Department of Child Health, Clinical Institute, Queen's University of Belfast, Belfast, UK.
Pediatr Allergy Immunol. 2010 Dec;21(8):1107-13. doi: 10.1111/j.1399-3038.2010.01071.x.
Asthma is a major risk cofactor for anaphylactic deaths in children with peanut allergy. Peanut allergy is generally thought to be a lifelong condition, but some children outgrow their coexistent asthma. It has recently been shown that children who have 'outgrown' their asthma symptoms may have ongoing eosinophilic airways inflammation. The need for regular inhaled corticosteroid treatment in peanut allergic children and adolescents who have outgrown their asthma is however unclear. The aims of our study were to look at fractional exhaled nitric oxide levels (FeNO), as a non-invasive marker of eosinophilic airways inflammation, in peanut allergic children and assess whether children with outgrown asthma had elevated levels. Children with peanut allergy were recruited at two pediatric allergy clinics in Belfast, UK. Exhaled nitric oxide levels (FeNO) were measured using the Niox Mino in all children. Of the 101 peanut allergic children who consented for enrollment in the study, 94 were successfully able to use the NIOX Mino. Age range was 4-15 yr (median 10 yr); 61% were boys. Thirty (32%) had never wheezed, 37 (39%) had current treated asthma, 20 (21%) had at least 1 wheezing episode within the last year but were not taking any regular asthma medication (wheeze no treatment), and 7 (7%) had outgrown asthma. All children with outgrown asthma had elevated levels of FeNO (> 35 ppb), and 75% of children defined as 'wheeze no treatment' had elevated FeNO levels (> 35 ppb). Outgrown asthma and children defined as 'wheeze no treatment' had higher levels of FeNO than those with no history of wheeze or current treated asthma (p = 0.003). In children with peanut allergy, we found that those who had outgrown asthma had elevated FeNO levels in keeping with ongoing eosinophilic airways inflammation.
哮喘是儿童花生过敏过敏性死亡的主要危险因素。一般认为花生过敏是一种终身疾病，但有些儿童会摆脱其并存的哮喘。最近有研究表明，“摆脱”哮喘症状的儿童可能存在持续的嗜酸性气道炎症。然而，对于已摆脱哮喘的花生过敏儿童和青少年，是否需要常规吸入皮质类固醇治疗尚不清楚。我们的研究目的是观察花生过敏儿童呼出气一氧化氮分数（FeNO），作为嗜酸性气道炎症的非侵入性标志物，并评估是否有“摆脱”哮喘的儿童其水平升高。在英国贝尔法斯特的两个儿科过敏诊所招募了花生过敏儿童。所有儿童均使用 Niox Mino 测量呼气一氧化氮水平（FeNO）。在同意参加这项研究的 101 名花生过敏儿童中，94 名成功使用了 NIOX Mino。年龄范围为 4-15 岁（中位数 10 岁）；61%为男孩。30 名（32%）从未喘息过，37 名（39%）目前有治疗性哮喘，20 名（21%）在过去一年中至少有 1 次喘息发作但未服用任何常规哮喘药物（无治疗性喘息），7 名（7%）已摆脱哮喘。所有“摆脱”哮喘的儿童的 FeNO 水平均升高（>35 ppb），75%的定义为“无治疗性喘息”的儿童的 FeNO 水平升高（>35 ppb）。“摆脱”哮喘和“无治疗性喘息”的儿童的 FeNO 水平高于无喘息或目前有治疗性哮喘的儿童（p=0.003）。在花生过敏儿童中，我们发现那些已“摆脱”哮喘的儿童的 FeNO 水平升高，提示持续存在嗜酸性气道炎症。
