Association between exhaled carbon monoxide and asthma outcomes in Peruvian children

Abstract

Background: Asthma prevalence continues to increase in low and middle-income countries, presenting challenges in assessing asthma control in resource-poor settings. Previous studies suggest that exhaled carbon monoxide (eCO) is higher with asthma severity and lower with treatment. We hypothesized that eCO levels may be elevated in children with asthma, particularly in children with partially controlled or uncontrolled asthma in a low-resource setting in Lima, Peru. Methods: We compared average eCO levels between 248 children with asthma and 221 healthy controls as well as the odds of asthma by eCO quartiles (0-1, 2, 3, and ≥4 ppm) using multivariable linear and logistic regression. eCO quartiles were also used to compare the odds of partially controlled or uncontrolled asthma (score ≤19 on the Asthma Control Test) in a multivariable logistic regression model. Findings: Average adjusted eCO level was 0.56 ppm (95% CI 0.07-1.05) higher in children with asthma. The adjusted odds of asthma were 1.22 (95% CI 0.75-1.97), 1.46 (0.81-2.63), and 1.76 (0.96-3.23) in the second, third, and fourth eCO quartiles compared to the first eCO quartile, respectively. Among children with asthma, the adjusted odds of partially controlled or uncontrolled asthma in those in the second, third, and fourth eCO quartiles, compared to the first, were 1.61 (95% CI 0.74-3.48), 3.66 (95% CI 1.51-8.87), and 2.50 (95% CI 1.06-5.90), respectively. Interpretation: eCO may serve as an inexpensive biomarker for asthma control, particularly in low-resource settings.

Asthma-prone areas modeling using a machine learning model

“…Transportation and movement of vehicles produce and emit more than 70% of carbon monoxide. This gas interferes with the transport of oxygen in the human blood, leading to impaired cell respiration 42 . The O 3 criterion showed that it had an inverse relationship with the FR value, i.e., in lower values of this parameter, asthma attacks were more likely to occur.…”

Levels of nasal exhaled hydrogen sulfide in the general population and allergic rhinitis patients

“…In recent years, research on the application of gas signal messengers, like nitric oxide (NO) and carbon monoxide (CO), in allergy medicine is rapidly gaining more attention because they are easy and fast to measure and they have a close relationship with disease activity. 6,7 Hydrogen sulfide (H 2 S) is increasingly recognized as another important gasotransmitter. 8 Endogenous H 2 S has been proved to contribute to the pathophysiology of various airway diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pulmonary fibrosis.…”

Changes in fractional exhaled nitric oxide, exhaled carbon monoxide and pulmonary function during the acute attack, treatment and remission phases of pediatric asthma

“…The eCO levels in asthmatic children is significantly higher during the acute period than in the clinical remission period (P<0.05). The investigations of many international researchers (18,19) are consistent with this, and since eCO is easy to detect clinically, many advocate its use as a biomarker of asthma management. In the preschool children aged 3-5 years with simple asthma in this study, the eCO levels in the acute period were significantly higher than those in the clinical remission period (P<0.05).…”