BACKGROUND: There are limited data assessing the relationship between fraction of exhaled nitric oxide and lung function or exacerbations in infants with recurrent wheezing. OBJECTIVES: In a longitudinal pilot study of children less than 2 years old, we assessed whether baseline fraction of exhaled nitric oxide was associated with lung function, bronchodilator responsiveness, changes in lung function, or subsequent exacerbations of wheezing. METHODS: Forced expiratory flows and volumes using the raised-volume rapid thoracic compression method were measured in 44 infants and toddlers (mean age, 15.7 months) with recurrent wheezing. Single-breath exhaled nitric oxide (SB-eNO) was measured at 50 mL/s. Lung function was again measured 6 months after enrollment. RESULTS: At enrollment, forced expiratory volume in 0.5 seconds (FEV(0.5)), forced expiratory flow at 25% to 75% of expiration (FEF(25-75)), and forced expiratory flow at 75% of expiration (FEF(75)) z scores for the cohort were significantly less than zero. There was no correlation between enrollment SB-eNO levels and enrollment lung function measures. SB-eNO levels were higher in infants with bronchodilator responsiveness (46.1 vs 23.6 ppb, P < .001) and was associated with a decrease in FEV(0.5) (r = -0.54, P = .001), FEF(25-75) (r = -0.6, P < .001), and FEF(75) (r = -0.55, P = .001) over 6 months. A 10-ppb increase in SB-eNO level was associated with a 0.4-point z score decrease in FEV(0.5), a 0.4-point z score decrease in FEF(25-75), and a 0.42-point z score decrease in FEF(75). SB-eNO level was superior to lung function and bronchodilator responsiveness in predicting subsequent wheezing treated with systemic steroids. CONCLUSIONS: SB-eNO level might predict changes in lung function and risk of future wheezing and holds promise as a biomarker to predict asthma in wheezy infants and toddlers. Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
BACKGROUND: There are limited data assessing the relationship between fraction of exhaled nitric oxide and lung function or exacerbations in infants with recurrent wheezing. OBJECTIVES: In a longitudinal pilot study of children less than 2 years old, we assessed whether baseline fraction of exhaled nitric oxide was associated with lung function, bronchodilator responsiveness, changes in lung function, or subsequent exacerbations of wheezing. METHODS: Forced expiratory flows and volumes using the raised-volume rapid thoracic compression method were measured in 44 infants and toddlers (mean age, 15.7 months) with recurrent wheezing. Single-breath exhaled nitric oxide (SB-eNO) was measured at 50 mL/s. Lung function was again measured 6 months after enrollment. RESULTS: At enrollment, forced expiratory volume in 0.5 seconds (FEV(0.5)), forced expiratory flow at 25% to 75% of expiration (FEF(25-75)), and forced expiratory flow at 75% of expiration (FEF(75)) z scores for the cohort were significantly less than zero. There was no correlation between enrollment SB-eNO levels and enrollment lung function measures. SB-eNO levels were higher in infants with bronchodilator responsiveness (46.1 vs 23.6 ppb, P < .001) and was associated with a decrease in FEV(0.5) (r = -0.54, P = .001), FEF(25-75) (r = -0.6, P < .001), and FEF(75) (r = -0.55, P = .001) over 6 months. A 10-ppb increase in SB-eNO level was associated with a 0.4-point z score decrease in FEV(0.5), a 0.4-point z score decrease in FEF(25-75), and a 0.42-point z score decrease in FEF(75). SB-eNO level was superior to lung function and bronchodilator responsiveness in predicting subsequent wheezing treated with systemic steroids. CONCLUSIONS:SB-eNO level might predict changes in lung function and risk of future wheezing and holds promise as a biomarker to predict asthma in wheezy infants and toddlers. Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
Authors: M Jones; R Castile; S Davis; J Kisling; D Filbrun; R Flucke; A Goldstein; C Emsley; W Ambrosius; R S Tepper Journal: Am J Respir Crit Care Med Date: 2000-02 Impact factor: 21.405
Authors: A B Goldstein; R G Castile; S D Davis; D A Filbrun; R L Flucke; K S McCoy; R S Tepper Journal: Am J Respir Crit Care Med Date: 2001-08-01 Impact factor: 21.405
Authors: Daniel Chang; Weiguo Yao; Christina J Tiller; Jeffrey Kisling; James E Slaven; Zhangsheng Yu; Mark H Kaplan; Robert S Tepper Journal: Eur Respir J Date: 2014-09-26 Impact factor: 16.671
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