Influence of atopy on exhaled nitric oxide in patients with stable asthma and rhinitis

Gratziou, C.; Lignos, M; Dassiou, M; Roussos, Ch.

doi:10.1034/j.1399-3003.1999.14d28.x

Cited by 160 publications

(163 citation statements)

References 34 publications

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“…In contrast with previous findings [16], we observed no significant difference in the eNO level according to the atopic status in the group of asthmatics with rhinitis. However, our results are consistent with those of Berlyne et al [50] comparing eNO to induced sputum, and are in accordance with the hypothesis of a similar physiological process between atopic and non-atopic asthma.…”

Section: Discussioncontrasting

confidence: 99%

“…These findings are consistent with previous studies, in which eNO levels from two to four times higher than normal were found in atopic asthmatic children [7], teenagers [15] and adults [16]. Among non-asthmatic children, atopic subjects had higher eNO concentrations than non-atopic subjects, which contrasts with previous results showing no difference in eNO levels between atopic and nonatopic individuals either in children [7] or in adults [15,16]. This might be due to the use in these studies of a high (250 mL/s) expiratory flow rate, which has been shown to have poor sensitivity [11,12,17].…”

Section: Discussionsupporting

confidence: 94%

“…In addition, our results suggest that the eNO level of atopic asthmatic children is greater than that of non-atopic asthmatic children. These findings are consistent with previous studies, in which eNO levels from two to four times higher than normal were found in atopic asthmatic children [7], teenagers [15] and adults [16]. Among non-asthmatic children, atopic subjects had higher eNO concentrations than non-atopic subjects, which contrasts with previous results showing no difference in eNO levels between atopic and nonatopic individuals either in children [7] or in adults [15,16].…”

Section: Discussionsupporting

confidence: 91%

“…As previously noted in adults [16] and in children [21], we found a low level of eNO that did not vary depending on the subjects' atopic or non-atopic status in the control group. This result was consistent with studies [22,23] that found no inflammatory modification of the bronchoalveolar lining in atopic or non-atopic healthy subjects.…”

Section: Discussionsupporting

confidence: 86%

“…In the light of these findings, a subject's atopic nature might simply reflect a state of immune sensitization to allergens. In contrast, as already noted in adults [16], a significant increase in eNO level was observed in the subgroup of atopic children with rhinitis. This finding lends support to the hypothesis of a relationship between the concentration of eNO and atopy, which is manifested in a certain number of cases by rhinitis.…”

Section: Discussionsupporting

confidence: 56%

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Interrelationships among asthma, atopy, rhinitis and exhaled nitric oxide in a population‐based sample of children

Jouaville¹,

Annesi‐Maesano

Nguyễn³

et al. 2003

Clin Experimental Allergy

116

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SummaryBackground Exhaled nitric oxide (eNO) has attracted increasing interest as a non-invasive marker of airway inflammation in asthma. However, little evidence exists on the influences exerted on eNO by the interrelations among atopic status, asthma and rhinitis. Methods Among the 1156 children who participated in a large-scale epidemiological survey on asthma and allergies (ISAAC II: International Study of Asthma and Allergies in Childhood Phase II) in the city of Clermont-Ferrand, 53 asthmatics without corticosteroid treatment and 96 nonasthmatics were invited to perform eNO and skin prick tests (SPTs) to 12 common allergens. Results Atopic asthmatic children had higher eNO than non-atopic asthmatic children (28.979.1 vs. 17.1713.1 p.p.b.; P 5 0.0004) with a significant increase when one SPT or more are positive (26.577.8 vs. 17.1713.1 p.p.b.; P 5 0.03). Similarly, non-asthmatic, atopic subjects had higher eNO than non-atopic subjects with a significant increase when two SPTs or more are positive (19.479.8 vs. 11.7 76.7 p.p.b.; P 5 0.003). In the case of equal levels of positive SPTs (0, 1, X2), asthmatic children always had higher eNO than non-asthmatic ones. Furthermore, among non-asthmatic children, the eNO level increased only in atopics who had rhinitis (20.7713 vs. 12.576.4 p.p.b. in atopic controls (subjects without rhinitis and asthma) and 12.376.6 p.p.b. in non-atopic controls; P 5 0.001), whereas among asthmatic children, eNO level increased in atopics independently of rhinitis (28.279.5 p.p.b. in those with rhinitis and 30.978.1 p.p.b. in those without) as well as in nonatopics with rhinitis (22.5717.2 p.p.b.). Conclusions Our data suggest that besides atopy and asthma, allergic rhinitis should also be taken into account in the assessment of eNO.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 56%

See 3 more Smart Citations

Interrelationships among asthma, atopy, rhinitis and exhaled nitric oxide in a population‐based sample of children

Jouaville¹,

Annesi‐Maesano

Nguyễn³

et al. 2003

Clin Experimental Allergy

116

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Natural pollen exposure increases in a dose‐dependent way Fraction of exhaled Nitric Oxide (FeNO) levels in patients sensitized to one or more pollen species

Olivieri

Marchetti

Murgia

et al. 2022

Clinical & Translational All

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Background Co‐exposures and polysensitization to several pollen species are very common in real life practice. However, little information exists on allergic symptoms and airway inflammation related to natural pollen exposure in large general population samples. Objective To assess the combined effect of sensitization and/or exposure to one or more pollen species on Fraction of exhaled Nitric Oxide (FeNO) levels. Methods Within Gene Environment Interactions in Respiratory Diseases (GEIRD) multicase‐control study, 1070 adults from the general population of Verona, Italy, underwent a clinical evaluation including standardized interview, spirometry, skin prick test to inhalants and FeNO measurement. Pollen exposure was assumed, when the mean pollen concentration in the previous week was above the cutoff established by the Italian Aerobiological Monitoring Network. Results Subjects sensitized to one or more pollen species were respectively 15.5% and 29.6%. FeNO levels were directly related to the number of both pollen species around and pollen‐related sensitizations. Median FeNO levels were directly related to number of pollen species around and pollen sensitization. FeNO levels increased from 15.4 ppb (p. 25–p. 75 = 9.9–21.0) outside the pollen season to 17.5 ppb (11.2–30.5) when there were ≥3 pollen species around. Likewise FeNO levels rose from 14.8 ppb (10.0–22.3) in not sensitized subjects, to 16.7 (10.1–25.0) in monosensitized and further to 20.4 (12.3–40.6) in poly‐sensitized. According to multivariable quantile regression, median FeNO was 17.9 ppb higher (p. 25–p. 75 = 12.5–23.3) for subjects sensitized and exposed to more than one pollen species, compared to subjects who were neither sensitized nor exposed. Differences in FEV1/FVC between groups were less pronounced ( − 2.0%, −4.1 to 0.1). Median FeNO level was 15.1 ppb (p. 25–p. 75 = 10.0–23.2) in subjects without pollen‐related symptoms, 17.8 ppb (12.1–40.2) in those with nasal symptoms only, and 22.7 ppb (14.7–43.0) in those with asthma‐like symptoms ( p < 0.001). Conclusion and clinical relevance Airways inflammation, evaluated by FeNO, increases in dose‐dependent manner from subjects monosensitized to pollen species to those poly‐sensitized, especially when asthma‐like symptoms on pollen exposure are also reported. This should be considered by allergists during natural pollen seasons when evaluating both pulmonary function and airways inflammation.

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Correlations between exhaled nitric oxide levels, blood eosinophilia, and airway obstruction reversibility in childhood asthma are detectable only in atopic individuals

Silvestri

Sabatini

Sale

et al. 2003

Pediatric Pulmonology

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The aim of this study was to compare in atopic and nonatopic asthmatic children correlations between two inflammation parameters, i.e., blood eosinophilia and exhaled nitric oxide (FE(NO)), and pulmonary function values, at baseline and after beta(2)-adrenergic bronchodilators. Ninety-two steroid-naive asthmatic children were evaluated: 26 were skin prick test- and RAST-negative (nonatopic subjects), whereas 66 were atopic, 15 being sensitized only to house dust mites (monosensitized) and 51 to mites and to at least one other class of allergens (polysensitized). Baseline spirometric values (FEV(1) and FEF(25-75%)) were similar in atopic and nonatopic groups (P > 0.1, each comparison). However, when compared to nonatopic subjects, atopic children showed a significantly higher degree of blood eosinophilia (3.0% and 6.7% white blood cell count, respectively; P = 0.0001) and higher FE(NO) levels (6.8 ppb and 16.0 ppb, respectively; P = 0.0001). While a positive correlation between FE(NO) levels and blood eosinophilia was observed in atopic children (r = 0.25, P = 0.041), no correlations between these two inflammation parameters and baseline pulmonary function values were demonstrated in any of the asthmatic groups. Inhalation of a beta(2)-agonist drug induced in the two asthmatic populations similar improvements in FEV(1) and FEF(25-75%) and no changes in FE(NO) levels or blood eosinophilia. However, only in atopic children positive correlations were found between percent variation in FEV(1) (delta%FEV(1)) and FE(NO) levels (r = 0.35, P = 0.006) or blood eosinophilia (r = 0.26, P = 0.04). Within the atopic group, no differences were found between mono- and polysensitized individuals in all parameters evaluated. Thus only in atopic children did parameters of inflammation correlate with airway obstruction reversibility.

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Influence of atopy on exhaled nitric oxide in patients with stable asthma and rhinitis

Cited by 160 publications

References 34 publications

Interrelationships among asthma, atopy, rhinitis and exhaled nitric oxide in a population‐based sample of children

Interrelationships among asthma, atopy, rhinitis and exhaled nitric oxide in a population‐based sample of children

Natural pollen exposure increases in a dose‐dependent way Fraction of exhaled Nitric Oxide (FeNO) levels in patients sensitized to one or more pollen species

Correlations between exhaled nitric oxide levels, blood eosinophilia, and airway obstruction reversibility in childhood asthma are detectable only in atopic individuals

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