Effects of atopy and rhinitis on exhaled nitric oxide values ‐ a systematic review

Linhares, Daniela; Jacinto, Tiago; Pereira, Ana Margarida; Fonseca, João

doi:10.1186/2045-7022-1-8

Cited by 29 publications

(29 citation statements)

References 37 publications

(38 reference statements)

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“…The relationship between FeNO and atopy has been shown in previous studies [5, 13, 24–27], and it has been confirmed by our data. In our study, we found that high FeNO levels also correlated with a high total serum IgE.…”

Section: Discussionsupporting

confidence: 93%

Longitudinal Assessment of High Versus Low Levels of Fractional Exhaled Nitric Oxide Among Children with Asthma and Atopy

Elmasri

Romero²,

Gilman

et al. 2014

Lung

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Purpose Fractional exhaled nitric oxide (FeNO) has emerged as an important biomarker in asthma. Increasing evidence points to atopy as a confounding factor in the interpretation of elevated FeNO. We conducted a longitudinal study to understand the clinical significance of FeNO as an inflammatory biomarker. Methods We identified 19 children aged 13–15 years at baseline with a significant elevation in FeNO ≥ 80 parts per billion (ppb) and randomly selected a group of children of similar age with a moderate elevation (40–79 ppb) and normal-to-low FeNO (<40 ppb). Between November 2010 and July 2011, three additional study visits were conducted. Results Ninety-three children participated in the study. There were 16, 24, and 53 participants in the high, mid, and low FeNO groups. During 1.5 years of follow-up, mean FeNO levels were 82.6 ppb (standard deviation [SD] = 65.9) for atopic asthmatics, 50.6 ppb (SD = 42.6) for nonasthmatic atopics, 17.0 ppb (SD = 10.8) for nonatopic asthmatics, and 17.8 ppb (SD = 13.9) for nonatopic nonasthmatics (p<0.001). FeNO levels remained stable: 63 % of the high FeNO group had a FeNO ≥ 80 across all 4 measurements and 87 % of the normal-to-low FeNO group had a FeNO of<40 across all 4 measurements. The high FeNO group also was found to have an elevation in IL-5 (p = 0.04), IL-6 (p = 0.003), IL-10 (p = 0.002), and total serum IgE (p<0.001), after adjustment by age, sex, height, body mass index, and atopy and asthma status. Conclusions An elevation of FeNO appears to indicate an atopic phenotype regardless of an asthma diagnosis, clinical symptoms, or corticosteroid use. An elevation of FeNO also is associated with a systemic elevation in inflammatory cytokines.

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Section: Discussionsupporting

confidence: 93%

Longitudinal Assessment of High Versus Low Levels of Fractional Exhaled Nitric Oxide Among Children with Asthma and Atopy

Elmasri

Romero²,

Gilman

et al. 2014

Lung

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“…The higher FENO levels in this group of pregnant women are consistent with a systematic review reporting elevated FENO in healthy adults and children with rhinitis [28] Rhinitis coexists in 75-80% of people with asthma. The greatest impact of comorbid rhinitis in these women appears to be related to severity which can be modified by adequate treatment.…”

Section: Discussionsupporting

confidence: 91%

Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life

et al. 2015

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“…Indeed, Cuttitta et al [29] evaluated the prevalence of BHR in children with AR by methacholine bronchial challenge: non-asthmatics displayed a high prevalence of BHR, significantly associated with persistent AR. In concordance, a recent systematic review reporting on the influence of AR on exhaled nitric oxide (eNO) values, a non-invasive marker of lower airway inflammation, concluded that it was higher in children with AR than in children with non-AR, without rhinitis, or atopic children [30].…”

Section: Pathophysiologic Evidencesupporting

confidence: 50%

Pediatric Allergic Rhinitis and Asthma: Can the March be Halted?

et al. 2013

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The strong epidemiologic and pathophysiologic link between allergic rhinitis (AR) and asthma has led to the concept of 'united airways disease' or 'respiratory allergy', implying that allergy, in its widest sense, underlies this clinical syndrome. Progression from AR to asthma is frequent and part of the 'atopic march'. Since pediatric immune responses are more adaptable and therefore may be more amenable to treatment, interventions at early childhood are characterized by a higher chance to affect the natural history of respiratory allergy. Although current treatments are quite effective in alleviating respiratory allergy symptoms, it has proven much more difficult to confirm any influence on the progression of the disease. Much more promising is the field of specific allergen immunotherapy, where current evidence, although not yet of ideal robustness, points towards a disease-modifying effect. In addition, newer or emerging, possibly more effective or more targeted interventions are promising in the preventive sense.

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Effects of atopy and rhinitis on exhaled nitric oxide values ‐ a systematic review

Cited by 29 publications

References 37 publications

Longitudinal Assessment of High Versus Low Levels of Fractional Exhaled Nitric Oxide Among Children with Asthma and Atopy

Longitudinal Assessment of High Versus Low Levels of Fractional Exhaled Nitric Oxide Among Children with Asthma and Atopy

Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life

Pediatric Allergic Rhinitis and Asthma: Can the March be Halted?

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