The Clinical Significance of Nasal Nitric Oxide Concentrations in Preschool Children with Nasal Inflammatory Disease

Chen, Qiaobin; Chen, Lang; Xiaoyin, Zheng; Zheng, Xin; Fang, Qiong; Xiao, Meng; Lin, Xun

doi:10.1159/000504192

Cited by 9 publications

(9 citation statements)

References 6 publications

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“…11 Analyzing the data found in this review, a different cell infiltrate was observed in allergic children, markedly with mastocytosis and eosinophilia, considering the fact that the predominance of these cells increases with age and it is still necessary to determine the validity of nasal cytology in rhinitis with perennial symptoms. [8][9][10][11][12] Chen et al 19 reported that nasal nitric oxide had higher rates in children with rhinitis compared to controls. Nasal nitric oxide can function as a non-invasive tool to detect nasal inflammatory diseases, however, despite recommendations for its use, cut-off values are not well defined.…”

Section: Discussionmentioning

confidence: 99%

“…There are few studies on nasal nitric oxide in healthy people, particularly young children and there are concerns about cost and availability. 19,25,26 Leukotrienes are arachidonic acid metabolites whose synthesis can be stimulated by the presence of antigens and cytokines. They have an established role in inflammatory diseases, including asthma and allergic rhinitis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Allergic Rhinitis in Preschoolers: A Systematic Review of Diagnostics

Diniz

Ribeiro

Lira

et al. 2023

Am J Rhinol�Allergy

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Background Most studies that seek to analyze the prevalence of allergic rhinitis do not include preschool children and the diagnosis in this age group is difficult. Objective Identify complementary tests to the diagnosis of allergic rhinitis in preschool children and verify if there is scientific robustness to propose a diagnostic algorithm for this condition in this age group. Methods Systematic review of the literature in four databases: SCIELO, PubMed/MEDLINE, LILACS and SCOPUS. Each article was initially chosen by title, abstract and by the keywords “allergic rhinitis,” “diagnosis” and “preschool.” Those articles selected entered the complete reading and data extraction phase. The study was registered in the International Prospective Register of Systematic Reviews under number CRD42020207053. Results Fourteen articles were suitable for analysis. In the assessment using Quality Assessment of Diagnostic Accuracy Studies – 2, all studies had at least one domain considered “high risk” or “undetermined risk.” Seven reports of nasal cytology, seven of specific IgE, four of immediate hypersensitivity skin test, one of nasal nitric oxide, three of total IgE and one of urinary leukotriene E4 were found. Eight articles evaluated more than one diagnostic test. Conclusion There are no defined criteria for the diagnosis of allergic rhinitis in preschool children. Nasal cytology, serum specific IgE and immediate hypersensitivity skin test were the most used tests. A reliable diagnostic criterion in this age group is necessary so that in the future it is possible to propose a diagnostic algorithm for allergic rhinitis in preschool children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Allergic Rhinitis in Preschoolers: A Systematic Review of Diagnostics

Diniz

Ribeiro

Lira

et al. 2023

Am J Rhinol�Allergy

View full text Add to dashboard Cite

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“…Several studies have used this method to compare nNO levels between patients with allergic rhinitis and healthy controls. They found that, in children with allergic rhinitis, nNO levels were significantly higher than those of healthy control children (9,16,22). Based on this result, we sought to determine whether there was a direct association between nNO and EOS or total IgE levels.…”

Section: The Measurement Of No Concentrations During Expirationmentioning

confidence: 98%

“…A visual analog scale can be used to effectively assess the symptom severity (8); however, some study point out that allergen test is invasive and may incite fear in children. Further, the high cost and long inspection time increase the burden of these tests (9). Moreover, allergic rhinitis can be difficult to distinguish from other common diseases among young children (10).…”

Section: Introductionmentioning

confidence: 99%

Clinical application of fractional exhaled nitric oxide and nasal nitric oxide levels for the assess eosinophilic inflammation of allergic rhinitis among children

Luo¹,

Chen²,

Ma³

et al. 2021

Transl Pediatr

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Background: Allergic rhinitis is one of the most common nasal inflammatory diseases among children.Assessment of clinical symptoms, skin prick test and serum immunoglobulin E (IgE) are common methods used to diagnose allergic rhinitis and assess inflammation degree in clinical settings. However, via blood tests assess eosinophils inflammation is invasive, and may cause fear in children. It makes have burden of the diagnosis of allergic rhinitis. Nasal nitric oxide (nNO) and fractional exhaled nitric oxide (FeNO) are noninvasive, inexpensive, and can provide immediate results. These methods may therefore be preferable to assess the inflammation of allergic rhinitis.Methods: This study was a retrospective analysis. We recruited 61 children with allergic rhinitis from November 2019 to March 2020. The participants were assessed using the FeNO and nNO tests. We also administered questionnaires and carried out traditional allergen and blood tests. We analyzed the relationship between diagnosis results and FeNO and nNO levels before and after the treatment of allergic rhinitis, to investigate the clinical application of FeNO and nNO levels for assess eosinophilic inflammation of allergic rhinitis in children. Results:We observed a significant association both FeNO, nNO level with eosinophils, total IgE. In different levels of eosinophils (EOS), the correlation of detection parameters had obvious change. FeNO and nNO levels were obvious higher compared to pre-treatment.Conclusions: Using NO concentration can indicates the extent of allergic inflammation and can measure allergy treatment effects combine other influence indexes. The combined use of FeNO and nNO levels may be a useful method for assess the degree of eosinophilic inflammation of allergic rhinitis in children.

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“…Several authors have already outlined the relevance of nFeNO as a marker of AR inflammation in children. [15][16][17] Notably, they have shown that nFeNO level in AR (with or without asthma) was significantly increased than controls. 18,19 However, to date, no studies have been conducted in children with allergic diseases analyzing inflammatory and functional parameters together.…”

Section: Introductionmentioning

confidence: 98%

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

Brindisi¹,

Vittori²,

Nola³

et al. 2021

JAA

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Background Allergic rhinitis (AR) and asthma are two common atopic diseases, often associated with a common ethiopathogenesis characterized by a Th2 inflammatory response with the release of many biomarkers, such as nitric oxide (NO). Purpose To evaluate and compare inflammatory (nFeNO and eFeNO) and functional (mNF and FEV1) parameters in AR children with or without asthma in comparison to controls. Secondly, we aimed to identify nFeNO cut-off values and verify their reliability to predict the presence of rhinitis or asthma alone or in combination. Patients and Methods We enrolled 160 children (6–12 years of age) with AR and/or asthma divided into four groups: controls, AR, asthma, and AR + asthma. All children underwent the following inflammatory and functional measurements: nFeNO, eFeNO, mNF and FEV1. Results We observed that levels of nFeNO were extremely higher in children with AR and even more in those with AR + asthma in respect to controls. Notably, all the pathological conditions, especially AR + asthma, showed significantly lower values of mNF compared to healthy children. A negative correlation linked mNF and nFeNO. Then, we found eFeNO values significantly higher in all the pathological groups compared to controls, with major values of this marker in patients affected by asthma and AR + asthma, as well as FEV1 values significantly lower in all the disease groups, especially in children with asthma and AR+ asthma. ROC curve analysis showed that nFeNO was a great predictor for rhinitis alone or with asthma, revealing an accurate cut-off of 662 ppb. Conclusion nFeNO measurement is non-invasive, easy to perform, economic and a valuable test in case of AR alone or in association with asthma. Thus, it should be used in patients with rhinitis, together with anterior active rhinomanometry (AAR) to diagnose and estimate the degree of nasal obstruction but also in children with asthma to assess their nasal involvement and improve the therapeutic management.

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The Clinical Significance of Nasal Nitric Oxide Concentrations in Preschool Children with Nasal Inflammatory Disease

Cited by 9 publications

References 6 publications

Allergic Rhinitis in Preschoolers: A Systematic Review of Diagnostics

Allergic Rhinitis in Preschoolers: A Systematic Review of Diagnostics

Clinical application of fractional exhaled nitric oxide and nasal nitric oxide levels for the assess eosinophilic inflammation of allergic rhinitis among children

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

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