BACKGROUND: The fractional concentration of exhaled nitric oxide (FeNO) is a noninvasive marker for airway inflammation but requires further study in preschool-aged children to determine its clinical relevance. OBJECTIVE: To determine whether the risk of respiratory tract illnesses (RTIs), disease burden, and atopic features are related to FeNO in preschool-aged children with moderate-to-severe intermittent wheezing. METHODS: We determined FeNO using the off-line tidal breathing technique in 89 children, aged 12 to 59 months, with moderate-to-severe intermittent wheezing. The risk of RTI was determined by comparing participants with a baseline FeNO of greater than the 75th percentile (24.4 ppb) with those with a baseline FeNO at the 75th percentile or lower using Cox regression analysis. RESULTS: The risk of RTI was significantly higher in children with an FeNO of greater than 24.4 ppb relative to those with lower FeNO values (adjusted relative risk, 3.80; 95% confidence interval, 1.74-8.22; P < .001). FeNO levels of greater than 24.4 ppb were associated with more positive skin test results to aeroallergens (P = .03) but not with other atopic characteristics or historic parameters of illness burden. CONCLUSIONS: An elevated FeNO in preschool-aged children with moderate-to-severe intermittent wheezing was associated with an increased risk of RTI during a 1-year follow-up. In addition, a higher FeNO was associated with aeroallergen sensitization.
BACKGROUND: The fractional concentration of exhaled nitric oxide (FeNO) is a noninvasive marker for airway inflammation but requires further study in preschool-aged children to determine its clinical relevance. OBJECTIVE: To determine whether the risk of respiratory tract illnesses (RTIs), disease burden, and atopic features are related to FeNO in preschool-aged children with moderate-to-severe intermittent wheezing. METHODS: We determined FeNO using the off-line tidal breathing technique in 89 children, aged 12 to 59 months, with moderate-to-severe intermittent wheezing. The risk of RTI was determined by comparing participants with a baseline FeNO of greater than the 75th percentile (24.4 ppb) with those with a baseline FeNO at the 75th percentile or lower using Cox regression analysis. RESULTS: The risk of RTI was significantly higher in children with an FeNO of greater than 24.4 ppb relative to those with lower FeNO values (adjusted relative risk, 3.80; 95% confidence interval, 1.74-8.22; P < .001). FeNO levels of greater than 24.4 ppb were associated with more positive skin test results to aeroallergens (P = .03) but not with other atopic characteristics or historic parameters of illness burden. CONCLUSIONS: An elevated FeNO in preschool-aged children with moderate-to-severe intermittent wheezing was associated with an increased risk of RTI during a 1-year follow-up. In addition, a higher FeNO was associated with aeroallergen sensitization.
Authors: Ronina A Covar; Stanley J Szefler; Richard J Martin; D A Sundstrom; Philip E Silkoff; James Murphy; David A Young; Joseph D Spahn Journal: J Pediatr Date: 2003-05 Impact factor: 4.406
Authors: Robert C Strunk; Stanley J Szefler; Brenda R Phillips; Robert S Zeiger; Vernon M Chinchilli; Gary Larsen; Kevin Hodgdon; Wayne Morgan; Christine A Sorkness; Robert F Lemanske Journal: J Allergy Clin Immunol Date: 2003-11 Impact factor: 10.793
Authors: Julie Kuriakose; Maria José Rosa; Matthew Perzanowski; Rachel Miller Journal: Am J Respir Crit Care Med Date: 2012-02-15 Impact factor: 21.405
Authors: Robert S Zeiger; David Mauger; Leonard B Bacharier; Theresa W Guilbert; Fernando D Martinez; Robert F Lemanske; Robert C Strunk; Ronina Covar; Stanley J Szefler; Susan Boehmer; Daniel J Jackson; Christine A Sorkness; James E Gern; H William Kelly; Noah J Friedman; Michael H Mellon; Michael Schatz; Wayne J Morgan; Vernon M Chinchilli; Hengameh H Raissy; Elizabeth Bade; Jonathan Malka-Rais; Avraham Beigelman; Lynn M Taussig Journal: N Engl J Med Date: 2011-11-24 Impact factor: 91.245
Authors: Jason S Debley; David C Stamey; Elizabeth S Cochrane; Kim L Gama; Gregory J Redding Journal: J Allergy Clin Immunol Date: 2010-05-11 Impact factor: 10.793
Authors: Maria José Rosa; Matthew S Perzanowski; Adnan Divjan; Steven N Chillrud; Lori Hoepner; Hanjie Zhang; Robert Ridder; Frederica P Perera; Rachel L Miller Journal: Nitric Oxide Date: 2014-05-27 Impact factor: 4.427
Authors: Meredith C McCormack; Charles Aloe; Jean Curtin-Brosnan; Gregory B Diette; Patrick N Breysse; Elizabeth C Matsui Journal: Chest Date: 2013-09 Impact factor: 9.410
Authors: Maria P White; Tessa K Kolstad; Molly Elliott; Elizabeth S Cochrane; David C Stamey; Jason S Debley Journal: J Asthma Allergy Date: 2020-01-07