Rouhos Annamari, Kainu Annette, Karjalainen Jouko, Lindqvist Ari, Piirilä Päivi, Sarna Seppo, Haahtela Tari, Sovijärvi Anssi R A
Division of Respiratory Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Clin Respir J. 2008 Jul;2(3):141-8. doi: 10.1111/j.1752-699X.2007.00045.x.
Elevated fractional exhaled nitric oxide (FENO) associates positively with symptomatic atopy among asthmatics and in the general population. It is, however, unclear whether sensitization to common allergens per se- as verified with positive skin prick tests--affects FENO in healthy individuals.
The aim of this study was to examine the association between FENO and sensitization to common allergens in healthy nonsmoking adults with no signs or symptoms of airway disorders.
FENO measurements (flow rate: 50 mL/s), skin prick tests to common inhalant allergens, structured interviews, spirometry, bronchodilatation tests and bronchial histamine challenges were performed on a randomly selected population of 248 subjects. Seventy-three of them (29%) were nonsmoking asymptomatic adults with no history of asthma, persistent or recurrent upper or lower airway symptoms and no signs of airway disorders in the tests listed above.
FENO concentrations were similar in skin prick test positive (n = 32) and negative (n = 41) healthy subjects, with median values of 13.2 and 15.5 ppb, respectively (P = 0.304). No correlation appeared between FENO and the number of positive reactions (r = -0.138; P = 0.244), or the total sum of wheal diameters (r = -0.135; P = 0.254). The nonparametric one-tailed 95% upper limits of FENO among skin prick positive and negative healthy nonsmoking subjects were 29 and 31 ppb, respectively.
Atopic constitution defined as positive skin prick test results does not increase FENO in healthy nonsmoking adults with no signs or symptoms of airway disorders. This suggests that same reference ranges for FENO can be applied to both skin prick test positive and negative subjects.
呼出气一氧化氮分数(FENO)升高与哮喘患者及普通人群中的症状性特应性呈正相关。然而,通过皮肤点刺试验证实的对常见变应原的致敏本身是否会影响健康个体的FENO尚不清楚。
本研究旨在探讨无气道疾病体征或症状的健康非吸烟成年人中FENO与对常见变应原致敏之间的关联。
对随机选取的248名受试者进行了FENO测量(流速:50 mL/s)、对常见吸入性变应原的皮肤点刺试验、结构化访谈、肺功能测定、支气管扩张试验和支气管组胺激发试验。其中73人(29%)为无哮喘病史、无持续性或复发性上、下气道症状且在上述检查中无气道疾病体征的非吸烟无症状成年人。
皮肤点刺试验阳性(n = 32)和阴性(n = 41)的健康受试者的FENO浓度相似,中位数分别为13.2和15.5 ppb(P = 0.304)。FENO与阳性反应数量(r = -0.138;P = 0.244)或风团直径总和(r = -0.135;P = 0.254)之间均无相关性。皮肤点刺试验阳性和阴性的健康非吸烟受试者中FENO的非参数单尾95%上限分别为29和31 ppb。
皮肤点刺试验结果为阳性所定义的特应性体质并不会使无气道疾病体征或症状的健康非吸烟成年人的FENO升高。这表明FENO的相同参考范围可应用于皮肤点刺试验阳性和阴性的受试者。