title: Lung function and biomarkers of airway inflammation during and after hospitalization for acute exacerbations of childhood asthma associated with viral respiratory symptoms.
abstract: BACKGROUND
  There are limited data assessing relationships between biomarkers of inflammation and lung function after hospitalization for asthma exacerbations in children.
  
  
  OBJECTIVE
  To assess the associations in asthmatic children among changes in lung function, fraction of exhaled nitric oxide (FENO), and cysteinyl leukotrienes (CysLTs) in exhaled breath condensate (EBC) after hospitalization for acute asthma.
  
  
  METHODS
  Spirometry and FENO were measured and EBC collected for CysLT measurement from 40 children during and 1, 2, and 4 weeks after hospitalization for an asthma exacerbation and during a single-study visit for 40 healthy children.
  
  
  RESULTS
  Enrollment FENO and EBC CysLT concentrations were higher in the children with asthma than in healthy individuals (mean FENO, 31.6 vs 7 ppb; P < .0001; mean EBC CysLT, 7.9 vs 4.9 ppb; P = .03). Among children with asthma, improvement in lung function reached a plateau within 2 weeks after hospital discharge. The EBC CysLT concentrations were not associated with changes in lung function, use of albuterol, or use of inhaled corticosteroids (ICSs). Among asthmatic children enrollment FENO was not associated with changes in lung function during follow-up. However, among children who had an elevated enrollment FENO (≥25 ppb), patients who did not use ICSs after hospital discharge had lower end-of-study lung function than those who used ICSs. At 2 and 4 weeks after hospital discharge, FENO was higher among patients who reported albuterol use more than twice weekly and among patients who reported no ICS use.
  
  
  CONCLUSIONS
  FENO measured at hospital discharge among children hospitalized with acute asthma may be useful in identifying patients who will respond to ICS therapy.
authors: Department of Pediatrics, Division of Pulmonary Medicine, Seattle Children's Hospital, University of Washington, Seattle, Washington 98105, USA. jason.debley@seattlechildrens.org
authors: Jason S
authors: JS
authors: Debley
authors: Elizabeth S
authors: ES
authors: Cochrane
authors: Gregory J
authors: GJ
authors: Redding
authors: Edward R
authors: ER
authors: Carter
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001249:Asthma / Q000150:complications / Q000276:immunology* / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D018836:Inflammation Mediators / Q000378:metabolism; D015289:Leukotrienes / Q000378:metabolism; D008168:Lung / Q000276:immunology* / Q000503:physiopathology*; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D012129:Respiratory Function Tests; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis / Q000276:immunology*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D015289:Leukotrienes; D009569:Nitric Oxide