Exhaled nitric oxide in children with allergic rhinitis: A potential biomarker of asthma development

Cara, Giuseppe Di; Marcucci, Francesco; Palomba, Antonella; Milioni, Maddalena; Pecoraro, Luca; Ciprandi, Giorgio; Buttafava, Serena; Frati, Franco; Verrotti, Alberto

doi:10.1111/pai.12326

Cited by 26 publications

(24 citation statements)

References 12 publications

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“…More interestingly, the follow-up data suggest that some AR patients with high FeNO values may develop asthma over time, confirming a recent study providing evidence that children with AR and high FeNO levels tend to also develop asthma [13]. In fact, about a quarter of AR patients with high FeNO values had asthma after 2 years.…”

Section: Discussionsupporting

confidence: 67%

“…These include: (i) the high prevalence of males, (ii) the relatively young age of the patients, (iii) that VAS scores reported only nasal obstruction and breathlessness, (iv) that a FEV 1 /FVC ratio <0.7 was considered as an abnormal limit rather than the lower limit of normal, (v) the inclusion of light smokers, and (vi) the lack of a long-term follow-up to confirm these findings. In particular, we limited the follow-up only to the patients with high FeNO values, presuming that high FeNO may predict further asthma onset, as previously reported [13]. Therefore, we considered these subjects as being at risk of asthma and deserving an accurate reevaluation.…”

Section: Discussionmentioning

confidence: 99%

“…It has been proposed that an FEF 25-75 value <65% predicted may be a marker of early bronchial involvement [12]. It has also been reported that AR children with high FeNO levels develop asthma later [13]. Therefore, we tested the hypothesis that FeNO may be a biomarker in AR patients able to define those with bronchial involvement and the potential of further progression to overt asthma.…”

Section: Introductionmentioning

confidence: 99%

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Fractional Exhaled Nitric Oxide: A Potential Biomarker in Allergic Rhinitis?

Ciprandi

Gallo

Ricciardolo

et al. 2017

Int Arch Allergy Immunol

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Background: The fractional concentration of exhaled nitric oxide (FeNO) is a surrogate biomarker for Th2-dependent bronchial inflammation. The present study investigated whether FeNO may characterize allergic rhinitis (AR) patients. Methods: A total of 553 AR patients (497 males, mean age 28.8 years) were evaluated. Those patients with a high FeNO underwent a 2-year follow-up. Results: Increased FeNO was associated with a significantly longer AR duration, impaired lung function, more severe symptoms, and more frequent bronchial hyperresponsiveness (BHR). At follow-up, 22 out of 82 patients (26.8%) with high FeNO levels (>50 ppb) developed asthma. Conclusions: AR patients may frequently have high FeNO values, exceeding 50 ppb. This might be associated with an initial impaired lung function, BHR, a perceived worsening of respiratory symptoms, and potential progression to asthma.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fractional Exhaled Nitric Oxide: A Potential Biomarker in Allergic Rhinitis?

Ciprandi

Gallo

Ricciardolo

et al. 2017

Int Arch Allergy Immunol

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“…Its development and validation have been revealed as useful for improving control of respiratory allergy in adolescents. Observing the degree of inflammation by local and systemic noninvasive biomarkers of Th2‐mediated inflammation has been proposed to guide asthma management, such as exhaled breath condensate markers (H 2 O 2 , pH levels ), blood and sputum eosinophils, FeNO , and serum periostin . These analyses are helpful, although they cannot be routinely performed.…”

Section: Diagnosis and Managementmentioning

confidence: 99%

Asthma and allergic rhinitis in childhood: what's new

Mastrorilli

Posa

Cipriani

et al. 2016

Pediatric Allergy Immunology

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Novel approaches are currently offered for the diagnostic workup and therapeutic management of allergic rhinitis and asthma. New predictive biomarkers of allergy and asthma are available. Primary and secondary prevention, earlier intervention, and modification of the natural history of allergic rhinitis and asthma are being intensively investigated. This review highlights advances in the understanding of the etiology, diagnosis, and management of atopic airway diseases in childhood, as well as prenatal and early-life risk factors and strategies for prevention.

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“…), predizendo significantemente o início de asma (OR:2.49, p<0,01). Portanto, valores acima de 35p.p.b., considerados patológicos, podem predizer com confiabilidade futuro início de asma em crianças com RA (DI CARA et al, 2014;SHAKER, 2014). Outros estudos também mostram a relevância do FeNO como possível marcador preditivo para hiperresponsividade brônquica em paciente com RA, sugerindo valores patológicos acima de 50 ppb, demonstrando a íntima relação entre as vias aéreas alta e baixa, sugerindo que sua medida poderia ser uma ferramenta de triagem na identificação de sujeitos com RA para o risco de desenvolver asma (CIPRANDI et al, 2017;CIRILLO et al, 2013).…”

Section: óXido Nítrico Exalado (Feno) E Nasal (Nno)unclassified

Biomarcadores Na Rinite Alérgica: Qual a Importância E Potencial Diagnóstico?

2017

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RESUMO:O objetivo deste estudo é apontar quais os novos potenciais marcadores biológicos na rinite alérgica (RA). Buscou-se nas bases de dados Scielo e PUBMED artigos com os descritores "Rinite Alérgica" e "Biomarcadores" ou "Citocinas" ou "Interleucinas" ou "Eicosanoides", bem como na língua inglesa. A perspectiva do uso de novos biomarcadores na rinite alérgica vem sendo pesquisada, visto que marcadores sensíveis e específicos da doença poderiam permitir rápido diagnóstico, avaliação do estágio da doença e estimação da resposta ao tratamento. Vários métodos para coleta de amostras não invasivos ou semi-invasivos nas vias aéreas oferecem a possibilidade de mensuração de uma grande quantidade de novos biomarcadores na RA. Como potenciais biomarcadores, a análise do perfil de citocinas nasais apresenta uma boa caracterização diagnóstica (IL-5 e IL-13), além da relação de severidade da doença (IL-9 e IL-17B). Como avaliação isolada, a dosagem sérica de Proteína da Célula de Clara (CC16) parece ter grande potencial, pois permite o diagnóstico e seus níveis estão inversamente relacionados com a severidade da doença. Além disso, a dosagem de FeNO vem como uma arma importante para predizer asma nos pacientes com RA. PALAVRAS-CHAVE:Biomarcadores; Rinite alérgica; Citocinas; Interleucinas; Eicosanoides. BIOMARKERS IN ALLERGIC RHINITIS: ITS IMPORTANCE AND DIAGNOSTIC POTENTIALABSTRACT: Current analysis deals with the new potential biological markers in allergic rhinitis. Scielo and PUBMED databases were researched for articles through descriptors "Allergic rhinitis" and "Biomarkers" or "Cytokines" or "Interleukins" or "Eicosanoids", in English and Portuguese. The use of new biomarkers for allergic rhinitis is researched since sensitive and specific markers provide a quick diagnosis, assessment of the disease´s stage and estimates of treatment responses. Several invasive and semi-invasive methods for sample collection from the aerial pathways make possible the measurement of a great number of new biomarkers in allergic rhinitis. As potential biomarkers, the analysis of nasal cytokines offers a good diagnose (IL-5 and IL-13), coupled to the disease´s severity (IL-9 and IL-17B). As an isolated evaluation, serum dosage of Clara Cell Protein (CC16) seems to be highly promising since it favors diagnosis with inversely related levels for the disease´s severity. Further, FeNO dosage is an important tool to predict asthma in AR patients.

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Exhaled nitric oxide in children with allergic rhinitis: A potential biomarker of asthma development

Cited by 26 publications

References 12 publications

Fractional Exhaled Nitric Oxide: A Potential Biomarker in Allergic Rhinitis?

Fractional Exhaled Nitric Oxide: A Potential Biomarker in Allergic Rhinitis?

Asthma and allergic rhinitis in childhood: what's new

Biomarcadores Na Rinite Alérgica: Qual a Importância E Potencial Diagnóstico?

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