Atopic sensitization to common allergens without symptoms or signs of airway disorders does not increase exhaled nitric oxide

Rouhos, Annamari; Kainu, Annette; Karjalainen, Jouko; Lindqvist, Ari; Piirilä, Päivi; Sarna, Seppo; Haahtela, Tari; Sovijärvi, Anssi

doi:10.1111/j.1752-699x.2007.00045.x

Cited by 18 publications

(17 citation statements)

References 31 publications

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“…Our findings may help to explain previous inconsistences that other studies have reported when using FeNO levels as a criterion in the diagnosis or management of asthma [6,8,12,15,22,23]. We found that FeNO>35 ppb predicted asthma with better accuracy than cutoffs of 20 ppb or 25 ppb.…”

Section: Discussionsupporting

confidence: 47%

“…The presence of a low to normal FeNO level in patients with chronic respiratory symptoms could also be helpful to rule out atopic status [20,22], however, there is a lack of strong evidence to support the role of FeNO in identifying atopy [2,5,11,[23][24][25]. One recent study by Yao et al reported that FeNO was a better marker of allergic sensitization than it was of asthma [17].…”

Section: Introductionmentioning

confidence: 99%

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Role Of Exhaled Nitric Oxide As A Predictor Of Atopy

Romero

Robinson

Baumann

et al. 2012

D39. Evaluation and Monitoring of Asthma and Copd

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Background: The fractional exhaled nitric oxide (FeNO) is a quantitative, noninvasive and safe measure of airways inflammation that may complement the assessment of asthma. Elevations of FeNO have recently been found to correlate with allergic sensitization. Therefore, FeNO may be a useful predictor of atopy in the general population. We sought to determine the diagnostic accuracy of FeNO in predicting atopy in a population-based study. Methods: We conducted a cross-sectional study in an age-and sex-stratified random sample of 13 to 15 year-olds in two communities in Peru. We asked participants about asthma symptoms, environmental exposures and sociodemographics, and underwent spirometry, assessment of FeNO and an allergy skin test. We used multivariable logistic regression to model the odds of atopy as a function of FeNO, and calculated area-under-the-curves (AUC) to determine the diagnostic accuracy of FeNO as a predictor of atopy. Results: Of 1441 recruited participants, 1119 (83%) completed all evaluations. Mean FeNO was 17.6 ppb (SD=0.6) in atopics and 11.6 ppb (SD=0.8) in non-atopics (p<0.001). In multivariable analyses, a FeNO>20 ppb was associated with an increase in the odds of atopy in non-asthmatics (OR=5.3, 95% CI 3.3 to 8.5) and asthmatics (OR=16.2, 95% CI 3.4 to 77.5). A FeNO>20 ppb was the best predictor for atopy with an AUC of 68% (95% CI 64% to 69%). Stratified by asthma, the AUC was 65% (95% CI 61% to 69%) in non-asthmatics and 82% (95% CI 71% to 91%) in asthmatics. Conclusions: FeNO had limited accuracy to identify atopy among the general population; however, it may be a useful indicator of atopic phenotype among asthmatics.

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Section: Discussionsupporting

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Role Of Exhaled Nitric Oxide As A Predictor Of Atopy

Romero

Robinson

Baumann

et al. 2012

D39. Evaluation and Monitoring of Asthma and Copd

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“…Thirty percent of the findings were considered abnormal (over 30.0 ppb [6]). A BlandAltman plot of the paired FENO measurements is given in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Repeatability of successive measurements with a portable nitric oxide analyser in patients with suggested or diagnosed asthma

Takalo

Piirilä

Sovijärvi

2008

Scandinavian Journal of Clinical and Laboratory Investigation

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The objective of our study was to determine the repeatability of successive measurements of exhaled nitric oxide (NO) with a portable device (NIOX MINO). We assembled a sample of 332 pairs of repeated NO measurements acquired in the same session. The mean of the two successive measurements varied from 4.0 to 279.5 parts per billion (ppb). The mean coefficient of repeatability (CoR) of the entire study sample was 2.4 ppb. The difference between paired measurements increased slightly with increasing fractional exhaled nitric oxide (FENO); for the mean FENO of 24.0 ppb the calculated CoR was 2.2 and for the FENO of 54 ppb it was 3.2 ppb. The difference between paired observations for FENO values <50 ppb was significantly lower than that for values >50 ppb (p<0.001). The demonstrated repeatability of successive measurements with the device supports the view that, when the exhalation manoeuvre is technically valid and FENO is within normal limits, repeated determinations of FENO are generally not necessary for screening. In other cases, the mean value of two successive measurements would represent a more reliable measurement result.

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“…Smoking exposure plays an inestimable role in evaluating the FeNO levels of an individual, thus probably explaining some of the contradictory results found in former studies of the associations of BHR with other measurements of airway regulation and inflammation [23,24]. Biological measurements of exposure to tobacco smoke were not performed, which results in a somewhat incomplete quantification of ETS exposure.…”

Section: Discussionmentioning

confidence: 99%

Dose-dependent association of smoking and bronchial hyperresponsiveness

et al. 2013

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Our aim was to study the association of smoking habits and environmental tobacco smoke (ETS) exposure with bronchial hyperresponsiveness (BHR).A random sample of 292 adults was examined using a structured interview, spirometry, skin prick tests, exhaled nitric oxide fraction (FeNO) and bronchial histamine challenge.A large majority of subjects with BHR were smokers or ex-smokers. Starting to smoke before 20 years of age was significantly associated with BHR, as was current smoking, quantity of smoking and ETS exposure. The severity of BHR increased significantly with increasing pack-years of exposure (p,0.001). Current smokers with decreased lung function were at a particularly high risk of BHR. Impaired forced expiratory volume in 1 s and mean maximal expiratory flow were independent determinants for more severe BHR, regardless of age. In multivariate analysis, smoking remained an independent determinant for BHR after adjustment for impaired lung function and other covariates: o15 pack-years yielded an odds ratio of 3.00 (95% CI 1.33-6.76) for BHR. The association between BHR and FeNO was dependent on smoking habits.The results indicate that smoking is a significant risk factor for BHR, with a dose-dependent pattern, and that the severity of BHR increases with pack-years. The findings strongly suggest assessment of smoking habits in subjects with BHR. @ERSpublications Bronchial hyperresponsiveness is dose-dependently linked to smoking; severity increases with pack-years

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Atopic sensitization to common allergens without symptoms or signs of airway disorders does not increase exhaled nitric oxide

Cited by 18 publications

References 31 publications

Role Of Exhaled Nitric Oxide As A Predictor Of Atopy

Role Of Exhaled Nitric Oxide As A Predictor Of Atopy

Repeatability of successive measurements with a portable nitric oxide analyser in patients with suggested or diagnosed asthma

Dose-dependent association of smoking and bronchial hyperresponsiveness

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