Exhaled nitric oxide and bronchial hyperresponsiveness in atopic asthmatic children with and without allergic rhinitis

Park, Junsung; Lee, Eun; Yang, Song-I; Yoon, Jisun; Cho, Hyun-Ju; Hong, Soo-Jong; Yu, Jinho

doi:10.4168/aard.2015.3.6.425

Original Article

Open Access


Allergy Asthma Respir Dis. 2015 Nov;3(6):425-431. Korean. Published online November 30, 2015. https://doi.org/10.4168/aard.2015.3.6.425
© 2015 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology


Exhaled nitric oxide and bronchial hyperresponsiveness in atopic asthmatic children with and without allergic rhinitis
Junsung Park,¹ Eun Lee,¹ Song-I Yang,² Jisun Yoon,¹ Hyun-Ju Cho,¹ Soo-Jong Hong,¹ and Jinho Yu¹
¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
²Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Correspondence to: Jinho Yu. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3922, Fax: +82-2-3010-6978, Email: jyu3922@gmail.com

Received July 15, 2015; Revised September 03, 2015; Accepted September 04, 2015.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Go to: Abstract
Purpose Children with asthma frequently have allergic rhinitis (AR) as a comorbidity. Asthmatic children with AR have a higher exhaled nitric oxide (eNO) level and bronchial hyperresponsiveness (BHR) than those without. The purpose of this study is to investigate the difference in lung function, eNO, and BHR between atopic asthma with and without AR, and the association of eNO and BHR with atopic intensity in total asthmatics. Methods We recruited 69 atopic asthmatic children with AR, 19 atopic asthmatic children without AR, 38 children with AR, and 43 nonatopic controls. We measured forced expiratory volume in one second (FEV₁) and forced expiratory flow at 25% to 75% of forced vital capacity (FEF_25%-75%), dose response slope (DRS) of bronchial challenge with methacholine and adenosine 5'-monophosphate (AMP), the levels of eNO, and the ratio of sum of allergen wheal diameter to histamine using skin prick tests. Results Atopic asthmatic children with AR had a higher eNO level compared to those without AR (P<0.05). However, there was no difference in FEV₁ %predicted, FEF_25%-75% %predicted, methacholine DRS, and AMP DRS between asthmatic children with and without AR. In total asthmatics, methacholine DRS and AMP DRS significantly correlated with eNO levels (r=0.338, P<0.001; r=0.365, P<0.001), but not with total IgE levels. However, eNO significantly correlated with total IgE levels (r=0.479, P<0.001). Conclusion These results suggest that AR may enhance airway inflammation but may not lead to enhanced BHR in children with asthma.


Keywords: Asthma; Allergic rhinitis; Comorbidity; Bronchial hyperreactivity; Exhaled nitric oxide

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Supplementary Material

http://www.aard.or.kr/src/sm/aard-3-425-s001.pdf

Supplement Table 1

Lung function, bronchial hyperresponsiveness, and exhaled nitric oxide among the study groups after correction with IgE

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Figures


	Fig. 1 Venn diagram of study subjects.
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Tables


	Table 1 Baseline characteristics of study participants
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	Table 2 Lung function, bronchial hyperresponsiveness, and exhaled nitric oxide among the study groups
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	Table 3 Correlation between lung function, bronchial hyperresponsiveness, and exhaled nitric oxide in subjects with atopic asthma
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