title: High exhaled nitric oxide levels may predict bronchial reversibility in allergic children with asthma or rhinitis.
abstract: BACKGROUND
  Allergic asthma and rhinitis may be associated. Airway inflammation is shared by both disorders. The measure of the fractional concentration of exhaled nitric oxide (FeNO) may be considered as a surrogate marker for airway inflammation, mainly in allergic patients. Reversibility to bronchodilation (BD) testing is a functional characteristic of asthma.
  
  
  OBJECTIVE
  The aim of this study was to evaluate whether FeNO may predict reversibility to BD in a pediatric cohort of allergic subjects with asthma (180) or rhinitis (150).
  
  
  METHODS
  Lung function (including forced expiratory volume at the first second (FEV(1)), forced volume capacity (FVC), forced expiratory flow at 25-75% of volume capacity (FEF (25-75))), FeNO measurement, and BD testing were performed in all children.
  
  
  RESULTS
  Lung function, FeNO, and sensitization type were significantly different in the two groups. A strong correlation was found between FeNO and ΔFEV(1) after BD. Two main predictors of reversibility were FeNO values >34 ppb [Odds RatioAdj (ORAdj) = 1.9] and sensitization to perennial allergens (ORAdj = 1.7).
  
  
  CONCLUSIONS
  This study provided evidence that FeNO was strongly related with the response to BD testing and could predict bronchial reversibility in children with allergic rhinitis or asthma. Therefore, a simple FeNO measurement could suggest relevant information about bronchial reversibility.
authors.affiliation: IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy. gio.cip@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Tosca
authors.forename: Michele
authors.initials: M
authors.lastname: Capasso
mesh_terms: D000293:Adolescent; D000420:Albuterol; D001249:Asthma / Q000175:diagnosis / Q000378:metabolism*; D001944:Breath Tests; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009569:Nitric Oxide / Q000032:analysis / Q000378:metabolism*; D012372:ROC Curve; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000378:metabolism*; D012680:Sensitivity and Specificity; D013147:Spirometry
chemical_list: D009569:Nitric Oxide; D000420:Albuterol