Could FeNO Predict Asthma in Patients with House Dust Mites Allergic Rhinitis?

Muntean, Ioana Adriana; Bocşan, Ioana Corina; Vesa, Ştefan Cristian; Miron, Nicolae; Nedelea, Irena; Deleanu, Diana

doi:10.3390/medicina56050235

Cited by 9 publications

(8 citation statements)

References 44 publications

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“…Maintaining good asthma control helps minimize the risk of asthma exacerbation as other studies have shown [ 23 , 28 ]. The group of uncontrolled asthma patients in our study representing 55.2%, was probably due to persistent inflammation in the lower airways even before symptoms appeared [ 29 ]. Preexisting airway inflammation may lead to exacerbation during a viral respiratory infection or in presence of other triggers, as other studies showed inflammatory diseases exacerbations during and after COVID-19 [ 1 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

A retrospective study regarding the influence of COVID-19 disease on asthma

et al. 2023

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Background During the Covid-19 pandemic patients suffering from asthma raised many concerns regarding the outcome ofthe impact of COVID-19 disease on their preexisting condition. The 2021 GINA report indicates that people with asthma do not appear to be at increased risk of a severe form of COVID-19. Method This study is a retrospective study of patients (n = 163) median age = 27.8 years, M:F = 1:1.26, with asthma evaluated using ACT (asthma control test) and VAS (visual analog scale) before and after COVID-19 disease. An ACT score over 20 points placed patients in the controlled asthma group. Results The overall evaluation for COVID-19 in our asthma patients revealed that 22.7% of the studied group had the COVID-19 disease (21.5% in the controlled asthma group and 24.5% in uncontrolled asthma group). Asthma disease history was longer in the uncontroled asthma group (128 ± 96.8 months vs. 296 ± 59.7 months, p = 0.05). Asthma treatment was conducted according to the GINA guideline, and 18.4% (30 pts) of the patients were on allergen immunotherapy treatment. Significantly more uncontrolled patients were significantly more in Step 1 and 5 of treatment (p = 0.05 and p = 0.03). During the COVID-19 pandemic, patients in the GINA step 5 of treatment experienced a worsening of asthma, often twice as severe as compared to patients with asthma in GINA step 1–4. In these patients, even mild COVID-19 disease led to worsened asthma symptoms, while severe COVID-19 led to a severe asthma impairment measured by ACT score (p = 0.03) and VAS scale (p = 0.02), with increased oral corticosteroids consumption. Conclusion Maintaining optimal asthma control should be able to reduce risk of severe outcomes after COVID-19 disease. Communication via phone with the specialist involved in their asthma care was very comforting for patients, thus confirming the necessity to include phone calls, smart phone’s application or online evaluations and counseling in long-term care of chronic diseases.

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Section: Discussionmentioning

confidence: 99%

A retrospective study regarding the influence of COVID-19 disease on asthma

et al. 2023

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“…In addition, the evaluation included the test performance against atopic dermatitis and allergic rhinitis, both known to contribute to the increase in FeNO [ 29 ]. It seems that allergic rhinitis plays a key role in subclinical inflammation in the lower airways [ 30 ]. The focus on currently treated asthma and not for asthma ever was justified by better reliability of the former manifestation of disease even if diagnosed based on the questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Screening Accuracy of FeNO Measurement for Childhood Asthma in a Community Setting

Barański

Zejda

2022

Children

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(1) Background: The exhaled fractional nitric oxide is a well-recognized biomarker used in clinical settings for controlling and managing asthma. Less is known about the value of Fractional Exhaled Nitric Oxide (FeNO) measurement in epidemiological studies on childhood asthma, although available evidence suggests that an increased FeNO is associated with an increased risk of asthma. (2) Aim: The aim of the study was to assess FeNO accuracy in the identification of children with asthma, participants in a population-based respiratory survey. (3) Material and methods: The cross-sectional study included 449 children, 224 (49.9%) boys and 225 (50.1%) girls aged 6–10 years. The FeNO was measured in 449 children; Spirometry tests were completed with 441 children, but technically acceptable spirometry was done in 350. All participants fulfilled the questionnaire (ISAAC) for assessment of the status of their respiratory system on which diagnosis was based on. FeNO and Spirometry were performed according to ERS/ATS recommendations. (4) Results: The FeNO was significantly higher in asthmatic children (n = 22): 27.3 ± 21.3 ppb; with allergic rhinitis (n = 106): 9.9 ± 21.6 ppb, with atopic dermatitis (n = 67) 20.8 ± 25.0 ppb, with an asthmatic tendency (n = 27): 19.8 ± 16.0 ppb in comparison to children without any respiratory/atopy symptoms. The highest diagnostic odds ratio and area under the curve were found in any treated asthma or asthma without any atopic symptoms in relation to FeNO cutoff > 35 ppb; DOR 4.85 and 8.37; AUC 0.615 and 0.795, respectively. The adjustment for spirometry parameters did not improve the diagnostic accuracy of FeNO. In each FeNO cutoff, there were more false positive than true positive subjects. (5) Conclusions. The best diagnostic accuracy of FeNO was for isolated asthma without any atopy against children without any coexisting respiratory or allergic disease. The sensitivity and specificity did not reach the required values for a good screening tool; therefore, it should not be used in epidemiological settings.

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“…In the present study, patients with clinical manifestations induced by grass pollen were included, even if some of them were sensitized to several allergens. The inflammatory response in pollen allergy may differ toward house dust mite allergic patients, due to different aspects of the allergens (perennial, dimensions, enzymatic properties) [ 42 , 43 , 44 , 45 ], but this hypothesis needs further investigation. Another reason for the low reduction in total IgE could be related to polysensitization of the patients, even if they did not report clinical manifestation during the grass pollen season.…”

Section: Discussionmentioning

confidence: 99%

Are Markers of Allergic Inflammation in Grass Pollen Allergy Influenced by H1 Antihistamines?

Bocşan

Muntean

Miron

et al. 2021

JCM

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Soluble intercellular adhesion molecule-1 (ICAM-1) and soluble vascular adhesion molecule-1 (VCAM-1) play important roles in allergic rhinitis (AR). Treatment with H1 antihistamines improves AR symptoms and in vitro reduces the levels of adhesion molecules. The aim of the study was to evaluate serum levels of ICAM-1 and VCAM-1 in patients with AR to grass pollen and their response to different H1 antihistamines. Material and methods: A total of 50 patients with grass pollen AR were clinically and biologically evaluated. ICAM-1 and VCAM-1 serum levels were evaluated during pollen season before and after treatment with levocetirizine and desloratadine through the ELISA method. Results: ICAM-1, VCAM-1, eosinophils, and total IgE were elevated in patients with AR, compared with healthy subjects. Both antihistamines improved specific symptoms of AR and increased patients’ quality of life during pollen season after one month of treatment. H1 antihistamines reduced VCAM-1, ICAM-1, and total IgE after one-month treatment but not significantly. Patients with increased baseline values tend to remain with increased values after one-month AH1 treatment. Conclusions: ICAM-1 and sVCAM-1 levels are higher in patients with grass pollen-induced AR than healthy controls during pollen exposure. Their serum levels tend to remain at high values during pollen season despite antihistaminic therapy.

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Could FeNO Predict Asthma in Patients with House Dust Mites Allergic Rhinitis?

Cited by 9 publications

References 44 publications

A retrospective study regarding the influence of COVID-19 disease on asthma

A retrospective study regarding the influence of COVID-19 disease on asthma

Screening Accuracy of FeNO Measurement for Childhood Asthma in a Community Setting

Are Markers of Allergic Inflammation in Grass Pollen Allergy Influenced by H1 Antihistamines?

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