Concurrence of elevated FeNO and airway hyperresponsiveness in nonasthmatic adolescents

Kalm-Stephens, Pia; Malinovschi, Andreï; Janson, Christer; Nordvall, Lennart; Alving, Kjell

doi:10.1002/ppul.24578

Cited by 7 publications

(6 citation statements)

References 37 publications

(80 reference statements)

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“…In addition, as set out in tables 3 and 4, RDR was found to be only associated with CANO rather than FeNO 50 in non-asthmatic subacute cough. Although FeNO 50 has been validated to be associated with airway responsiveness [25,26], several studies suggested that CANO might be more relevant to airway responsiveness [27,28]. Therefore, it is comprehensible that only CANO, not FeNO 50 , was significantly associated with RDR, which was also consistent with our former conclusion that CANO showed a stronger correlation with spirometric parameters than FENO 50 in asthmatic and non-asthmatic subacute cough.…”

Section: Discussionsupporting

confidence: 87%

Clinical implications of concentration of alveolar nitric oxide in asthmatic and non-asthmatic subacute cough

Zeng¹,

Chen²,

Chen³

et al. 2021

J. Breath Res.

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Asthma is an important cause of subacute cough. The concentration of alveolar nitric oxide (CANO) is a sensitive inflammatory indicator in peripheral airways, and it has received much less attention than the fraction of exhaled nitric oxide (FeNO50). The main objective of this study was to explore the correlation between CANO and clinical parameters in asthmatic and non-asthmatic subacute cough, which might promote understanding of the clinical utility of CANO in these special patient populations. 155 patients with subacute cough were included consecutively, of which 25 were diagnosed as asthmatic. Data for demographic characteristics, FeNO50, CANO, baseline spirometry, bronchial provocation test (or bronchodilation test) and response dose ratio (RDR) were collected. Differences between the asthmatic and non-asthmatic groups were analyzed. Spearman’s correlation coefficient (ρ) was used to evaluate the correlation between FeNO50, CANO and other clinical parameters. In patients with subacute cough, baseline CANO values did not differ between asthmatic and non-asthmatic patients (4.4(1.3, 11.4) versus 4.0(2.1, 6.8) ppb, P > 0.05). Besides, CANO exhibited a stronger association with pulmonary function parameters when compared with FeNO50. For asthmatic subacute cough, CANO was inversely correlated with FEV1/FVC (ρ = −0.69, P < 0.01) and small airway parameters including MEF25 (ρ = −0.47, P < 0.05) and MMEF (ρ = −0.45, P < 0.05). For non-asthmatic subacute cough, CANO was inversely correlated with MEF25 (ρ = −0.19, P < 0.05) and RDR (ρ = −0.21, P < 0.05). In subacute cough, asthmatic and non-asthmatic patients had similar values of baseline CANO. In both asthmatic and non-asthmatic subacute cough, CANO exhibited a stronger association with pulmonary function parameters when compared with FeNO50. A low CANO value in non-asthmatic subacute cough corresponded to a higher value of RDR, which implied a stronger tendency towards airway responsiveness.

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Section: Discussionsupporting

confidence: 87%

Clinical implications of concentration of alveolar nitric oxide in asthmatic and non-asthmatic subacute cough

Zeng¹,

Chen²,

Chen³

et al. 2021

J. Breath Res.

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“…Дані 9 досліджень показали, що, хоча рівні FeNO у дітей у віці 0-4 років корелюють з прогностичним індексом астми та візингом, однак, очевидно, недостатньо доказів, щоб визначити, чи результати FeNO у віці 0-4 років можуть надійно передбачити майбутній діагноз астми [8,9]. Також є дані що у багатьох підлітків без наявної клінічної картини астми відзначається підвищення рівня FeNO, що вказує на наявну гіперчутливість бронхів, пряму кореляцію з рівнем еозинофілів крові та може бути предиктором розвитку БА у майбутньому [2].…”

Section: Asthma and Allergyunclassified

The Role and Significance of the FeNO Test in Different Asthma Endotypes

Tsaryk,

Udovenko,

Gumeniuk

et al. 2024

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Abstract. Bronchial asthma (BA) is one of the most frequent cause of inflammations of the airway and frequently characterized by eosinophilia, IgE production, and Th2 cytokine expression. Despite the wide prevalence of spirometry in BA diagnostic, the significance of FeNO test is the one of sensitive marker of eosinophilic inflammation in early asthma diagnosis. The pathogenesis of allergic inflammation has different endotypes which is poorly understood. The aim of our study is to evaluate the relation between different allergic inflammation indicators (eosinophils and IgE levels) and rates of FeNO results in patients with BA. Materials and methods. In this work we analyzed the basal levels of FeNO NIOX® test, serum IgE levels and eosinophils in patients with first diagnosed asthma before the treatment. In our study we included 125 patients with BA and 20 healthy control. Group 1 (n = 67) were the patients with BA and high IgE (Th-2 endotype), Group 2 (n = 58) — BA and normal IgE levels, but increased eosinophils (eosinophilic asthma). The levels of serum IgE was determined using ELISA. The FeNO results determined by NIOX VERO® analyzer. Results. The serum concentrations of IgE was higher in Group 1 (267.3 ± 57.6) IU/ml, Group 2 (37.2 ± 14.7) IU/ml and had no significant difference than healthy control (24.9 ± 7.7) IU/ml, p < 0.05. Eosinophils were higher in Group 2 (684 ± 228) cells/mcl than in Group 1 (456 ± 177) cells/mcl and control (104 ± 53) cells/mcl, p < 0.01. Also we determined positive strong correlation between serum IgE and blood eosinophils in Group 1 patients (r = 0.823) and no correlation in Group 2 (r = 0.324). The results of FeNO were significantly higher (47.2 ± 6.4) ppb in patients with higher IgE and high eosinophils (Group 1) than in Group 2 (34.6 ± 5.9) ppb and healthy control (12.4 ± 4.3) ppb, p < 0.05. Conclusion. The higher FeNO results were in patient with Th2 asthma endotype than in eosinophilic asthma. We could conclude that patients, which eosinophils induced by allergy, have association between serum IgE, blood eosinophils and FeNO results. Instead, patients with eosinophilic asthma and low serum IgE have other not Th2-induced mechanism of eosinophils activation (recurrent infections, haptens influence, non-steroidal anti-inflammatory drugs intolerance and ect.). We can assume that eosinophils can crystallize in the bronchi of the patients with eosinophilic asthma caused by other cytokines rather than Th2. In this case, FeNO activity depends on the Th2 eosinophils maintenance and more sensitive in patients with allergic exogenous asthma.

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“…14 FENO has also been found to correspond well to elevated levels of blood eosinophils, often correlated to allergic inflammation. 22 Both peanut allergic individuals with and without asthma 23 have been found to express high levels of FENO even though peanut is primarily a food and not inhalant allergen. 23,24 Johnson et al have reported that asthmatic patients aged 10-35 years, with a sensitization to peanut allergen molecules Ara h 1, h 2 and h 3 or the hazelnut storage proteins Cor a 9 and Cor a 14, were found to express higher levels of FENO than individuals without peanut sensitization, 24 especially in the youngest age group.…”

Section: Inflammatory Biomarkers and Systemic Inflammationmentioning

confidence: 99%

“…FENO is driven by the activation of the Th2 pathway 18 and elevated levels are often found in patients with untreated type 2 inflammation in bronchi and bronchioles, comorbid nasal polyposis, airborne allergy and in patients with an airborne allergy such as to furry animals, house dust mites and pollen 14,19–21 and food allergens 14 . FENO has also been found to correspond well to elevated levels of blood eosinophils, often correlated to allergic inflammation 22 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development of sensitization to peanut and storage proteins and relation to markers of airway and systemic inflammation: A 24‐year follow‐up

Tedner

Klevebro

Bergström

et al. 2022

Allergy

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Background Long‐time data of peanut allergy over time is sparse. We aimed to study the longitudinal development of sensitization to peanut extract and storage protein allergen molecules and associations with asthma status, airway and systemic inflammation markers. Methods The Swedish birth cohort BAMSE followed 4089 participants with questionnaires, clinical investigations and blood sampling between 0 and 24 years. Information on (i) background factors at 2 months, (ii) peanut allergy symptoms and IgE data (ImmunoCAP) at 4, 8, 16, and 24 years, and (iii) IgE to storage proteins, lung function data including exhaled nitric oxide (FENO) as well as systemic inflammatory markers at 24 years of age were collected. Results The prevalence of peanut extract sensitization, defined as IgE ≥ 0.35 kUA/L, was 5.4%, 8.0%, 7.5%, and 6.2% at 4, 8, 16, and 24 years of age, respectively. Between 8 and 24 years of age, (33/1565) participants developed IgE‐ab to peanut extract (median 1,4, range 0.7–2.6 kUA/L), and among those 85% were also sensitized to birch. Only six individuals developed sensitization to Ara h 2 (≥0.1 kUA/L) between 8 and 24 years of age, of whom three had an IgE‐ab level between 0.1–0.12 kUA/L. Storage protein sensitization was associated with elevated FENO, blood eosinophils and type 2 inflammation‐related systemic proteins. Conclusion Sensitization to peanut extract after 4 years of age is mainly induced by birch cross‐sensitization and IgE to Ara h 2 rarely emerges after eight years of age. Storage protein sensitization is associated with respiratory and systemic inflammation.

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Concurrence of elevated FeNO and airway hyperresponsiveness in nonasthmatic adolescents

Cited by 7 publications

References 37 publications

Clinical implications of concentration of alveolar nitric oxide in asthmatic and non-asthmatic subacute cough

Clinical implications of concentration of alveolar nitric oxide in asthmatic and non-asthmatic subacute cough

The Role and Significance of the FeNO Test in Different Asthma Endotypes

Development of sensitization to peanut and storage proteins and relation to markers of airway and systemic inflammation: A 24‐year follow‐up

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