Xepapadaki Paraskevi, Korovessi Paraskevi, Bachert Claus, Finotto Susetta, Jartti Tuomas, Lakoumentas John, Kowalski Marek L, Lewandowska-Polak Anna, Lukkarinen Heikki, Zhang Nan, Zimmermann Theodor, Papadopoulos Nikolaos G
Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Upper Airways Research Laboratory, Ghent University Hospital, 9000 Ghent, Belgium.
J Clin Med. 2020 Jan 9;9(1):187. doi: 10.3390/jcm9010187.
Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and has been used for monitoring asthma. Here, we assess the characteristics of FeNO from preschool to school age, in parallel with asthma activity. A total of 167 asthmatic children and 66 healthy, age-matched controls were included in the 2-year prospective PreDicta study evaluating wheeze/asthma persistence in preschool-aged children. Information on asthma/rhinitis activity, infections and atopy was recorded at baseline. Follow-up visits were performed at 6-month intervals, as well as upon exacerbation/cold and 4-6 weeks later in the asthmatic group. We obtained 539 FeNO measurements from asthmatics and 42 from controls. At baseline, FeNO values did not differ between the two groups (median: 3.0 ppb vs. 2.0 ppb, respectively). FeNO values at 6, 12, 18 and 24 months (4.0, CI: 0.0-8.6; 6.0, CI: 2.8-12.0; 8.0, CI: 4.0-14.0; 8.5, CI: 4.4-14.5 ppb, respectively) increased with age (correlation ≤ 0.001) and atopy ( = 0.03). FeNO was non-significantly increased from baseline to the symptomatic visit, while it decreased after convalescence ( = 0.007). Markers of disease activity, such as wheezing episodes and days with asthma were associated with increased FeNO values during the study ( < 0.05 for all). Age, atopy and disease activity were found to be important FeNO determinants in preschool children. Longitudinal and individualized FeNO assessment may be valuable in monitoring asthmatic children with recurrent wheezing or mild asthma.
呼出一氧化氮分数（FeNO）是嗜酸性气道炎症的一种非侵入性标志物，已用于监测哮喘。在此，我们评估从学龄前到学龄期FeNO的特征，并与哮喘活动情况作对比。一项为期2年的前瞻性PreDicta研究纳入了167名哮喘儿童和66名年龄匹配的健康对照，该研究评估学龄前儿童喘息/哮喘的持续情况。在基线时记录哮喘/鼻炎活动、感染和特应性的信息。哮喘组每隔6个月进行随访，以及在病情加重/感冒时和4 - 6周后进行随访。我们从哮喘患者中获得了539次FeNO测量值，从对照中获得了42次。在基线时，两组的FeNO值没有差异（中位数分别为3.0 ppb和2.0 ppb）。在6、12、18和24个月时的FeNO值（分别为4.0，可信区间：0.0 - 8.6；6.0，可信区间：2.8 - 12.0；8.0，可信区间：4.0 - 14.0；8.5，可信区间：4.4 - 14.5 ppb）随年龄增加（相关性≤0.001）和特应性增加（P = 0.03）。从基线到有症状就诊时FeNO无显著增加，而在恢复期后下降（P = 0.007）。疾病活动标志物，如喘息发作次数和哮喘天数，在研究期间与FeNO值升高相关（所有P均<0.05）。年龄、特应性和疾病活动被发现是学龄前儿童FeNO的重要决定因素。纵向和个体化的FeNO评估对于监测反复喘息或轻度哮喘的儿童可能有价值。
