Source: Annual Congress 2002 - The role of inflammatory markers in children with asthma
Disease area: Airway diseases, Paediatric lung diseases

Abstract

The meaning of increased exhaled nitric oxide (eNO) in non-asthmatic subjects with chronic respiratory symptoms (CRS) or in subjects without a history of CRS is still controversial. We aimed to compare eNO outcomes from different criteria of atopy in 348 unselected schoolchildren (mean age 10.2 yrs, range 8.2-11.7, 158 males). eNO was collected in 1-L mylar bags (exhalation flow 58 mL/s, pressure 10 cmH2O) and analyzed by chemioluminiscence; subjects undergone skin prick tests for Dermatophagoides (pteronissinus and farinae), mixed grass, mixed trees, Alternaria tenuis and cat dander; parents were asked to complete a validated questionnaire on respiratory symptoms. Atopy was defined as the presence of at least one positive skin reaction (a wheal >= 3 mm); the sum of positive wheals (prick index) and its frequency distribution was calculated. Atopic-asthmatic (AA) subjects showed significantly higher geometric mean (95% CI) eNO levels than non-atopic asthmatic (NAA) subjects [20.3 (15.5 to 26.6) ppb vs 10.7 (8.5 to 13.4) ppb, p=0.004]; however, atopic subjects with no respiratory symptoms (NRS), persistent rhinitis alone (PRA) or lower respiratory tract symptoms other than asthma (LRTS) showed no different eNO levels than their non-atopic counterparts. When a prick index over the 33° percentile (> 6 mm) was used for comparison of eNO outcomes, differences in all groups increased; e.g. atopic vs non-atopic NRS subjects [16.0 (12.5 to 20.5) ppb vs 9.8 (9.1 to 10.4) ppb, p=0.035], atopic vs non-atopic LRTS subjects [18.9 (13.3 to 26.1) ppb vs 10.2 (8.9 to 11.7) ppb, p=0.005]. We conclude that increased eNO in unselected children highly suggest atopic airway inflammation independently of the presence of asthma.

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M. Barreto, M. P. Villa, S. Martella, Z. Bohmerova, C. Falasca, M. T. Darder, M. Montesano, R. Ronchetti (Rome, Italy). Measurements of atopy and airway inflammation in unselected schoolchildren. Eur Respir J 2002; 20: Suppl. 38, 935

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