Exercise-induced bronchoconstriction (EIB) is not associated with exhaled nitric oxide (FeNO) in adolescent athletes

Ersson, Karin; Johansson, Henrik; Mallmin, Elisabet; Malinovschi, Andreï

doi:10.1183/13993003.congress-2019.pa4508

Cited by 3 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While some researchers have reported that a high FeNO (≥50 ppb) is predictive of EIB in children, 27,28 others have argued that FeNO should not be employed to detect EIB in adolescents. 29 The purpose of this study was therefore to investigate the diagnostic value of FeNO in the assessment of EIB in a large cohort of elite and recreational athletes. A secondary aim was to evaluate whether athletic standard, selfreported respiratory symptoms, and/or sex influence the diagnostic value of FeNO.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fractional exhaled nitric oxide in the assessment of exercise‐induced bronchoconstriction: A multicenter retrospective analysis of UK‐based athletes

Dickinson

Gowers

Sturridge

et al. 2023

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

Introduction Exercise‐induced bronchoconstriction (EIB) is not only highly prevalent in people with asthma, but can also occur independently, particularly in athletes. Fractional exhaled nitric oxide (FeNO) is an indirect biomarker of type 2 airway inflammation that has an established role in the assessment and management of asthma. The aim was to evaluate the value of FeNO in the assessment of EIB in athletes. Method Multicenter retrospective analysis. In total, 488 athletes (male: 76%) performed baseline FeNO, and spirometry pre‐ and post‐indirect bronchial provocation via eucapnic voluntary hyperpnea (EVH). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for established FeNO thresholds—that is, intermediate (≥25 ppb) and high FeNO (≥40 ppb and ≥ 50 ppb)—and were evaluated against objective evidence of EIB (≥10% fall in FEV1). The diagnostic accuracy of FeNO was calculated using receiver operating characteristics area under the curve (ROC‐AUC). Results Thirty‐nine percent of the athletes had a post‐EVH fall in FEV1 consistent with EIB. FeNO values ≥25 ppb, ≥40 ppb, and ≥ 50 ppb were observed in 42%, 23%, and 17% of the cohort, respectively. The sensitivity of FeNO ≥25 ppb was 55%, which decreased to 37% and 27% at ≥40 ppb and ≥ 50 ppb, respectively. The specificity of FeNO ≥25 ppb, ≥40 ppb, and ≥ 50 ppb was 66%, 86%, and 89%, respectively. The ROC‐AUC for FeNO was 0.656. Conclusions FeNO ≥40 ppb provides good specificity, that is, the ability to rule‐in a diagnosis of EIB. However, due to the poor sensitivity and predictive values, FeNO should not be employed as a replacement for indirect bronchial provocation in athletes.

show abstract

Section: Introductionmentioning

confidence: 99%

“…To date, however, there remains a lack of consensus regarding the value of FeNO to predict EIB in athletes. While some researchers have reported that a high FeNO (≥50 ppb) is predictive of EIB in children, 27,28 others have argued that FeNO should not be employed to detect EIB in adolescents 29 …”

Section: Introductionmentioning

confidence: 99%

Fractional exhaled nitric oxide in the assessment of exercise‐induced bronchoconstriction: A multicenter retrospective analysis of UK‐based athletes

Dickinson

Gowers

Sturridge

et al. 2023

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

show abstract

How to detect young athletes at risk of exercise-induced bronchoconstriction?

Goossens

Decaesteker

Jonckheere

et al. 2022

Paediatric Respiratory Reviews

View full text Add to dashboard Cite

Fractional exhaled nitric oxide in the assessment of exercise-induced bronchoconstriction: a multicentre retrospective analysis of UK-based athletes

Dickinson

Gowers

Sturridge

et al. 2022

01.05 - Clinical Respiratory Physiology, Exercise and Functional Imaging

View full text Add to dashboard Cite

Exercise-induced bronchoconstriction (EIB) is not only highly prevalent in people with asthma, but can also occur independently, particularly in athletes. Fractional exhaled nitric oxide (FeNO) is an indirect biomarker of type 2 airway inflammation that has an established role in the assessment and management of asthma. The aim was to evaluate the value of FeNO in the assessment of EIB in athletes.Method: Multicenter retrospective analysis. In total, 488 athletes (male: 76%) performed baseline FeNO, and spirometry pre-and post-indirect bronchial provocation via eucapnic voluntary hyperpnea (EVH). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for established FeNO thresholds-that is, intermediate (≥25 ppb) and high FeNO (≥40 ppb and ≥ 50 ppb)-and were evaluated against objective evidence of EIB (≥10% fall in FEV 1 ). The diagnostic accuracy of FeNO was calculated using receiver operating characteristics area under the curve (ROC-AUC).Results: Thirty-nine percent of the athletes had a post-EVH fall in FEV 1 consistent with EIB. FeNO values ≥25 ppb, ≥40 ppb, and ≥ 50 ppb were observed in 42%, 23%, and 17% of the cohort, respectively. The sensitivity of FeNO ≥25 ppb was 55%, which decreased to 37% and 27% at ≥40 ppb and ≥ 50 ppb, respectively. The specificity of FeNO ≥25 ppb, ≥40 ppb, and ≥ 50 ppb was 66%, 86%, and 89%, respectively. The ROC-AUC for FeNO was 0.656. Conclusions:FeNO ≥40 ppb provides good specificity, that is, the ability to rulein a diagnosis of EIB. However, due to the poor sensitivity and predictive values, FeNO should not be employed as a replacement for indirect bronchial provocation in athletes.

show abstract

Exercise-induced bronchoconstriction (EIB) is not associated with exhaled nitric oxide (FeNO) in adolescent athletes

Cited by 3 publications

References 0 publications

Fractional exhaled nitric oxide in the assessment of exercise‐induced bronchoconstriction: A multicenter retrospective analysis of UK‐based athletes

Fractional exhaled nitric oxide in the assessment of exercise‐induced bronchoconstriction: A multicenter retrospective analysis of UK‐based athletes

How to detect young athletes at risk of exercise-induced bronchoconstriction?

Fractional exhaled nitric oxide in the assessment of exercise-induced bronchoconstriction: a multicentre retrospective analysis of UK-based athletes

Contact Info

Product

Resources

About