Elevated Exhaled Nitric Oxide in High-Risk Neonates Precedes Transient Early but Not Persistent Wheeze

Abstract

An elevated Fe(NO) level in asymptomatic neonates born to mothers with asthma preceded the development of transient early wheezing, but not persistent wheezing during preschool age, and was unrelated to atopy. This suggests an early disease process other than small airway caliber contributing to the transient wheezing phenotype.

NO kidding: exhaled nitric oxide fraction in preschool children

“…The results were in line with earlier studies suggesting an association between FeNO early in life and respiratory symptoms, lung function, airways reactivity and/or asthma later in life [7][8][9][10][11]. The different populations studied, the different techniques used to measure FeNO and the different outcomes assessed may explain conflicting results with other studies [12][13][14]. CHAWES et al [12] showed that elevated FeNO at 1 month of age did precede transient early wheeze, but not persistent wheeze, and was unrelated to atopy.…”

“…The different populations studied, the different techniques used to measure FeNO and the different outcomes assessed may explain conflicting results with other studies [12][13][14]. CHAWES et al [12] showed that elevated FeNO at 1 month of age did precede transient early wheeze, but not persistent wheeze, and was unrelated to atopy.…”

Characterizing wheeze phenotypes to identify endotypes of childhood asthma, and the implications for future management

“…Studies have found that this biomarker can be used as a biomarker for transient wheeze but not for persistent wheeze phenotypes. As early as age one month, an elevated exhaled FeNO was seen in children who had recurrent wheeze in the first year of life but not thereafter [77]. FeNO is therefore likely a marker of airway inflammation and contemporaneous recurrent wheeze rather than a marker of distinct asthma endotypes.…”

“…Fraction of Exhaled Nitric Oxide (FeNO), indicative of Th2-type airway inflammation, has been proposed as a potential biomarker for distinguishing endotypes [76][77][78][79] in early life due to its noninvasive nature [76,[80][81][82][83][84]. However, FeNO is strongly correlated with atopy [85][86][87][88].…”

Predictive value of exhaled nitric oxide in healthy infants for asthma at school age

“…The value of FeNO after birth to predict later symptoms before relevant exposure to environmental factors has been prospectively investigated in only two studies [9,10]. LATZIN et al [9] reported that infants born to atopic mothers had increased FeNO prior to respiratory symptoms and that this association was enhanced in mothers who smoked.…”