title: Association between the Asthma Predictive Index and levels of exhaled nitric oxide in infants and toddlers with recurrent wheezing.
abstract: It is difficult to make an early identification of which children with recurrent wheezing will develop asthma in the following years. The Asthma Predictive Index (API) is a questionnaire based on clinical and laboratory parameters used for this end. The measurement of fractional exhaled nitric oxide (FE NO) has been used as a marker of eosinophilic airway infammation in asthma patients. Objective. To determine the association between the Asthma Predictive Index and FE NO levels in children younger than 3 years old with recurrent wheezing. Materials and methods. Observational, cross sectional study. Children younger than 36 months old with 3 or more episodes of bronchial obstruction in the past year who were inhaled corticosteroid-naive or leukotriene receptor antagonist-naive were included. After recording clinical data, FE NO was measured by a chemiluminescence analyzer during tidal breathing (online method). Results. A total of 52 children aged 5-36 months old were included. Patients with a positive API accounted for 60% of the population and had higher levels of FE NO than those with a negative API, with a median (range) of 13.5 ppb (0.7-31) versus 5.6 ppb (0.1-20.8), respectively (p <0.01). A high FE NO (>8 ppb) was observed in 74% of children with a positive API and in 26% of those with a negative API (p <0.01). Conclusions. This study found an association between high levels of exhaled nitric oxide and a positive Asthma Predictive Index in children younger than 3 years old with recurrent wheezing.
authors.affiliation: Centro Respiratorio Dr. Alberto R.Álvarez, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina. juanbalinotti@gmail.com
authors.forename: Juan Emilio
authors.initials: JE
authors.lastname: Balinotti
authors.forename: Alejandro
authors.initials: A
authors.lastname: Colom
authors.forename: Carlos
authors.initials: C
authors.lastname: Kofman
authors.forename: Alejandro
authors.initials: A
authors.lastname: Teper
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000378:metabolism*; D001944:Breath Tests; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D011237:Predictive Value of Tests; D012135:Respiratory Sounds / Q000175:diagnosis*
chemical_list: D009569:Nitric Oxide