Alyasin Soheila, Kanannejad Zahra, Nabavizadeh Seyed Hesamodin, Esmaeilzadeh Hossein, Sadeghi Erfan, Shojaadini Hafez, Akbarzadeh Ashkan, Ayareh Nazanin, Johari Leila
Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran AND Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Allergy Asthma Immunol. 2025 Jun 26;24(4):441-450.
Fractional exhaled nitric oxide (FeNO) has emerged as a potential biomarker for differentiating between various causes of non-chronic cough, particularly in conditions associated with airway inflammation, such as asthma. This study aimed to evaluate the diagnostic efficacy of FeNO in pediatric patients with non-chronic cough and its ability to differentiate between asthma exacerbations and respiratory tract infections. Seventy-five pediatric patients aged 10-18 years with non-chronic cough were categorized into three groups: good control asthma (GCA, n=28), acute asthma exacerbation (AAE, n=26), and respiratory tract infection (RTI, n=21). Clinical assessments included FeNO measurement, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, hemoglobin (HB), platelet count (PLT), and immunoglobulin E (IgE) levels. Univariate and multivariate multinomial logistic regression models were applied to assess the predictive value of these variables. FeNO levels were significantly higher in the AAE group (46.58±22.66 ppb) compared to the GCA and RTI groups, indicating elevated eosinophilic airway inflammation in asthma exacerbations. CRP was a significant predictor of both AAE and RTI, with a one-unit increase in CRP increasing the odds of exacerbation or infection by 2.6-fold. Body max index (BMI) was inversely associated with the risk of RTI. Hemoglobin, platelet count, and IgE levels were significantly higher in the AAE group compared to the other groups, while WBC counts, though elevated, were not statistically significant. FeNO associated with other inflammatory markers, including CRP and BMI, could enhance diagnostic accuracy and inform clinical decision-making in managing pediatric respiratory conditions. To confirm these results, future studies with larger sample sizes should be performed.
呼出一氧化氮分数（FeNO）已成为区分非慢性咳嗽各种病因的潜在生物标志物，尤其是在与气道炎症相关的疾病中，如哮喘。本研究旨在评估FeNO在小儿非慢性咳嗽患者中的诊断效能及其区分哮喘急性发作和呼吸道感染的能力。75名年龄在10 - 18岁的小儿非慢性咳嗽患者被分为三组：良好控制的哮喘（GCA，n = 28）、哮喘急性发作（AAE，n = 26）和呼吸道感染（RTI，n = 21）。临床评估包括FeNO测量、C反应蛋白（CRP）、红细胞沉降率（ESR）、白细胞（WBC）计数、血红蛋白（HB）、血小板计数（PLT）和免疫球蛋白E（IgE）水平。应用单变量和多变量多项逻辑回归模型评估这些变量的预测价值。与GCA组和RTI组相比，AAE组的FeNO水平显著更高（46.58±22.66 ppb），表明哮喘急性发作时嗜酸性气道炎症升高。CRP是AAE和RTI的重要预测指标，CRP每增加一个单位，急性发作或感染的几率增加2.6倍。身体质量指数（BMI）与RTI风险呈负相关。与其他组相比，AAE组的血红蛋白、血小板计数和IgE水平显著更高，而WBC计数虽升高但无统计学意义。FeNO与包括CRP和BMI在内的其他炎症标志物相关，可提高诊断准确性并为小儿呼吸道疾病的临床决策提供依据。为证实这些结果，应进行更大样本量的未来研究。
