Columbia Center for Children's Environmental Health (CCCEH), Columbia University, New York, New York 10032, USA.
Pediatr Pulmonol. 2011 Jan;46(1):83-91. doi: 10.1002/ppul.21328. Epub 2010 Sep 16.
To determine the feasibility of using a multiple flow offline fractional exhaled nitric oxide (FeNO) collection method in an inner-city cohort and determine this population's alveolar and conducting airway contributions of NO. We hypothesized that the flow independent NO parameters would be associated differentially with wheeze and seroatopy.
As part of a birth cohort study, 9-year-old children (n=102) of African-American and Dominican mothers living in low-income NYC neighborhoods had FeNO samples collected offline at constant flow rates of 50, 83, and 100 ml/sec. Seroatopy was defined as having measurable (≥ 0.35 IU/ml) specific IgE to any of the five inhalant indoor allergens tested. Current wheeze (last 12 months) was assessed by ISAAC questionnaire. Bronchial NO flux (J(NO) ) and alveolar NO concentration (C(alv)) were estimated by the Pietropaoli and Hogman methods.
Valid exhalation flow rates were achieved in 96% of the children. Children with seroatopy (53%) had significantly higher median J(NO) (522 pl/sec vs. 161 pl/sec, P<0.001) when compared to non-seroatopic children; however, median C(alv) was not significantly different between these two groups (5.5 vs. 5.8, P=0.644). Children with wheeze in the past year (21.6%) had significantly higher median C(alv) (8.4 ppb vs. 4.9 ppb, P<0.001), but not J(NO) (295 pl/sec vs. 165 pl/sec, P=0.241) when compared with children without wheeze. These associations remained stable after adjustment for known confounders/covariates.
The multiple flow method was easily implemented in this pediatric inner-city cohort. In this study population, alveolar concentration of NO may be a better indicator of current wheeze than single flow FeNO.
确定在内城队列中使用多流速离线部分呼出一氧化氮（FeNO）采集方法的可行性，并确定该人群中 NO 的肺泡和传导气道贡献。我们假设，与喘息和血清阳性相关的独立于流速的 NO 参数将存在差异。
作为一项出生队列研究的一部分，居住在纽约市低收入社区的非裔美国人和多米尼加裔母亲的 9 岁儿童（n=102）以 50、83 和 100 ml/sec 的恒定流速离线采集 FeNO 样本。血清阳性定义为对所测试的五种吸入室内过敏原中的任何一种具有可测量的（≥0.35IU/ml）特异性 IgE。当前喘息（过去 12 个月）通过 ISAAC 问卷进行评估。支气管一氧化氮通量（J（NO））和肺泡一氧化氮浓度（C（alv））通过 Pietropaoli 和 Hogman 方法进行估计。
96%的儿童实现了有效的呼气流速。与非血清阳性儿童相比，血清阳性儿童（53%）的 J（NO）中位数（522 pl/sec 与 161 pl/sec，P<0.001）明显更高；然而，这两组之间的 C（alv）中位数没有显著差异（5.5 与 5.8，P=0.644）。过去一年有喘息的儿童（21.6%）的 C（alv）中位数（8.4 ppb 与 4.9 ppb，P<0.001）明显更高，但 J（NO）中位数（295 pl/sec 与 165 pl/sec，P=0.241）没有差异。这些关联在调整已知混杂因素/协变量后仍然稳定。
多流速方法在这个儿科内城队列中很容易实施。在本研究人群中，NO 的肺泡浓度可能是当前喘息的更好指标，而不是单一流速的 FeNO。
