Correlation Of Exhaled Nitric Oxide With Level Of Control In Children With Asthma

PART ONE：Related factors of exhaled nitric oxide withdisease in childrenObjective: Fraction of exhaled nitric oxide (FeNO) is a biomarker associated with airwayinflammation in child asthma. The study was aimed to investigate the related factors ofFeNO in children with asthma.Methods: A total of1068children with asthma and210heath control children attackswere enrolled in the study. Asthma related factors were collected using the standarddisease questionnaire. And FeNO was assessed using online FeNO measurements,anthropometric measurements.Results: The children with asthma had a significant higher FeNO value than the heathcontrol children (24.74±22.72PPB vs.11.88±8.25PPB, P<0.05). The FeNO value in allthe children correlated with age, weight, height and body surface area rather than a historyof allergies, eczema or other skin allergic diseases, and a family history of allergies. Asignificant higher FeNO value was seen in the asthma children with allergic rhinitis, whilea decrease in the FeNO was shown in those achieving control medication use.Conclusion：FeNO measurement is useful in the diagnosis of child asthma, which maycorrelate with asthma related factors including height, weight, age, history of allergicrhinitis, allergic rhinitis and a long-term use of asthma control medication. PART TWO：Correlations of exhaled nitric oxide with diseasephenotype and level of control in children with asthmaObjective: Few data have been available to indicate if fraction of exhaled nitric oxide(FeNO) could be predicted different phenotype and control level in child asthma. The aimof this study was to investigate the correlations of FeNO with disease phenotype and levelof control in children with asthma.Methods: A total of1068enrolled asthma children were assigned into typical asthmagroup and cough variant asthma (CVA) group according to the definition of asthma.According to the level of disease control, the typical asthma group was further dividedinto well-control group, partial-control group and poor-control group; the CVA group wasfurther divided into well-control group and poor-control group. Clinical data werecollected using the standard disease questionnaire. And FeNO was assessed using onlineFeNO measurements, anthropometric measurements.Results: All the children in the typical asthma group have a significant higher FeNO valuethan the children who had no asthma attacks (P<0.05). The CVA group also had a higherFeNO value than those non-asthma children, which was related to medication use. Thewell-control CVA children achieved a decreased FeNO value, compared with thepoor-control CVA children and the well-control children with typical ashma.Conclusion: FeNO may be helpful to differentiate CVA from asthma and assess the levelof asthma control. PART THREE：Correlations of exhaled nitric oxide with lungfunction in children with asthmaObjective: Few data have been shown that fraction exhaled nitric oxide (FeNO), anindicator of airway inflammation, may be related to the airway obstruction in child asthma.Our study was aimed to investigate the correlations of FeNO with lung function inchildren with asthma.Methods: Pulmonary function and FeNO were assessed in a total of1011asthma children,who were included at Asthma Clinic of Shanghai Xinhua Hospital between June andSeptember,2013. Analysis of linear correlation was used to analyze the correlation ofFeNO with pulmonary function index including FEV1, FVC, PEF, FEF25, FEF50, FEF75and MMEF.Results: The FeNO value in1011asthma children was (24.84±23.00) PPB, which notonly negatively correlated with lung function of the big airways including FEV1, FVC andPEF, but also negatively correlated with lung function of the small airways includingPEF25, PEF50, PEF75and MMEF.Conclusion：Elevated FeNO may be predicted decreased lung function in child asthma.