Atopic disease and exhaled nitric oxide in an unselected population of young adults.
BACKGROUND
Several studies have reported elevated levels of fractional exhaled nitric oxide (FeNO) in atopic patients, particularly in asthmatic patients, suggesting that FeNO is a marker of bronchial inflammation. However, the independent influence of different atopic entities (eczema, allergic rhinitis, and asthma) on FeNO has never been studied in the general population.


OBJECTIVE
To study the influence of a questionnaire-based diagnosis of atopic diseases and IgE and lung function measurements on FeNO levels.


METHODS
This study was part of a follow-up on otitis media of a birth cohort of 1,328 children born in Nijmegen, the Netherlands, between September 1, 1982, and August 31, 1983. Within the birth cohort, the incidence of asthma, allergic rhinitis, and eczema was determined, and off-line FeNO, spirometry, and IgE measurements were performed at the age of 21 years.


RESULTS
FeNO measurements were successfully performed in 361 participants. Median FeNO levels were significantly higher in those with vs without eczema (23.6 vs 18.0 ppb; P < .0001), those with vs without allergic rhinitis (20.7 vs 17.8 ppb; P = .0001), and those with vs without atopic asthma (23.3 vs 18.1 ppb; P = .02) but not in those with vs without asthma (20.8 vs 18.3 ppb; P = .24). Eczema, allergic rhinitis, smoking, sex, and atopic sensitization appeared to be independently associated with log FeNO in this population sample, whereas (atopic) asthma was not. No effect on FeNO levels was observed for lung function parameters.


CONCLUSIONS
Eczema, allergic rhinitis, and atopic status were all independently associated with elevated FeNO levels, whereas (atopic) asthma was not. This finding implies that future studies into the role of FeNO in asthma should consider the influence of atopic disease outside the lungs.
van Asch
Charlotte J J
CJ
Department of Paediatric Respiratory Medicine, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, the Netherlands.
Balemans
Walter A F
WA
Rovers
Maroeska M
MM
Schilder
Anne G M
AG
van der Ent
Cornelis K
CK
D000328:Adult; D000941:Antigens / Q000276:immunology; D001249:Asthma / Q000453:epidemiology / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D015992:Body Mass Index; D001944:Breath Tests; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009569:Nitric Oxide / Q000032:analysis / Q000378:metabolism*; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology / Q000378:metabolism*; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology / Q000378:metabolism*; D012727:Sex Characteristics; D012907:Smoking / Q000453:epidemiology / Q000378:metabolism; D013147:Spirometry; D011795:Surveys and Questionnaires; D014797:Vital Capacity / Q000502:physiology
D000941:Antigens; D015415:Biomarkers; D009569:Nitric Oxide; D007073:Immunoglobulin E