title: Relationship between exhaled NO, respiratory symptoms, lung function, bronchial hyperresponsiveness, and blood eosinophilia in school children.
abstract: BACKGROUND
  Exhaled nitric oxide (eNO) may serve as a non-invasive marker of airway inflammation but its relationship with other commonly used measures has not been evaluated.
  
  
  METHODS
  Levels of eNO in a sample of 450 children aged 7-12 years out of a total sample of 2504 school children living in different urban areas near motorways were determined. The aim of this cross-sectional study was to explore the relationship between eNO, impairment of lung function (PEF, FVC, FEV(1) and MMEF), bronchial hyperresponsiveness (BHR), and blood eosinophilia in children with and without atopy as assessed by skin prick testing.
  
  
  RESULTS
  Regression analysis showed that wheezing and nasal discharge and conjunctivitis that had occurred during the previous 12 months were positively associated with eNO levels in atopic children (relative increase of 1.48 and 1.41, respectively; p<0.05) but not in non-atopic children. Similarly, BHR and the number of blood eosinophils per ml were positively associated with eNO levels in atopic children (relative increase of 1.55 and 2.29, respectively; p<0.05) but not in non-atopic children. The lung function indices PEF, FVC, FEV(1) and MMEF were not associated with eNO levels.
  
  
  CONCLUSIONS
  In addition to conventional lung function tests and symptom questionnaires, eNO is a suitable measure of airway inflammation and its application may reinforce the power of epidemiological surveys on respiratory health.
authors.affiliation: Laboratory for Pathology and Immunobiology, National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands. P.Steerenberg@rivm.nl
authors.forename: P A
authors.initials: PA
authors.lastname: Steerenberg
authors.forename: N A H
authors.initials: NA
authors.lastname: Janssen
authors.forename: G
authors.initials: G
authors.lastname: de Meer
authors.forename: P H
authors.initials: PH
authors.lastname: Fischer
authors.forename: S
authors.initials: S
authors.lastname: Nierkens
authors.forename: H
authors.initials: H
authors.lastname: van Loveren
authors.forename: A
authors.initials: A
authors.lastname: Opperhuizen
authors.forename: B
authors.initials: B
authors.lastname: Brunekreef
authors.forename: J G C
authors.initials: JG
authors.lastname: van Amsterdam
mesh_terms: D001991:Bronchitis / Q000209:etiology / Q000503:physiopathology*; D002648:Child; D004787:Environmental Pollution; D004802:Eosinophilia / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008450:Maximal Midexpiratory Flow Rate / Q000502:physiology; D009569:Nitric Oxide / Q000032:analysis*; D012044:Regression Analysis; D012111:Residence Characteristics; D012120:Respiration Disorders / Q000175:diagnosis* / Q000503:physiopathology; D012135:Respiratory Sounds; D014797:Vital Capacity / Q000502:physiology
chemical_list: D009569:Nitric Oxide