Nitric oxide as a biomarker of allergic inflammation in children

S. E. Tsyplenkova, Yu. L. Mizernitsky
2007 Russian Pulmonology  
The aim of this study was to analyze clinical importance of exhaled nitric oxide (NOex) measurement for early detection, differential diagnosis and control of treatment of chronic respiratory pathology in children. The study involved 412 children of 5 to 18 years old with different chronic bronchopulmonary diseases. Apart from a typical clinical, laboratory, and instrumental diagnostic methods, NOex was measured in all the children using the chemiluminescent gas analyzer 280i (Sievers, USA).
more » ... control group included 30 healthy children aged 5 to 18 with mean NOex 14.8 ± 1.4 ррb (9.2 ÷ 21.4 ррb). The majority of asthmatic children had high NOex (> 20 ppb in 284 (90 %) asthmatic children), р < 0.01, both in stable asthma and exacerbation. The NOex level was directly correlated to the severity and period of the disease (frequency of asthma attacks, time from the last asthma attack, lung function parameters), and blood levels of allergic markers (eosinophils, total IgE, circulating immune complexes, IL-4). Therefore, NOex monitoring was useful in evaluating the efficacy of different treatment modes. In other chronic respiratory diseases, NOex level was also elevated but to lesser degree. In children with primary ciliary dyskinesia, NOex was significantly below the normal level that could be used as a preliminary screening tool. In conclusion, NOex measurement is a reliable and objective method to control allergic inflammation in the airways. It is of great clinical importance and is helpful in differential diagnosis of chronic respiratory diseases and confirmation of the diagnosis. It allows individual choice of therapy, control of the patient's adherence to treatment and prognosis of future exacerbations.
doi:10.18093/0869-0189-2007-0-4-69-78 fatcat:ptocviepmzdthljahkkjg2zhem