Inhaled fluticasone dipropionate decreases levels of nitric oxide in recurrenty wheezy infants

Moeller, Alexander; Franklin, Peter; Hall, Graham L.; Turner, Steve; Straub, Daniel; Wildhaber, Johannes H.; Stick, Stephen M.

doi:10.1002/ppul.20055

Cited by 42 publications

(42 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12,44 In fact, the FDA approved the use of FeNO in individuals with asthma to monitor response to anti-inflammatory agents. 44 The results of the present study confirm that FeNO may be a valuable biomarker of response to inhaled anti-inflammatory therapy in children with asthma.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Seasonal variation and environmental predictors of exhaled nitric oxide in children with asthma

Spanier

Hornung

Kahn

et al. 2008

Pediatric Pulmonology

View full text Add to dashboard Cite

SummaryThe fraction of exhaled nitric oxide (FeNO), a measure of airway inflammation, shows promise as a noninvasive tool to guide asthma management, but there is a paucity of longitudinal data about seasonal variation and environmental predictors of FeNO in children. The objective of this project was to evaluate how environmental factors affect FeNO concentrations over a 12-month study period among children with doctor diagnosed asthma. We conducted a prospective cohort study of 225 tobacco-smoke exposed children age 6 to 12 years with doctor-diagnosed asthma including measures of FeNO, medication use, settled indoor allergens (dust mite, cat, dog, and cockroach), and tobacco smoke exposure. Baseline geometric mean FeNO was 12.4 ppb (range 1.9 to 60.9 ppb). In multivariable analyses, higher baseline FeNO levels, atopy, and fall season were associated with increased FeNO levels, measured 6 and 12 months after study initiation, whereas inhaled steroid use, summer season, and increasing nicotine exposure were associated with lower FeNO levels. In secondary analyses of allergen sensitization, only sensitization to dust mite and cat were associated with increased FeNO levels. Our data demonstrate that FeNO levels over a year long period reflected baseline FeNO levels, allergen sensitization, season, and inhaled steroid use in children with asthma. These results indicate that FeNO levels are responsive to common environmental triggers as well as therapy for asthma in children. Clinicians and researchers may need to consider an individual's baseline FeNO levels to manage children with asthma.

show abstract

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13] In a recent randomized trial, Smith et al found that maintenance doses of inhaled corticosteroid could be significantly reduced by using FeNO to guide treatment in chronic asthma in adults. 14 Thus, FeNO, is increasingly recognized as a supplementary tool to optimize pharmacologic therapy.…”

Section: Introductionmentioning

confidence: 99%

Seasonal variation and environmental predictors of exhaled nitric oxide in children with asthma

Spanier

Hornung

Kahn

et al. 2008

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…Reduced lung function in infancy was associated with respiratory morbidity and treatment needs at preschool age [65]. Some studies showed improvement of lung function, such as forced expiratory volume in 0.5 s, in infants with recurrent wheezing after ICS treatment or oral treatment with montelukast, whereas others did not show significant changes [63,64,74,75].…”

Section: Infant Lung Functionmentioning

confidence: 99%

“…Different methods have been used to assess lung function in wheezy infants including the analysis of tidal flow-volume breathing loops, forced expirations from either normal inspiration (rapid thoracic compression technique) or from total lung capacity (raised volume rapid thoracic compression technique) or body plethysmography [62][63][64][65][66][67]. Infant lung function testing has been used to assess phenotypes in infants with wheezing and to develop prediction models for persistent asthma [68].…”

Section: Infant Lung Functionmentioning

confidence: 99%

Monitoring asthma in childhood: lung function, bronchial responsiveness and inflammation

et al. 2015

Self Cite

View full text Add to dashboard Cite

This review focuses on the methods available for measuring reversible airways obstruction, bronchial hyperresponsiveness (BHR) and inflammation as hallmarks of asthma, and their role in monitoring children with asthma. Persistent bronchial obstruction may occur in asymptomatic children and is considered a risk factor for severe asthma episodes and is associated with poor asthma outcome. Annual measurement of forced expiratory volume in 1 s using office based spirometry is considered useful. Other lung function measurements including the assessment of BHR may be reserved for children with possible exercise limitations, poor symptom perception and those not responding to their current treatment or with atypical asthma symptoms, and performed on a higher specialty level. To date, for most methods of measuring lung function there are no proper randomised controlled or large longitudinal studies available to establish their role in asthma management in children.Noninvasive biomarkers for monitoring inflammation in children are available, for example the measurement of exhaled nitric oxide fraction, and the assessment of induced sputum cytology or inflammatory mediators in the exhaled breath condensate. However, their role and usefulness in routine clinical practice to monitor and guide therapy remains unclear, and therefore, their use should be reserved for selected cases. @ERSpublications Review on the role of lung function, measurement of BHR and airway inflammation in monitoring of children with asthma

show abstract

“…Exhaled nitric oxide and other assessments of airways inflammation Elevated exhaled nitric oxide fractions (FeNO) have been found in wheezing infants, especially when they are atopic [70,71], and these normalise during treatment with ICSs [72] and montelukast [73,74]. FeNO in infants are affected by environmental exposures and genetic predisposition to atopy [75].…”

Section: Lung Function Testsmentioning

confidence: 99%

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Brand¹,

Baraldi²,

Bisgaard³

et al. 2008

European Respiratory Journal

743

759

View full text Add to dashboard Cite

There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis.Based on the limited evidence available, inhaled short-acting b 2 -agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast is recommended for the treatment of episodic (viral) wheeze and can be started when symptoms of a viral cold develop.Given the large overlap in phenotypes, and the fact that patients can move from one phenotype to another, inhaled corticosteroids and montelukast may be considered on a trial basis in almost any preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit.Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes.

show abstract

Inhaled fluticasone dipropionate decreases levels of nitric oxide in recurrenty wheezy infants

Cited by 42 publications

References 29 publications

Seasonal variation and environmental predictors of exhaled nitric oxide in children with asthma

Seasonal variation and environmental predictors of exhaled nitric oxide in children with asthma

Monitoring asthma in childhood: lung function, bronchial responsiveness and inflammation

Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach

Contact Info

Product

Resources

About