Correlation Between Fractional Exhaled Nitric Oxide Levels and Efficacy of Inhaled Corticosteroids in Children With Bronchial Asthma

Abstract

To investigate correlation between fractional exhaled nitric oxide (FeNO) levels and efficacy of inhaled corticosteroids in children with bronchial asthma. Between October 2013 and December 2014, 133 cases of children with bronchial asthma were randomly divided into the glucocorticoid group (n = 67; inhaled with Seretide/Pulmicort) and the nonglucocorticoid group (n = 66; inhaled with short-acting β2 receptor agonist if needed); and alternatively 72 cases of healthy children were regarded as the control group. FeNO, forced expiratory volume in 1 second to predicted value, forced expiratory volume in 1 second/forced vital capacity, induced sputum eosinophils (EOS)%, and total serum immunoglobulin (Ig) E and serum EOS% were detected and childhood asthma control test (C-ACT) scale was investigated pretreatment and 3 and 6 months posttreatment, respectively. FeNO levels, induced sputum EOS%, total serum IgE, and serum EOS% were significantly lower, whereas forced expiratory volume in 1 second to predicted value, forced expiratory volume in 1 second/forced vital capacity, and C-ACT scores were obviously improved in the glucocorticoid group 6 months posttreatment compared with those of pretreatment (all P < 0.05). FeNO levels, induced sputum EOS%, and total serum IgE were significantly lower, whereas C-ACT scores were significantly higher in the glucocorticoid group compared with those of the nonglucocorticoid group (all P < 0.05). In the glucocorticoid group, induced sputum EOS% and total serum IgE showed significantly positive correlations with FeNO levels (r = 0.73, P < 0.01; r = 0.56, P < 0.01), whereas C-ACT scores were negatively correlated with FeNO levels (r = -0.67, P < 0.01). FeNO levels might be correlated with efficacy of inhaled corticosteroids in children with bronchial asthma.

<p>The Value of Inflammatory Biomarkers in Differentiating Asthma–COPD Overlap from COPD</p>

“…This may be attributed to the reduced expression of inflammatory biomarkers when using ICS. 21,22 Shi et al 42 confirmed that FeNO was negatively associated with FEV 1 %pred in COPD and ACO. However, Liu et al 43…”

“…However, all of them are affected by factors such as therapeutic drugs and smoking. [21][22][23][24] Therefore, the present study was conducted to further evaluate the accuracy of FeNO, EOS, and NLR in ACO diagnosis after excluding the influence of ICS and smoking use. Congruent with some previous studies, [15][16][17][18][19][20] our results confirmed the higher levels of FeNO and EOS in ACO patients than in COPD patients, especially in those without ICS use or with a smoking history.…”

“…In addition, most studies included patients with a history of smoking or ICS use, [15][16][17][18][19][20] which might affect the expressions of the inflammatory biomarkers. [21][22][23][24] What's more, there is no research on the NLR in distinguishing between COPD and ACO. To address these problems, the present retrospective study was performed to further evaluate the accuracy of FeNO, EOS, and NLR for the clinical diagnosis of ACO after eliminating the influence of confounding factors.…”

Effects of salbutamol aerosol combined with magnesium sulfate on T-lymphocyte subgroup and Th1/Th2 cytokines of pediatric asthma

“…Bronchial asthma in children is a chronic inflammatory disease characterized by bronchial hyper-responsiveness and mediated by various cells, including mast cells, T lymphocytes and eosinophilic granulocytes (1). The main clinical symptoms included chest distress, annihilation and coughing caused by airway constriction, which can easily induce weakness of breathing, cyanosis and depression signs (2).…”