Role of Fractional Exhaled Nitric Oxide in Predicting Development of Allergic Rhinits in Children with Bronchial Asthma

Han Seok Ko; Sun Hee Choi; Yeong Ho Rha

doi:10.7581/pard.2012.22.2.180

Journal List > Pediatr Allergy Respir Dis > v.22(2) > 1033171

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Ko, Choi, and Rha: Role of Fractional Exhaled Nitric Oxide in Predicting Development of Allergic Rhinits in Children with Bronchial Asthma

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(2): 180-187.

Published online: 30 June 2012

DOI: https://doi.org/10.7581/pard.2012.22.2.180

Role of Fractional Exhaled Nitric Oxide in Predicting Development of Allergic Rhinits in Children with Bronchial Asthma

Han Seok Ko, MD, Sun Hee Choi, MD, Yeong Ho Rha, MD

Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.

Corresponding author (yhrha@khu.ac.kr)

Received 16 February 2012 Revised 8 March 2012 Accepted 29 March 2012

Abstract

Purpose

Fractional exhaled nitric oxide (FeNO) has been widely reported as a marker for airway inflammationin, and FeNO have shown increased levels in the non-asthmatic patients with other atopy related diseases, such as rhinitis. Bronchial hyperresponsiveness is a characteristic feature of asthma, which is often associated with airway inflammationin allergic rhinitis. It has been suggested that asthma is associated with rhinitis, which is a link between the upper and the lower airways, beyond allergy associated inflammation in the respiratory tract. To evaluate the usefulness of FeNO measurement, as a risk factor of allergic and nonallergic rhinitis in children with asthma.

Methods

Fifty-three children included in this study were diagnosed as asthma from April through August 2005 in the Department of Pediatrics, Kyung Hee University School of Medicine. They conducted FeNO monitoring, total eosinophil count and serum immunoglobulin E at that time. We put a question to the participants' parents about the doctor diagnosed participants' manifestations (sneezing, nasal congestion, nasal itching, rhinorrhea), via a telephone interview survey or at the outpatient department in July 2011. Statistical analyses were performed using IBM SPSS ver. 18.0.

Results

The overall prevalence of rhinitis, among the 53 children, was 67.9%. The means of FeNO differed significantly between the two groups, being higher in children who have rhinitis symptoms and lower in asymptomatic children. (mean±SD, 29.4±24.6 to 13.6±11.8 parts per billion; P=0.003; T-test)

Conclusion

To take the measurement of FeNO value in asthmatics may be a tool in the predictor of the causes of rhinitis.

Keywords: Asthma, Fractional exhaled nitric oxide, Allergic rhinitis, Child

Figures and Tables

Fig. 1

(A) Total eosinophil count concentrations in allergic rhinitis patients group (n=18) and control groups (n=10). Geographic mean values are represented by the longer horizontal bars, and standard deviation (SD) ranges between the shorter horizontal bars. (B) Serum immunoglobulin E (IgE) concentrations in allergic rhinitis patients group (n=18) and control groups (n=10). Geographic mean values are represented by the longer horizontal bars, and SD ranges between the shorter horizontal bars. AR, allergic rhinitis.

Fig. 2

Exhaled nitric oxide concentrations in allergic rhinitis patients group (n=36) and control groups (n=17). Geographic mean values are represented by the longer horizontal bar, and standard deviation standard deviation (SD) ranges between the shorter horizontal bars. AR, allergic rhinitis; FeNO, fractional exhaled nitric oxide; ppb, parts per billion.

Fig. 3

Correlation of allergic rhinitis (AR) prevalence with atopic dermatitis (AD) history.

Fig. 4

Correlation of allergic rhinitis (AR) prevalence with family history of atopic disease.

Table 1

General Characteristics of the Study Populations

Significance of differences was tested using a T-test or a chi-square test.

TEC, total eosinophil count; IgE, immunoglobulin E.

^*Group of patient with asthma who developing allergic rhinitis. ^†Group of patient with asthma who did not developing allergic rhinitis.

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