Exhaled nitric oxide and airway hyperresponsiveness to adenosine 5′-monophosphate and methacholine in children with asthma

Matthew S. Perzanowski, Young Yoo

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: There is increasing interest in the role of indirect bronchial challenges because clinical studies have shown that indirect airway hyperresponsiveness (AHR) reflects underlying airway inflammation better than direct AHR. Fractional exhaled nitric oxide (FeNO) appears to be a useful clinical tool for assessing airway inflammation noninvasively. We examined whether FeNO is more closely related to AHR to indirect stimuli than AHR to direct stimuli in children with mild to moderate asthma. Methods: Fifty-nine asthmatic children aged 6-16 years without rhinitis, underwent spirometry, FeNO measurement and blood tests for serum total IgE, blood eosinophil count and serum eosinophil cationic protein (ECP). All subjects underwent methacholine and adenosine 5-monophosphate (AMP) challenge tests at intervals of 3 days. Results: In a univariate linear regression analysis, FeNO was significantly associated with both PC20 AMP (R2 = 0.341, p < 0.001) and PC20 methacholine (R2 = 0.188, p = 0.001). After adjustment for age, sex, serum total IgE and blood eosinophil count, the association between FeNO and PC20 AMP (β = -1.98, p = 0.001) was more robust than that between FeNO and PC20 methacholine (β = -0.87, p = 0.081). The significant correlation between FeNO and PC20 AMP was observed in the steroid-naïve group (β = -2.48, p = 0.001), but not in the steroid-treated group (β = 0.88, p = 0.463). Conclusions: FeNO levels were more closely associated with PC20 AMP than with PC20 methacholine. This relationship could only be seen in the steroid-naïve subjects. These results suggest that FeNO levels in children with asthma may be more closely related to indirect AHR than to direct AHR.

Original languageEnglish
Pages (from-to)107-113
Number of pages7
JournalInternational Archives of Allergy and Immunology
Volume166
Issue number2
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Methacholine Chloride
Adenosine Monophosphate
Nitric Oxide
Asthma
Steroids
Eosinophils
Immunoglobulin E
Eosinophil Cationic Protein
Inflammation
Spirometry
Hematologic Tests
Rhinitis
Serum
Linear Models
Regression Analysis

Keywords

  • Adenosine 5′-monophosphate
  • Airway hyperresponsiveness
  • Childhood asthma
  • Exhaled nitric oxide
  • Methacholine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Exhaled nitric oxide and airway hyperresponsiveness to adenosine 5′-monophosphate and methacholine in children with asthma. / Perzanowski, Matthew S.; Yoo, Young.

In: International Archives of Allergy and Immunology, Vol. 166, No. 2, 01.01.2015, p. 107-113.

Research output: Contribution to journalArticle

@article{4b200efcddb94cef87e2d6e2f0e63f5f,
title = "Exhaled nitric oxide and airway hyperresponsiveness to adenosine 5′-monophosphate and methacholine in children with asthma",
abstract = "Background: There is increasing interest in the role of indirect bronchial challenges because clinical studies have shown that indirect airway hyperresponsiveness (AHR) reflects underlying airway inflammation better than direct AHR. Fractional exhaled nitric oxide (FeNO) appears to be a useful clinical tool for assessing airway inflammation noninvasively. We examined whether FeNO is more closely related to AHR to indirect stimuli than AHR to direct stimuli in children with mild to moderate asthma. Methods: Fifty-nine asthmatic children aged 6-16 years without rhinitis, underwent spirometry, FeNO measurement and blood tests for serum total IgE, blood eosinophil count and serum eosinophil cationic protein (ECP). All subjects underwent methacholine and adenosine 5-monophosphate (AMP) challenge tests at intervals of 3 days. Results: In a univariate linear regression analysis, FeNO was significantly associated with both PC20 AMP (R2 = 0.341, p < 0.001) and PC20 methacholine (R2 = 0.188, p = 0.001). After adjustment for age, sex, serum total IgE and blood eosinophil count, the association between FeNO and PC20 AMP (β = -1.98, p = 0.001) was more robust than that between FeNO and PC20 methacholine (β = -0.87, p = 0.081). The significant correlation between FeNO and PC20 AMP was observed in the steroid-na{\"i}ve group (β = -2.48, p = 0.001), but not in the steroid-treated group (β = 0.88, p = 0.463). Conclusions: FeNO levels were more closely associated with PC20 AMP than with PC20 methacholine. This relationship could only be seen in the steroid-na{\"i}ve subjects. These results suggest that FeNO levels in children with asthma may be more closely related to indirect AHR than to direct AHR.",
keywords = "Adenosine 5′-monophosphate, Airway hyperresponsiveness, Childhood asthma, Exhaled nitric oxide, Methacholine",
author = "Perzanowski, {Matthew S.} and Young Yoo",
year = "2015",
month = "1",
day = "1",
doi = "10.1159/000375237",
language = "English",
volume = "166",
pages = "107--113",
journal = "International Archives of Allergy and Immunology",
issn = "1018-2438",
publisher = "S. Karger AG",
number = "2",

}

TY - JOUR

T1 - Exhaled nitric oxide and airway hyperresponsiveness to adenosine 5′-monophosphate and methacholine in children with asthma

AU - Perzanowski, Matthew S.

AU - Yoo, Young

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: There is increasing interest in the role of indirect bronchial challenges because clinical studies have shown that indirect airway hyperresponsiveness (AHR) reflects underlying airway inflammation better than direct AHR. Fractional exhaled nitric oxide (FeNO) appears to be a useful clinical tool for assessing airway inflammation noninvasively. We examined whether FeNO is more closely related to AHR to indirect stimuli than AHR to direct stimuli in children with mild to moderate asthma. Methods: Fifty-nine asthmatic children aged 6-16 years without rhinitis, underwent spirometry, FeNO measurement and blood tests for serum total IgE, blood eosinophil count and serum eosinophil cationic protein (ECP). All subjects underwent methacholine and adenosine 5-monophosphate (AMP) challenge tests at intervals of 3 days. Results: In a univariate linear regression analysis, FeNO was significantly associated with both PC20 AMP (R2 = 0.341, p < 0.001) and PC20 methacholine (R2 = 0.188, p = 0.001). After adjustment for age, sex, serum total IgE and blood eosinophil count, the association between FeNO and PC20 AMP (β = -1.98, p = 0.001) was more robust than that between FeNO and PC20 methacholine (β = -0.87, p = 0.081). The significant correlation between FeNO and PC20 AMP was observed in the steroid-naïve group (β = -2.48, p = 0.001), but not in the steroid-treated group (β = 0.88, p = 0.463). Conclusions: FeNO levels were more closely associated with PC20 AMP than with PC20 methacholine. This relationship could only be seen in the steroid-naïve subjects. These results suggest that FeNO levels in children with asthma may be more closely related to indirect AHR than to direct AHR.

AB - Background: There is increasing interest in the role of indirect bronchial challenges because clinical studies have shown that indirect airway hyperresponsiveness (AHR) reflects underlying airway inflammation better than direct AHR. Fractional exhaled nitric oxide (FeNO) appears to be a useful clinical tool for assessing airway inflammation noninvasively. We examined whether FeNO is more closely related to AHR to indirect stimuli than AHR to direct stimuli in children with mild to moderate asthma. Methods: Fifty-nine asthmatic children aged 6-16 years without rhinitis, underwent spirometry, FeNO measurement and blood tests for serum total IgE, blood eosinophil count and serum eosinophil cationic protein (ECP). All subjects underwent methacholine and adenosine 5-monophosphate (AMP) challenge tests at intervals of 3 days. Results: In a univariate linear regression analysis, FeNO was significantly associated with both PC20 AMP (R2 = 0.341, p < 0.001) and PC20 methacholine (R2 = 0.188, p = 0.001). After adjustment for age, sex, serum total IgE and blood eosinophil count, the association between FeNO and PC20 AMP (β = -1.98, p = 0.001) was more robust than that between FeNO and PC20 methacholine (β = -0.87, p = 0.081). The significant correlation between FeNO and PC20 AMP was observed in the steroid-naïve group (β = -2.48, p = 0.001), but not in the steroid-treated group (β = 0.88, p = 0.463). Conclusions: FeNO levels were more closely associated with PC20 AMP than with PC20 methacholine. This relationship could only be seen in the steroid-naïve subjects. These results suggest that FeNO levels in children with asthma may be more closely related to indirect AHR than to direct AHR.

KW - Adenosine 5′-monophosphate

KW - Airway hyperresponsiveness

KW - Childhood asthma

KW - Exhaled nitric oxide

KW - Methacholine

UR - http://www.scopus.com/inward/record.url?scp=84925441122&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925441122&partnerID=8YFLogxK

U2 - 10.1159/000375237

DO - 10.1159/000375237

M3 - Article

VL - 166

SP - 107

EP - 113

JO - International Archives of Allergy and Immunology

JF - International Archives of Allergy and Immunology

SN - 1018-2438

IS - 2

ER -