunology
  • Exhalation / physiology*
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Male
  • Methacholine Chloride / administration & dosage
  • Nitric Oxide / metabolism*
  • Respiratory Function Tests / methods
  • Rhinitis, Allergic / drug therapy
  • Rhinitis, Allergic / physiopathology*
  • Skin Tests / methods

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Methacholine Chloride
  • Nitric Oxide
  • Immunoglobulin E