0
Clinical Investigations: NITRIC OXIDE |

Increase in Alveolar Nitric Oxide in the Presence of Symptoms in Childhood Asthma*

Bruno Mahut; Christophe Delacourt; Françoise Zerah-Lancner; Jacques De Blic; Alain Harf; Christophe Delclaux
Author and Funding Information

*From Unité INSERM U492-Université Paris XII (Drs. Harf and Delclaux), Faculté de Médecine de Créteil, Créteil; Service de Physiologie—Explorations Fonctionnelles (Drs. Mahut and Zerah-Lancner), Henri Mondor, AP-HP; Créteil; Service de Pédiatrie (Dr. Delacourt), Centre Hospitalier Intercommunal de Créteil, Créteil; Service de Pneumologie—Allergologie Pédiatrique, Necker—Enfants Malades, AP-HP (Dr. De Blic), Paris, France.

Correspondence to: Christophe Delclaux, MD, PhD, Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94 010 Créteil, France; e-mail: christophe.delclaux@creteil.inserm.fr



Chest. 2004;125(3):1012-1018. doi:10.1378/chest.125.3.1012
Text Size: A A A
Published online

Study objectives: To determine respective contributions of alveolar and proximal airway compartments in exhaled nitric oxide (NO) output (Q̇no) in pediatric patients with asthma and to correlate their variations with mild symptoms or bronchial obstruction.

Patients and design: In 15 asthmatic children with recent mild symptoms, 30 asymptomatic asthmatic children, and 15 healthy children, exhaled NO concentration was measured at multiple expiratory flow (V̇) rates allowing the calculation of alveolar and proximal airway contributions in Q̇no, using two approaches, ie, linear and nonlinear models.

Measurements and results: Asymptomatic and recently symptomatic patients were not significantly different regarding FEV1 and maximum V̇ between 25% and 75% of FVC (MEF25–75): FEV1, 93.3 ± 13.4% vs 90 ± 7.5%; MEF25–75, 70 ± 22% vs 68 ± 28% of predicted values, respectively (mean ± SD). Maximal airway Q̇no output was significantly higher in recently symptomatic vs asymptomatic patients (p < 0.0001), and in asymptomatic patients vs healthy children (p < 0.02): 134 ± 7 nl/min, 55 ± 43 nl/min, and 19 ± 8 nl/min, respectively. In a multiple regression analysis, variables that influenced airway Q̇no output were symptoms (p < 0.0001) and distal airway obstruction as assessed by MEF25–75 (p < 0.05). Alveolar NO concentration (FAno) was significantly (p < 0.03) higher in recently symptomatic than in patients without symptoms, whereas it was not significantly different between asymptomatic patients and healthy children: 7.2 ± 2.4 parts per billion (ppb), 5.5 ± 2.7 ppb, and 4.2 ± 2.0 ppb, respectively.

Conclusions: An increase in FAno was observed in the presence of symptoms, and proximal airway NO output was correlated with distal obstruction during asthma.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Diagnostic challenges of childhood asthma. Curr Opin Pulm Med Published online Oct 31, 2016;
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543