Fractional exhaled nitric oxide measurements are most closely associated with allergic sensitization in school-age children

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:124

Article

Jackson, Daniel J.^1,2  Virnig, Christine M.²  Gangnon, Ronald E.^3,4  Evans, Michael D.³  Burton, Ryan M.²  Lemanske, Robert F., Jr.² 

[1] Univ Wisconsin, Sch Med & Publ Hlth, Dept Pediat, Madison, WI 53792 USA

[2] Univ Wisconsin, Dept Med, Madison, WI 53792 USA

[3] Univ Wisconsin, Dept Biostat & Med Informat, Madison, WI 53792 USA

[4] Univ Wisconsin, Dept Populat Hlth Sci, Madison, WI 53792 USA

关键词: Fractional exhaled nitric oxide (FeNO);    asthma;    allergic sensitization;    atopic dermatitis;    lung junction;    children;    seasonality;    atopy;   

DOI  :  10.1016/j.jaci.2009.07.024

来源: Elsevier

【 摘 要 】

Background: Factors affecting fractional exhaled nitric oxide (FeNO) in early childhood are incompletely understood. Objective: To examine the relationships between FeNO and allergic sensitization, total IgE, atopic dermatitis, rhinitis, asthma, and lung function (spirometry) in children. Methods: Children at high risk of asthma and other allergic diseases because of parental history were enrolled at birth and followed prospectively. FeNO was measured by an online technique at ages 6 and 8 years. Relationships among FeNO, various atopic characteristics, and asthma were evaluated. Results: Reproducible FeNO measurements were obtained in 64% (135/210) of 6-year-old and 93% (180/194) of 8-year-old children. There was seasonal variability in FeNO. Children with aeroallergen sensitization at ages 6 and 8 years had increased levels of FeNO compared with those not sensitized (geometric mean; 6 years, 10.9 vs 6.7 parts per billion [ppb], P < .0001; 8 years, 14.6 vs 7.1 ppb, P < .0001). FeNO was higher in children with asthma than in those without asthma at 8 years but not 6 years of age (6 years, 9.2 vs 8.3 ppb, P = .48; 8 years, 11.5 vs 9.2 ppb, P = .03). At 8 years of age, this difference was no longer significant in a multivariate model that included aeroallergen sensitization (P = .33). There were no correlations between FeNO and spirometric indices at 6 or 8 years of age. Conclusion: These findings underscore the importance of evaluating allergen sensitization status when FeNO is used as a potential biomarker in the diagnosis and/or monitoring of atopic diseases, particularly asthma. (J Allergy Clin Immunol 2009;124:949-53.)

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