Title:Studying the Role of Alveolar Exhaled Nitric Oxide in Combination with
Bronchial Nitric Oxide to Predict Asthma Control in Children with Asthma:
A Real-Life Prospective Study
Volume: 19
Issue: 1
Author(s): Thuy Nguyen-Thi-Dieu, Hanh Do-Thi, Huong Nguyen-Thi-Quynh, Huong Le-Thi-Minh and Sy Duong-Quy*
Affiliation:
- Department of Respiratory Diseases, Lam Dong Medical College, Dalat, Vietnam
- Division of Immuno-Allergology, Penn State Medical College, Hershey Medical Center, PA
117033, USA
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
Keywords:
Asthmatic children, allergic asthma, FENO, CANO, asthma control, inhaled corticosteroid.
Abstract:
Background: Fractional Exhaled Nitric Oxide (FENO) is currently used as a biomarker
of airway inflammation in patients with asthma. However, the role of alveolar nitric oxide (CANO)
in asthmatic children has not been clearly demonstrated.
Methods: It was a prospective and descriptive study. The measurement of FENO and CANO, spirometry,
blood eosinophil counts (BEC), and total IgE levels were performed for each study subject.
Results: This study included 109 uncontrolled asthmatic children without inhaled corticosteroid
(ICS) treatment. The exhaled NO level in asthmatic patients was significantly higher than in control
subjects: FENO: 22.5 vs. 8.4 ppb; CANO: 5.9 vs. 2.8 ppb; J’awNO (maximum airway nitric oxide
flux): 56.9 vs. 18.7 ppb; respectively. The sensitivities and specificities for asthma diagnosis with
the cut-off of CANO at 3.5 ppb and 5.0 ppb were 74.3% and 73.3%, and 46.0% and 83.3%, respectively.
There were the moderate and the weak correlations between CANO with FENO and CANO
with IgE in asthmatic patients (r = 0.465, 95%CI (0.133-0.659), P=0.001; r=0.133, 95%CI (0.068-
0.497), P=0.184; respectively). The percentage of controlled asthma in patients with CANO ≥5 ppb
at inclusion was higher than that in CANO <5 ppb group.
Conclusion: Exhaled NO is a relevant biomarker of allergic asthma. The level of FENO and CANO
might be used to predict asthma control in children.