Relationships between Fraction of Nitric Oxide, Airway Hyperresponsiveness, Blood Eoshinophil Counts and Serum Eosinophil Cationic Protein in Asthmatic Children

Hyeon Seok Seo; Bo Hyun Chung; Ha Neul Park; Sung Chul Seo; Bauer Siegfried; Dae Jin Song; Ji Tae Choung; Young Yoo

doi:10.7581/pard.2012.22.3.282

Journal List > Pediatr Allergy Respir Dis > v.22(3) > 1033186

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Seo, Chung, Park, Seo, Siegfried, Song, Choung, and Yoo: Relationships between Fraction of Nitric Oxide, Airway Hyperresponsiveness, Blood Eoshinophil Counts and Serum Eosinophil Cationic Protein in Asthmatic Children

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(3): 282-291.

Published online: 30 September 2012

DOI: https://doi.org/10.7581/pard.2012.22.3.282

Relationships between Fraction of Nitric Oxide, Airway Hyperresponsiveness, Blood Eoshinophil Counts and Serum Eosinophil Cationic Protein in Asthmatic Children

Hyeon Seok Seo, MD¹, Bo Hyun Chung, MD¹, Ha Neul Park, MD¹, Sung Chul Seo, PhD², Bauer Siegfried, MD^1,², Dae Jin Song, MD^1,², Ji Tae Choung, MD^1,², Young Yoo, MD^1,²

¹Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.

²Environmental Health Center for Childhood Asthma, Korea University Anam Hospital, Seoul, Korea.

Corresponding author (yoolina@korea.ac.kr)

Received 8 June 2012 Revised 20 August 2012 Accepted 3 September 2012

Abstract

Purpose

The measurement of fraction of nitric oxide (FeNO) is a noticeable tool that reflects airway inflammation in asthmatic patients. We wanted to find out the relationship between pulmonary function, bronchial hyperresponsiveness (AHR), blood eosinophilic inflammatory markers and FeNO level before and after methacholine bronchoprovocation test in asthmatic patients.

Methods

Fifty-five children, who visited the Allergy Clinic of Korea University Anam Hospital from March 2011 to February 2012, due to asthmatic symptoms, such as history of episodic wheezing or dyspnea during the previous year and resolved after using bronchodilators, were enrolled. We performed the baseline pulmonary function and methacholine bronchoprovocation test in the enrolled patients. Blood eosinophil counts and blood eosinophil cationic protein (ECP) were measured. FeNO levels were measured before and after the methacholine bronchoprovocation test.

Results

The mean FeNO levels (36.3 ppb) fell after methacholine bronchoprovocation test (25.7 ppb). Forced expiratory volume in one second (FEV₁) %pred inversely correlated both with FeNO level before (R²=0.07, P=0.029) and after (R²=0.059, P=0.01) methacholine bronchoprovocation test. The provocative concentration, causing a 20% decrease in FEV₁ to methacholine (methacholine PC₂₀) inversely correlated both with FeNO levels before (R²=0.086, P=0.001) and after (R²=0.141, P=0.001) the challenge. FeNO level measured at bronchoconstriction state significantly correlated with blood eosinophil counts (R²=0.112, P=0.028). Serum ECP levels correlated FeNO level, neither before nor after bronchoprovocation.

Conclusion

The baseline FeNO levels were higher in asthmatic children. However, FeNO levels rather decreased after methacholine induced bronchoconstriction. Repeated spirometry maneuver was considered to have an effect on reducing FeNO levels. FeNO correlated with pulmonary function, airway AHR and blood eosinophil counts.

Keywords: Asthma, Methacholine bronchoprovocation, Airway hyperresponsiveness, FeNO, Blood eosinophils, ECP

Figures and Tables

Fig. 1

Fraction of exhaled nitric oxide (FeNO) concentrations in before and after methacholine (MCh) challenge. Geometric mean values are represented by the longer horizontal bars, and 1 SD ranges represented by the quadrangles. Maximum values and minimum values are represented by the shorter horizontal bars.

Fig. 2

Correlation between fraction of exhaled nitric oxide (FeNO) concentrations and FEV₁%pred. FeNO values were correlated negatively with FEV₁%pred before (R²=0.07, P=0.029) and after methacholine (MCh) challenge. (R²=0.059, P=0.01) FEV₁, forced expiratory volume in one second.

Fig. 3

Correlation between fraction of exhaled nitric oxide (FeNO) concentrations and methacholine (MCh) PC₂₀. FeNO values were correlated negatively with PC₂₀ before (R²=0.086, P=0.001) and after MCh challenge.(R²=0.141, P=0.001)

Fig. 4

Correlation between fraction of exhaled nitric oxide (FeNO) concentrations and blood eosinophils. FeNO values were correlated positively with blood eosinophils after methacholine (MCh) challenge (R²=0.112, P=0.028) but were not correlated with blood eosinophils before MCh challenge.(R²=0.082, P=0.211)

Fig. 5

Correlation between fraction of exhaled nitric oxide (FeNO) concentrations and blood eosinophil cationic protein (ECP). FeNO values were not correlated with blood ECP before (R²=0.0001, P=0.549) and after MCh challenge.(R²=0.014, P=0.203)

Table 1

Demographic Characteristics and Blood Eoshinophil Markers in Asthmatic Children

Values are presented as absolute mean (±SD) or geometric mean (range of 1 SD).

IgE, immunoglobulin E.

Table 2

Pulmonary Function Parameters in Asthmatic Children

Values are presented as mean±SD or geometric mean (range of 1 SD).

FEV₁, forced expiratory volume in one second; FVC, forced vital capacity.

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