Association of wheezing phenotypes with fractional exhaled nitric oxide in children
Asthma comprises a heterogeneous group of disorders characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR). Airway inflammation, which induces AHR and recurrence of asthma, is the main pathophysiology of asthma. The fractional exhaled nitric oxide (FeNO) level...
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| Format: | Article |
| Language: | English |
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Korean Pediatric Society
2014-05-01
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| Series: | Korean Journal of Pediatrics |
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| Online Access: | http://kjp.or.kr/upload/pdf/kjped-57-211.pdf |
| _version_ | 1818544689868963840 |
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| author | Jung Yeon Shim |
| author_facet | Jung Yeon Shim |
| author_sort | Jung Yeon Shim |
| collection | DOAJ |
| description | Asthma comprises a heterogeneous group of disorders characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR). Airway inflammation, which induces AHR and recurrence of asthma, is the main pathophysiology of asthma. The fractional exhaled nitric oxide (FeNO) level is a noninvasive, reproducible measurement of eosinophilic airway inflammation that is easy to perform in young children. As airway inflammation precedes asthma attacks and airway obstruction, elevated FeNO levels may be useful as predictive markers for risk of recurrence of asthma. This review discusses FeNO measurements among early-childhood wheezing phenotypes that have been identified in large-scale longitudinal studies. These wheezing phenotypes are classified into three to six categories based on the onset and persistence of wheezing from birth to later childhood. Each phenotype has characteristic findings for atopic sensitization, lung function, AHR, or FeNO. For example, in one birth cohort study, children with asthma and persistent wheezing at 7 years had higher FeNO levels at 4 years compared to children without wheezing, which suggested that FeNO could be a predictive marker for later development of asthma. Preschool-aged children with recurrent wheezing and stringent asthma predictive indices also had higher FeNO levels in the first 4 years of life compared to children with wheezing and loose indices or children with no wheeze, suggesting that FeNO measurements may provide an additional parameter for predicting persistent wheezing in preschool children. Additional large-scale longitudinal studies are required to establish cutoff levels for FeNO as a risk factor for persistent asthma. |
| first_indexed | 2024-12-11T22:51:43Z |
| format | Article |
| id | doaj.art-5ef8747be6634165a0ebeb4999fca40c |
| institution | Directory Open Access Journal |
| issn | 1738-1061 2092-7258 |
| language | English |
| last_indexed | 2024-12-11T22:51:43Z |
| publishDate | 2014-05-01 |
| publisher | Korean Pediatric Society |
| record_format | Article |
| series | Korean Journal of Pediatrics |
| spelling | doaj.art-5ef8747be6634165a0ebeb4999fca40c2022-12-22T00:47:25ZengKorean Pediatric SocietyKorean Journal of Pediatrics1738-10612092-72582014-05-0157521121610.3345/kjp.2014.57.5.2112014600016Association of wheezing phenotypes with fractional exhaled nitric oxide in childrenJung Yeon Shim0Department of Pediatrics, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Asthma comprises a heterogeneous group of disorders characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR). Airway inflammation, which induces AHR and recurrence of asthma, is the main pathophysiology of asthma. The fractional exhaled nitric oxide (FeNO) level is a noninvasive, reproducible measurement of eosinophilic airway inflammation that is easy to perform in young children. As airway inflammation precedes asthma attacks and airway obstruction, elevated FeNO levels may be useful as predictive markers for risk of recurrence of asthma. This review discusses FeNO measurements among early-childhood wheezing phenotypes that have been identified in large-scale longitudinal studies. These wheezing phenotypes are classified into three to six categories based on the onset and persistence of wheezing from birth to later childhood. Each phenotype has characteristic findings for atopic sensitization, lung function, AHR, or FeNO. For example, in one birth cohort study, children with asthma and persistent wheezing at 7 years had higher FeNO levels at 4 years compared to children without wheezing, which suggested that FeNO could be a predictive marker for later development of asthma. Preschool-aged children with recurrent wheezing and stringent asthma predictive indices also had higher FeNO levels in the first 4 years of life compared to children with wheezing and loose indices or children with no wheeze, suggesting that FeNO measurements may provide an additional parameter for predicting persistent wheezing in preschool children. Additional large-scale longitudinal studies are required to establish cutoff levels for FeNO as a risk factor for persistent asthma.http://kjp.or.kr/upload/pdf/kjped-57-211.pdfNitric oxideLung function testPhenotypePreschool childWheezing |
| spellingShingle | Jung Yeon Shim Association of wheezing phenotypes with fractional exhaled nitric oxide in children Korean Journal of Pediatrics Nitric oxide Lung function test Phenotype Preschool child Wheezing |
| title | Association of wheezing phenotypes with fractional exhaled nitric oxide in children |
| title_full | Association of wheezing phenotypes with fractional exhaled nitric oxide in children |
| title_fullStr | Association of wheezing phenotypes with fractional exhaled nitric oxide in children |
| title_full_unstemmed | Association of wheezing phenotypes with fractional exhaled nitric oxide in children |
| title_short | Association of wheezing phenotypes with fractional exhaled nitric oxide in children |
| title_sort | association of wheezing phenotypes with fractional exhaled nitric oxide in children |
| topic | Nitric oxide Lung function test Phenotype Preschool child Wheezing |
| url | http://kjp.or.kr/upload/pdf/kjped-57-211.pdf |
| work_keys_str_mv | AT jungyeonshim associationofwheezingphenotypeswithfractionalexhalednitricoxideinchildren |