Effect of Natural Grass Pollen Exposure on Exhaled Nitric Oxide in Asthmatic Children

Baraldi, Eugenio; Carra, S; Dario, Cinzia; Azzolin, Nicoletta M.; Ongaro, Riccardo; Marcer, G; Zacchello, Franco

doi:10.1164/ajrccm.159.1.9804063

Cited by 105 publications

(83 citation statements)

References 26 publications

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“…Interestingly, a reduction in the average orally exhaled NO level was noted on the morning of day 7, which was a Monday. This may indicate a relationship between NO and stress or exposure to environmental factors like allergen or pollution [23,24]. The authors conclude that this reduction was not due to drift in the setup, since some subjects showed a decrease while others showed an increase between the days 3 and 7.…”

Section: Discussionmentioning

confidence: 92%

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Palm¹,

Gräf

Lundberg³

et al. 2000

Eur Respir J

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Nitric oxide (NO) is present in the human nasal airways and has been suggested to originate primarily from the paranasal sinuses. The aim of this study was to establish a new and reproducible method for measurement of nasal NO.Through repeated single-breath measurements the intra-and inter-individual variations of NO levels in nasally (into a tightly fitting mask covering the nose) and orally exhaled air were determined in healthy humans. Variations due to the methods used were investigated. The contribution of oral NO to the nasal exhalations by introducing a mouthwash procedure was also studied.This study shows distinct individual values of NO in nasally and orally exhaled air of healthy humans. Some diurnal variability was also found with a rise in NO in nasally and orally exhaled air over the day, but no, or little, day-to-day variability when comparing the results from separate mornings. There was no correlation between NO levels in nasally and orally exhaled air, whereas there was a strong correlation between NO levels in air exhaled through the left and right nostril. The levels of NO in air exhaled at 0.17 L . s -1 through either nostril separately were higher than in air exhaled at the same flow rate through both nostrils simultaneously. After the introduction of a mouthwash procedure the level of NO in orally, but not nasally exhaled air was reduced.To conclude the method using nasal exhalation into a nose mask is highly reproducible. It is also suggested that subtracting the level of NO in orally exhaled air, after mouthwash, from that in nasally exhaled air, would adequately reflect nasal NO levels. Eur Respir J 2000; 16: 236±241.

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Section: Discussionmentioning

confidence: 92%

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Palm¹,

Gräf

Lundberg³

et al. 2000

Eur Respir J

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“…BARALDI et al [23] demonstrated that, during the pollen season, FE,NO increased significantly in spite of a lack of significant changes in FEV1, and also showed a relatively high FE,NO in these patients outside the grass pollen season, in agreement with the hypothesis that mild airway inflammation may persist even in the absence of symptoms [14]. A significant time-dependent modulation of FE,NO during house dust mite avoidance has previously been observed in a group of allergic asthmatic children during a stay in the Alpine environment, despite discontinuation of steroid therapy [24].…”

Section: Discussionmentioning

confidence: 99%

“…FE,NO has been demonstrated to be more promptly modified by exposure to or avoidance of relevant allergens in allergic asthmatic children [23,24] than lung function.…”

Section: Discussionmentioning

confidence: 99%

Exhaled nitric oxide in asthmatic children exposed to relevant allergens: effect of flunisolide

Piacentini

Bodini

Costella³

et al. 2000

Eur Respir J

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Inhaled corticosteroids are capable of reducing the level of exhaled nitric oxide (expiratory nitric oxide fraction (FE,NO)) in asthmatic patients in a dosedependent fashion. The aim of this study was to evaluate whether or not treatment with an inhaled steroid can prevent changes in FE,NO after the exposure to relevant allergens, following avoidance, in asthmatic children allergic to house dust mite.Thirty-two house dust mite-allergy asthmatic children were randomly allocated to treatment with inhaled flunisolide (500 mg b.i.d.) or placebo and evaluated before and 2 weeks after a period of natural exposure to mite antigens. Lung function and FE,NO were evaluated.FE,NO was increased in the placebo-treated group after antigen exposure. Treatment with inhaled flunisolide prevented such increase in FE, NO (p<0.001). No change was observed in lung function parameters.Inhaled flunisolide is effective in preventing the increase in airway inflammation observed in allergic asthmatic children re-exposed to allergens. It is well recognized that asthma is an inflammatory disease and that indoor allergens, in particular house dust mite, represent a relevant factor in the aetiology of the disease [1]. It has been demonstrated that the development or worsening of asthma symptoms in children may be alleviated by allergen avoidance [2,3] or by suppressing the bronchial response to allergen challenge [4±9].In recent years, different markers have been proposed for the evaluation of level of airway inflammation [10]. Among these, the measurement of exhaled nitric oxide levels (expiratory nitric oxide fraction (FE,NO)) is considered a noninvasive means of assessing the degree of airway inflammation in asthmatics [11±13].Recent studies have shown that inhaled corticosteroids are capable of decreasing the FE,NO in asthmatic patients in a dose-dependent fashion [14,15].In this study, whether treatment with an inhaled steroid can prevent changes in FE,NO after a brief period of exposure to relevant allergens was evaluated in a group of asthmatic children allergic to house dust mite. Material and methods SubjectsThirty-two children (26 males and six females), ranging in age 6±15 yrs and with a history of bronchial asthma and a positive skin-prick test to house dust mite, were evaluated at the "Istituto Pio XII" long-stay hospital (Misurina, Belluno, Italy), situated at an altitude of 1,756 m in the Italian Alps. None of the patients had had respiratory infections for $2 months before the beginning of the study and none of them were allergic to furry pets.None of the children had received oral corticosteroids for $2 months or inhaled corticosteroids for $1 month before the study since they were staying in a house dust mite-free environment.The study was approved by the Istituto Pio XII Ethics Committee and both children and their parents gave informed consent. Study designThe study was performed between December 1997 and January 1998. The children admitted to the study had been living at the Istituto Pio XII, an environment fre...

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“…There is strong evidence that sensitization to some allergens is more strongly related to exhaled NO than sensitization to others. 12,13 There is evidence that exposure to perennial allergens, such as house dust mite, are more likely to cause airway inflammation than exposure to seasonal allergens. An…”

mentioning

confidence: 99%

“…12 Also, cat dander is a perennial allergen and has been associated with asthma symptoms. Exhaled NO is also increased in atopic children and among symptomatic subjects.…”

mentioning

confidence: 99%

Uso do óxido nítrico em crianças com asma persistente

Vega-Briceño¹,

Sánchez²

2006

J. Pediatr. (Rio J.)

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Effect of Natural Grass Pollen Exposure on Exhaled Nitric Oxide in Asthmatic Children

Cited by 105 publications

References 26 publications

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements

Exhaled nitric oxide in asthmatic children exposed to relevant allergens: effect of flunisolide

Uso do óxido nítrico em crianças com asma persistente

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