Bronchial and alveolar nitric oxide in exercise-induced bronchoconstriction in asthmatic children.
BACKGROUND
Epidemiological studies have shown an association between the severity of exercise-induced bronchoconstriction (EIB) and fractional exhaled nitric oxide at the flow of 50 mL/s (FeNO(50)). However, no study has assessed the correlation between alveolar production (C(alv)) and bronchial flux (J(NO)) of nitric oxide (NO) and EIB in asthmatic children.


OBJECTIVE
To identify the relationship between severity of EIB and bronchial or alveolar nitric oxide.


METHODS
Our group included 36 allergic children with intermittent asthma. The EIB was determined by a standard exercise challenge and the severity was expressed as the maximum change in percentage from the baseline value of lung function (ΔFEV(1)%, ΔFEF(25-75)%) after exercising. A chemiluminescence analyser at multiple flows was used to calculate FeNO(50), J(NO) and C(alv,) which reflect large airways, J(NO) and alveolar concentration of NO respectively.


RESULTS
Sixteen (44.4%) children presented a ∆FEV(1) ≥ 10%, eight (22.2%) had ∆FEV(1) ≥ 15% and nine (25%) children had a ∆FEF(25-75) ≥ 26%. A significant correlation was observed between severity of EIB and FeNO(50) , J(NO) and C(alv.) EIB was significantly more severe in children sensitive to indoor allergens compared with outdoor allergens only (P = 0.014); those children showed also higher levels of C(alv) (P = 0.003) and of J(NO) (P = 0.044).


CONCLUSIONS
Our results suggest that inflammation is present in the central and peripheral airways and that it is associated with the severity of EIB. Clinicaltrials.gov NCT00952835.
Department of Pediatrics, University of Verona, Verona, Italy.
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Chinellato
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Piazza
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Peroni
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Sandri
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Chiorazzo
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Boner
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Piacentini
D001250:Asthma, Exercise-Induced / Q000378:metabolism / Q000503:physiopathology*; D001980:Bronchi / Q000378:metabolism / Q000503:physiopathology*; D016084:Bronchoconstriction; D002648:Child; D005080:Exercise Test; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D011650:Pulmonary Alveoli / Q000378:metabolism / Q000503:physiopathology*; D013147:Spirometry
D009569:Nitric Oxide