Low Exhaled Nitric Oxide in School-Age Children with Bronchopulmonary Dysplasia and Airflow Limitation

Baraldi, Eugenio; Bonetto, G.; Zacchello, Franco; Filippone, Marco

doi:10.1164/rccm.200403-298oc

Cited by 170 publications

(138 citation statements)

References 31 publications

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“…The FeNO values recorded in the pre-term-born individuals in our series were normal, suggesting that there is no predominant eosinophil-mediated inflammatory pathway in these subjects' airways [37], whereas increased 8-isoprostane levels in preterm-born cases point to active oxidative stress. The association of an increased oxidative stress with normal FeNO values might represent an apparent paradox.…”

Section: Paediatric Lung Diseasementioning

confidence: 54%

Evidence of unexpected oxidative stress in airways of adolescents born very pre-term

Filippone¹,

Bonetto²,

Corradi

et al. 2012

Eur Respir J

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105

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Prematurity and its main respiratory complication, bronchopulmonary dysplasia (BPD), are potentially associated with lifelong respiratory morbidities and/or lung function abnormalities. The mechanisms behind these long-term respiratory problems are still unclear.We assessed airway oxidative stress in adolescents born very pre-term (f32 gestational weeks) by measuring 8-isoprostane concentration in exhaled breath condensate (EBC). In addition, the study protocol included spirometry and measurement of exhaled nitric oxide fraction (FeNO).The study groups included 34 ex-pre-term adolescents with BPD, 18 ex-pre-term adolescents without BPD and 34 healthy controls born at term.Regardless of a history of BPD, the ex-premature adolescents had higher EBC 8-isoprostane levels (median (interquartile range) BPD 9.5 (7.3-12.2) pg?mL -1 ; pre-term non-BPD 10 (8.1-16) pg?mL -1 ) than the controls (3.2 (1.9-6.5) pg?mL -1 ) (p,0.001). Forced expiratory volume in 1 s was lower in the BPD group (mean¡SD Z-score -2.1¡1.58) than in the pre-term non-BPD individuals (-1.13¡1.15), who showed in turn significantly lower values than the controls (0.18¡0.83; p,0.001). FeNO was similar in the three groups (p50.55).Our data show that, after premature birth, evidence of oxidative stress in the airways may be detected into adolescence, suggesting that long-term respiratory abnormalities after pre-term birth may be associated with an ongoing airway disease and not just a stabilised structural lung damage.

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Section: Paediatric Lung Diseasementioning

confidence: 54%

Evidence of unexpected oxidative stress in airways of adolescents born very pre-term

Filippone¹,

Bonetto²,

Corradi

et al. 2012

Eur Respir J

Self Cite

105

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show abstract

“…32 Unlike in patients with asthma, airflow obstruction was only partially reversible after administration of bronchodilators, with 68%-72% of children with BPD not responding at all to such treatment. 33,34 These results suggest that structural changes originating in the neonatal period may lead to fixed reductions in airway caliber. At the alveolar level, impaired gas transfer has been documented with lower diffusion capacity in patients born preterm.…”

Section: Are We Seeing a New Pulmonary Overlapping Syndrome?mentioning

confidence: 82%

Preterm birth: risk factor for early-onset chronic diseases

Luu

Katz

Leeson

et al. 2015

CMAJ

118

100

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“…While 29% of children with prior BPD had doctor-diagnosed asthma and recent asthma medication, there was no increase in either the prevalence of atopy or levels of FeNO in these children, suggesting a different underlying pathophysiology to that usually observed in childhood asthma [26]. The fact that the airways obstruction observed in these children was only partially reversible raises the issue as to whether these children have been correctly diagnosed, or optimally treated [11].…”

Section: Respiratory Morbiditymentioning

confidence: 85%

Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age

Lum¹,

Kirkby²,

Welsh³

et al. 2010

Eur Respir J

156

140

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Advances in neonatal care have resulted in increased survival of children born extremely pre-term (EP). Nevertheless the incidence of bronchopulmonary dysplasia and longterm respiratory morbidity remains high. We investigated the nature of pathophysiological changes at 11 yrs of age to ascertain whether respiratory morbidity in EP children primarily reflects alterations in the lung periphery or more centralised airway function in this population.Spirometry, plethysmography, diffusing capacity, exhaled nitric oxide, multiple-breath washout, skin tests and methacholine challenge were used during laboratory-based assessments in a subgroup of the 1995 EPICure cohort and in controls.Results were obtained in 49 EP and 52 control children. Lung function abnormalities were found in 78% of EP children, with evidence of airway obstruction, ventilation inhomogeneity, gas trapping and airway hyperresponsiveness. Levels of atopy and exhaled nitric oxide were similar between the groups. Prior wheeze was associated with significant reductions in forced flows and volumes. By contrast, abnormalities of the lung periphery appear to be mediated primarily through EP birth per se.The prevalence of lung function abnormalities, which is largely obstructive in nature and likely to have long-term implications, remains high among 11-yr-old children born EP. Spirometry proved an effective means of detecting these persistent abnormalities.

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Low Exhaled Nitric Oxide in School-Age Children with Bronchopulmonary Dysplasia and Airflow Limitation

Cited by 170 publications

References 31 publications

Evidence of unexpected oxidative stress in airways of adolescents born very pre-term

Evidence of unexpected oxidative stress in airways of adolescents born very pre-term

Preterm birth: risk factor for early-onset chronic diseases

Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age

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