Nitric oxide as a clinical guide for asthma management in children

Abstract

Asthma is a chronic inflammation of both large and small airways. The treatment of asthma has undergone a number of evolutions over the last several decades, nowadays consisting in bronchodilators and corticosteroids to reduce the inflammation. Exhaled nitric oxide, an easily and rapidly obtained noninvasive study, is a potential surrogate for measuring airways inflammation. The study was conducted at the Clinical Pediatric Hospital “St. John” from Galaţi where using a FeNO (fractional exhaled nitric oxide) detector, a number of 53 children already diagnosed with asthma were analyzed. The method is noninvasive and cost-reductive compared to other melhods used in these cases. A number of 53 were tested using fractional exhaled nitric oxide. From this number, 36 children presented elevated FeNO values (>20 ppb) while 17 of them presented normal values. After the corticosteroid treatment, all the children had lower values. Measuring fractional exhaled nitric oxide (FeNO), a marker of airway inflammation, is useful in the early confirmation or exclusion of asthma in children, especially in cases where the diagnosis is not clear at presentation. FeNO is elevated in untreated or under-treated asthma and decreases in a dose-dependent manner with the use of inhaled corticosteroids.