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Exhaled nitric oxide: Not associated with asthma, symptoms, or spirometry in children with sickle cell anemia.

ABSTRACT: The significance of fractional exhaled nitric oxide (Feno) levels in children with sickle cell anemia (SCA) is unclear, but increased levels can be associated with features of asthma and thus increased morbidity.We sought to determine factors associated with Feno and whether Feno levels are associated with increased rates of acute chest syndrome (ACS) and pain.All participants had SCA, were part of the prospective observational Sleep and Asthma Cohort study, and had the following assessments: Feno levels, spirometry, blood samples analyzed for hemoglobin, white blood cell counts, eosinophil counts and total serum IgE levels, questionnaires about child medical and family history, and review of medical records.The analytic sample included 131 children with SCA (median age, 11.2 years; age range, 6-18 years) followed for a mean of 16.2 years, including a mean of 5.1 years after baseline Feno data measurements. In multivariable analyses higher Feno levels were associated with ln(IgE) levels (P < .001) and the highest quartile of peripheral eosinophil counts (P = .03) but not wheezing symptoms, baseline spirometric indices, or response to bronchodilator. Multivariable analyses identified that the incident rate of ACS was associated with ln(Feno) levels (P = .03), as well as male sex (P = .025), wheezing causing shortness of breath (P = .002), and ACS at less than 4 years of age (P < .001). Feno levels were not associated with future pain episodes.Steady-state Feno levels were not associated with an asthma diagnosis, wheezing symptoms, lung function measures, or prior sickle cell morbidity but were associated with markers of atopy and increased risk of future ACS events.

SUBMITTER: Cohen RT

PROVIDER: S-EPMC5330622 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Exhaled nitric oxide: Not associated with asthma, symptoms, or spirometry in children with sickle cell anemia.

Cohen Robyn T RT Rodeghier Mark M Kirkham Fenella J FJ Rosen Carol L CL Kirkby Jane J DeBaun Michael R MR Strunk Robert C RC

The Journal of allergy and clinical immunology 20160809 5

<h4>Background</h4>The significance of fractional exhaled nitric oxide (Feno) levels in children with sickle cell anemia (SCA) is unclear, but increased levels can be associated with features of asthma and thus increased morbidity.<h4>Objectives</h4>We sought to determine factors associated with Feno and whether Feno levels are associated with increased rates of acute chest syndrome (ACS) and pain.<h4>Methods</h4>All participants had SCA, were part of the prospective observational Sleep and Asth ...[more]

PMID: 27521278

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Project description:BackgroundEpidemiological studies have provided strong evidence that fine particulate matter (PM2.5; aerodynamic diameter ? 2.5 ?m) can exacerbate asthmatic symptoms in children. Pro-oxidant components of PM2.5 are capable of directly generating reactive oxygen species. Oxidative burden is used to describe the capacity of PM2.5 to generate reactive oxygen species in the lung.ObjectiveIn this study we investigated the association between airway inflammation in asthmatic children and oxidative burden of PM2.5 personal exposure.MethodsDaily PM2.5 personal exposure samples (n = 249) of 62 asthmatic school-aged children in Montreal were collected over 10 consecutive days. The oxidative burden of PM2.5 samples was determined in vitro as the depletion of low-molecular-weight antioxidants (ascorbate and glutathione) from a synthetic model of the fluid lining the respiratory tract. Airway inflammation was measured daily as fractional exhaled nitric oxide (FeNO).ResultsA positive association was identified between FeNO and glutathione-related oxidative burden exposure in the previous 24 hr (6.0% increase per interquartile range change in glutathione). Glutathione-related oxidative burden was further found to be positively associated with FeNO over 1-day lag and 2-day lag periods. Results further demonstrate that corticosteroid use may reduce the FeNO response to elevated glutathione-related oxidative burden exposure (no use, 15.8%; irregular use, 3.8%), whereas mold (22.1%), dust (10.6%), or fur (13.1%) allergies may increase FeNO in children with versus children without these allergies (11.5%). No association was found between PM2.5 mass or ascorbate-related oxidative burden and FeNO levels.ConclusionsExposure to PM2.5 with elevated glutathione-related oxidative burden was associated with increased FeNO.CitationMaikawa CL, Weichenthal S, Wheeler AJ, Dobbin NA, Smargiassi A, Evans G, Liu L, Goldberg MS, Godri Pollitt KJ. 2016. Particulate oxidative burden as a predictor of exhaled nitric oxide in children with asthma. Environ Health Perspect 124:1616-1622;?http://dx.doi.org/10.1289/EHP175.

Dataset Information

Exhaled nitric oxide: Not associated with asthma, symptoms, or spirometry in children with sickle cell anemia.

Publications

Exhaled nitric oxide: Not associated with asthma, symptoms, or spirometry in children with sickle cell anemia.

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