title: Exhaled nitric oxide during infancy as a risk factor for asthma and airway hyperreactivity.
abstract: Childhood asthma is often characterised by elevated exhaled nitric oxide (eNO), decreased lung function, increased airway reactivity and atopy; however, our understanding of when these phenotypic airway characteristics develop remains unclear. This study evaluated whether eNO, lung function, airway reactivity and immune characteristics during infancy are risk factors of asthma at age 5 years. Infants with eczema, enrolled prior to wheezy illness (n=116), had eNO, spirometry, airway reactivity and allergen sensitisation assessed at entry to the study and repeated at age 5 years (n=90). Increasing eNO at entry was associated with an increased risk of asthma (p=0.037) and increasing airway reactivity (p=0.015) at age 5 years. Children with asthma at 5 years of age had a greater increase in eNO between infancy and age 5 years compared with those without asthma (p=0.002). Egg sensitisation at entry was also associated with an increased risk of asthma (p=0.020), increasing eNO (p = 0.002) and lower forced expiratory flows (p=0.029) as a 5 year-old. Our findings suggest that, among infants at high risk for developing asthma, eNO early in life may provide important insights into the subsequent risk of asthma and its airway characteristics.
authors.affiliation: Dept of Pediatrics, James Whitcomb Riley Hospital for Children, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chang
authors.affiliation: Dept of Pediatrics, James Whitcomb Riley Hospital for Children, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Yao
authors.affiliation: Dept of Pediatrics, James Whitcomb Riley Hospital for Children, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Tiller
authors.affiliation: Dept of Pediatrics, James Whitcomb Riley Hospital for Children, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kisling
authors.affiliation: Dept of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Slaven
authors.affiliation: Dept of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Zhangsheng
authors.initials: Z
authors.lastname: Yu
authors.affiliation: Dept of Pediatrics, James Whitcomb Riley Hospital for Children, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA Dept of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Kaplan
authors.affiliation: Dept of Pediatrics, James Whitcomb Riley Hospital for Children, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA rtepper@iupui.edu.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Tepper
mesh_terms: D000485:Allergens / Q000737:chemistry; D001249:Asthma / Q000378:metabolism*; D001944:Breath Tests / Q000379:methods*; D002675:Child, Preschool; D016207:Cytokines / Q000378:metabolism; D004485:Eczema / Q000378:metabolism; D045853:Exhalation; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008297:Male; D009569:Nitric Oxide / Q000032:analysis*; D010641:Phenotype; D012119:Respiration; D012135:Respiratory Sounds; D012307:Risk Factors; D013147:Spirometry
chemical_list: D000485:Allergens; D016207:Cytokines; D009569:Nitric Oxide; D007073:Immunoglobulin E