Expired nitric oxide and airway reactivity in infants at risk for asthma

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:122

Article

Tepper, Robert S.¹  Llapur, Conrado J.²  Jones, Marcus H.³  Tiller, Christina¹  Coates, Cathy¹  Kimmel, Risa¹  Kisling, Jeffrey¹  Katz, Barry⁴  Ding, Yan⁴  Swigonski, Nancy¹ 

[1] Indiana Univ, Med Ctr, James Whitcomb Riley Hosp Children, Dept Pediat,Wells Ctr Pediat Res, Indianapolis, IN 46202 USA

[2] Univ Nacl Tucuman, Fac Med, Hosp Nino Jesus, Dept Pediat,Catedra Metodol Invest, San Miguel De Tucuman, Argentina

[3] Pontificia Univ Catolica Rio de Janeiro, Dept Pediat, Porto Alegre, Brazil

[4] Indiana Univ, Med Ctr, Dept Biostat, Indianapolis, IN 46202 USA

关键词: atopy;    eczema;    airway reactivity;   

DOI  :  10.1016/j.jaci.2008.07.022

来源: Elsevier

【 摘 要 】

Background: Family histories of atopy, as well as histories of atopic dermatitis and food allergy, are important risk factors for an infant to have asthma. Although atopic sensitization appears to contribute to the development of asthma, it is unclear when the airways become involved with the atopic process and whether airway function relates to the atopic characteristics of the infant. Objective: We sought to evaluate whether atopic infants without prior episodes of wheezing have increased expired nitric oxide (eNO) levels and heightened airway reactivity. Methods: Infants with eczema were recruited, and atopic status was defined by specific IgE levels to foods or aeroallergens and total IgE levels. eNO, forced expiratory flow at 75% exhaled volume (FEF(75)), and airway reactivity to inhaled methacholine were measured in sedated infants. Airway reactivity was quantified by using the provocative concentration to decrease FEF75 by 30%. Results: Median age for the 114 infants evaluated was 10.7 months (range, 2.6-19.1 months). Infants sensitized to egg or milk compared with infants sensitized to neither egg nor milk had lower flows (FEF75: 336 vs 285 mL/s, P < .003) and lower InPC(30) (mg/mL) provocative concentrations to decrease FEF75 by 30% (-0.6 vs -1.2, P < .02) but no difference in eNO levels. Infants with total serum IgE levels of greater than 20 IU/mL had higher eNO levels compared with infants with IgE levels of 20 IU/mL or less (14.6 vs 11.2 ppb, P < .023) but no difference in forced flows or airway reactivity. Conclusions: Our findings suggest that atopic characteristics of the infant might be important determinants of the airway physiology of forced expiratory flows, airway reactivity, and eNO.

【 授权许可】

Free