Pediatr Allergy Respir Dis.  2012 Jun;22(2):180-187.

Role of Fractional Exhaled Nitric Oxide in Predicting Development of Allergic Rhinits in Children with Bronchial Asthma

• Ko HS
• Choi SH
• Rha YH

Abstract

PURPOSE
Fractional exhaled nitric oxide (FeNO) has been widely reported as a marker for airway inflammationin, and FeNO have shown increased levels in the non-asthmatic patients with other atopy related diseases, such as rhinitis. Bronchial hyperresponsiveness is a characteristic feature of asthma, which is often associated with airway inflammationin allergic rhinitis. It has been suggested that asthma is associated with rhinitis, which is a link between the upper and the lower airways, beyond allergy associated inflammation in the respiratory tract. To evaluate the usefulness of FeNO measurement, as a risk factor of allergic and nonallergic rhinitis in children with asthma.
METHODS
Fifty-three children included in this study were diagnosed as asthma from April through August 2005 in the Department of Pediatrics, Kyung Hee University School of Medicine. They conducted FeNO monitoring, total eosinophil count and serum immunoglobulin E at that time. We put a question to the participants' parents about the doctor diagnosed participants' manifestations (sneezing, nasal congestion, nasal itching, rhinorrhea), via a telephone interview survey or at the outpatient department in July 2011. Statistical analyses were performed using IBM SPSS ver. 18.0.
RESULTS
The overall prevalence of rhinitis, among the 53 children, was 67.9%. The means of FeNO differed significantly between the two groups, being higher in children who have rhinitis symptoms and lower in asymptomatic children. (mean+/-SD, 29.4+/-24.6 to 13.6+/-11.8 parts per billion; P=0.003; T-test)
CONCLUSION
To take the measurement of FeNO value in asthmatics may be a tool in the predictor of the causes of rhinitis.

Keyword

Asthma; Fractional exhaled nitric oxide; Allergic rhinitis; Child

MeSH Terms

Aluminum Hydroxide
Asthma
Carbonates
Child
Eosinophils
Estrogens, Conjugated (USP)
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Inflammation
Interviews as Topic
Nitric Oxide
Outpatients
Parents
Pediatrics
Prevalence
Pruritus
Respiratory System
Rhinitis
Rhinitis, Allergic, Perennial
Risk Factors
Aluminum Hydroxide
Carbonates
Estrogens, Conjugated (USP)
Immunoglobulin E
Immunoglobulins
Nitric Oxide

Figure

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  Fig. 1 (A) Total eosinophil count concentrations in allergic rhinitis patients group (n=18) and control groups (n=10). Geographic mean values are represented by the longer horizontal bars, and standard deviation (SD) ranges between the shorter horizontal bars. (B) Serum immunoglobulin E (IgE) concentrations in allergic rhinitis patients group (n=18) and control groups (n=10). Geographic mean values are represented by the longer horizontal bars, and SD ranges between the shorter horizontal bars. AR, allergic rhinitis.

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  Fig. 2 Exhaled nitric oxide concentrations in allergic rhinitis patients group (n=36) and control groups (n=17). Geographic mean values are represented by the longer horizontal bar, and standard deviation standard deviation (SD) ranges between the shorter horizontal bars. AR, allergic rhinitis; FeNO, fractional exhaled nitric oxide; ppb, parts per billion.

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  Fig. 3 Correlation of allergic rhinitis (AR) prevalence with atopic dermatitis (AD) history.

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  Fig. 4 Correlation of allergic rhinitis (AR) prevalence with family history of atopic disease.

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