title: Asthma, atopy and exhaled nitric oxide in a cohort of 6-yr-old New Zealand children.
abstract: BACKGROUND
  Exhaled nitric oxide has been promoted as a non-invasive measure of airway inflammation, with clinical utility for the diagnosis and management of asthma.
  
  
  OBJECTIVE
  We studied associations between exhaled nitric oxide, asthma and atopy in a variety of clinically relevant phenotypes in a cohort of 6-yr-old children.
  
  
  METHODS
  Asthma was defined using standard questionnaire criteria, atopy was measured using skin prick tests (SPT) and specific IgE to common allergens, and exhaled nitric oxide was measured using a chemiluminescence analyser according to American and European Thoracic Society criteria.
  
  
  RESULTS
  Exhaled nitric oxide was strongly related to atopy and in particular to sensitization to house dust mites. Children with non-allergic asthma had no increase in exhaled nitric oxide compared with non-asthmatic children. Compared with children who never wheezed both late onset and persistent, wheezing was associated with increased FE(NO), while early transient wheezing was not. Elevated levels of exhaled nitric oxide amongst children with allergic asthma were almost entirely explained by their levels of specific IgE to aeroallergens, predominantly D pteronyssinus.
  
  
  CONCLUSIONS
  Airway inflammation as measured by exhaled nitric oxide in young New Zealand children is related to their level of specific IgE to aeroallergens. This has implications for the utility of nitric oxide as a diagnostic and management tool in childhood asthma and for the importance of specific IgE as a marker of asthma severity.
authors: Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand. julian.crane@otago.ac.nz
authors: Julian
authors: J
authors: Crane
authors: Philippa
authors: P
authors: Lampshire
authors: Kristin
authors: K
authors: Wickens
authors: Michael
authors: M
authors: Epton
authors: Robert
authors: R
authors: Siebers
authors: Tristram
authors: T
authors: Ingham
authors: Philip
authors: P
authors: Pattemore
authors: Ian
authors: I
authors: Town
mesh_terms: D000485:Allergens / Q000009:adverse effects* / Q000276:immunology; D000818:Animals; D001249:Asthma / Q000175:diagnosis* / Q000276:immunology; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D002648:Child; D015331:Cohort Studies; D040002:Dermatophagoides pteronyssinus / Q000276:immunology*; D045853:Exhalation / Q000276:immunology; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D007249:Inflammation / Q000276:immunology; D008297:Male; D009520:New Zealand; D009569:Nitric Oxide / Q000032:analysis*; D012135:Respiratory Sounds / Q000276:immunology; D012137:Respiratory System / Q000276:immunology; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D000485:Allergens; D015415:Biomarkers; D009569:Nitric Oxide; D007073:Immunoglobulin E