Document Detail


Exhaled nitric oxide, lung function, and exacerbations in wheezy infants and toddlers.
MedLine Citation:
PMID:  20462633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jason S Debley; David C Stamey; Elizabeth S Cochrane; Kim L Gama; Gregory J Redding
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-05-11
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  125     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-01     Completed Date:  2010-08-24     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1228-1234.e13     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Pediatrics, Division of Pulmonary Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA. jason.debley@seattlechildrens.org
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MeSH Terms
Descriptor/Qualifier:
Asthma / diagnosis*,  physiopathology
Breath Tests* / instrumentation,  methods
Bronchodilator Agents / administration & dosage
Female
Humans
Infant
Infant, Newborn
Male
Nitric Oxide / analysis*
Pilot Projects
Predictive Value of Tests
Respiratory Function Tests
Respiratory Sounds
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
I ULI RR025014-01/RR/NCRR NIH HHS; K23 HL077626/HL/NHLBI NIH HHS; K23 HL077626-01A1/HL/NHLBI NIH HHS; K23HL077626/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 10102-43-9/Nitric Oxide
Comments/Corrections
Comment In:
J Allergy Clin Immunol. 2010 Jun;125(6):1235-6   [PMID:  20513520 ]

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