Abstract
Fractional exhaled nitric oxide (FeNO) is a non-invasive test for evaluating the degree of airway inflammation and for the diagnosis, evaluation, and treatment of asthma. We attempted to measure FeNO levels in Korean children with asthma and determine its cutoff value for diagnosing asthma. We enrolled 176 children and adolescents between the ages of 5 and 18 years, who visited for the evaluation of chronic cough, shortness of breath, and wheezing. Among them, 138 patients who underwent skin prick tests or inhalation Immuno CAP (UniCAP; Pharmacia, Uppsala, Sweden) tests for allergy testing together with a pulmonary function test were included. FeNO was measured using a NIOX MINO (Aerocrine AB, Solna, Sweden) instrument according to the American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines. There were 29 patients with asthma, 43 with rhinitis, and 38 with asthma and allergic rhinitis. In the asthma group, FeNO levels significantly correlated with total immunoglobulin E (r = 0.572, p < 0.001), but did not show significant correlation with pulmonary function test parameters (forced vital capacity—FVC, forced expiratory volume in one second—FEV1, FEV1/FVC) or PC20 (provocative concentration of methacholine causing a 20% fall in FEV1). The FeNO cutoff values obtained in the asthma and asthma rhinitis groups were 16.5 ppb and 18.5 ppb, respectively. Hence, we provide a FeNO cutoff value according to the presence or absence of rhinitis in pediatric patients with asthma.
Highlights
Asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness and reversible airway obstruction
Fractional exhaled nitric oxide (FeNO) levels significantly correlated with total immunoglobulin E (r = 0.572, p < 0.001), but did not show significant correlation with pulmonary function test parameters or PC20
Fractional exhaled nitric oxide (FeNO) is a tool, that reflects the degree of eosinophilic airway inflammation and has the advantage of being relatively easy to perform and is noninvasive; it has been increasingly utilized in recent years [3]
Summary
Asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness and reversible airway obstruction. Pulmonary function tests have been widely used for the diagnosis and evaluation of the severity of asthma, as well as for guiding treatment, while sputum tests and bronchoalveolar lavage have been used to evaluate the degree of airway inflammation. Fractional exhaled nitric oxide (FeNO) is a tool, that reflects the degree of eosinophilic airway inflammation and has the advantage of being relatively easy to perform and is noninvasive; it has been increasingly utilized in recent years [3]. This test is especially useful for evaluating airway inflammation in children, in whom it is difficult to perform sputum collection or bronchoalveolar lavage [4]. Since the measured value can be influenced by several factors, standard test guidelines were developed by the American
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