J Korean Med Sci.  2011 Oct;26(10):1265-1269. 10.3346/jkms.2011.26.10.1265.

Exhaled Nitric Oxide is Associated with Allergic Inflammation in Children

• Choi BS
• Kim KW
• Lee YJ
• Baek J
• Park HB
• Kim YH
• Sohn MH
• Kim KE

• KMID: 1785981
• DOI: http://doi.org/10.3346/jkms.2011.26.10.1265

Abstract

Exhaled nitric oxide (eNO) has been proposed as a noninvasive marker of airway inflammation in asthma. In asthmatic patients, exhaled NO levels have been shown to relate with other markers of eosinophilic recruitment, which are detected in blood, sputum, bronchoalveolar lavage fluid and bronchial biopsy samples. The purpose of this study was to assess the possible relationship between eNO and allergic inflammation or sensitization in childhood asthma and allergic rhinitis. Subjects consisted of 118 asthmatic children, 79 patients with allergic rhinitis, and 74 controls. Their age ranged from 6 to 15 yr old. eNO level, peripheral blood eosinophil count, eosinophil cationic protein (ECP), serum total IgE level and specific IgE levels were measured. Methacholine challenge test and allergic skin prick test for common allergens were performed in all subjects. Atopic group (n = 206, 44.48 +/- 30.45 ppb) had higher eNO values than non-atopic group (n = 65, 20.54 +/- 16.57 ppb, P < 0.001). eNO level was significantly higher in patients with asthma (42.84 +/- 31.92 ppb) and in those with allergic rhinitis (43.59 +/- 29.84 ppb) than in healthy controls (27.01 +/- 21.34 ppb, P < 0.001) but there was no difference between asthma and allergic rhinitis group. eNO also had significant positive correlations with Dermatophagoides pteronyssinus IgE level (r = 0.348, P < 0.001), Dermatophagoides farinae IgE level (r = 0.376, P < 0.001), and the number of positive allergens in skin prick test (r = 0.329, P = 0.001). eNO had significant positive correlations with peripheral blood eosinophil count (r = 0.356, P < 0.001), serum total IgE level (r = 0.221, P < 0.001), and ECP (r = 0.436, P < 0.001). This study reveals that eNO level is associated with allergic inflammation and the degree of allergic sensitization.

Keyword

Exhaled Nitric Oxide; Asthma; Allergic Rhinitis; Allergy; Sensitization

MeSH Terms

Adolescent
Allergens/immunology
Animals
Asthma/*immunology
*Breath Tests
Bronchial Provocation Tests
Child
Dermatophagoides pteronyssinus/immunology
Eosinophil Cationic Protein/analysis/blood/immunology
Eosinophils
Exhalation
Female
Humans
Hypersensitivity, Immediate/*immunology
Immunoglobulin E/blood
Leukocyte Count
Male
Nitric Oxide/*analysis
Rhinitis, Allergic, Seasonal/*immunology

Figure

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  Fig. 1 Comparison of eNO level between atopic asthma, allergic rhinitis (AR), atopic control, non-atopic asthma, and non-atopic control. Atopic group (44.48 ± 30.45 ppb) had higher eNO values than non-atopic group (20.54 ± 16.57 ppb) (P < 0.001).

• 

  Fig. 2 Correlation between serum total IgE and eNO levels (A), specific IgE of Der p and eNO level (B), and specific IgE of Der f and eNO level (C). eNO had positive correlations with serum total IgE level (r = 0.221, P < 0.001), Der p IgE level (r = 0.348, P < 0.001), and Der f IgE level (r = 0.376, P < 0.001).

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  Fig. 3 Correlation between the number of positive skin prick test (SPT) and eNO level. The number of positive SPT were positively correlated with eNO level (r = 0.329, P = 0.001).

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  Fig. 4 Correlation between serum total eosinophil count (TEC) and eNO level (A) and serum total ECP and eNO level (B). eNO had positive correlations with TEC (r = 0.356, P < 0.001) and ECP (r = 0.436, P < 0.001).

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