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Comparison of exhaled nitric oxide, serum eosinophilic cationic protein, and soluble interleukin‐2 receptor in exacerbations of pediatric asthma
Author(s) -
Lanz Miguel J.,
Leung Donald Y. M.,
McCormick David R.,
Harbeck Ronald,
Szefler Stanley J.,
White Carl W.
Publication year - 1997
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(199711)24:5<305::aid-ppul1>3.0.co;2-h
Subject(s) - medicine , exhaled nitric oxide , asthma , gastroenterology , eosinophil cationic protein , morning , expiration , allergy , eosinophil , immunology , spirometry , respiratory system
The hypotheses tested in this study were that during acute asthma exacerbations (1) exhaled nitric oxide concentrations [eNO] are a more sensitive, noninvasive indicator of asthma disease activity than serum markers of inflammation such as eosinophil cationic protein (ECP) or soluble interleukin 2 receptor (sIL2R), and (2) elevated [eNO] are reduced after treatment with glucocorticoids (GC). Peak eNO levels were measured by chemiluminescence during slow expiration. Seven asthmatic subjects (mean age 11 yrs; mean morning FEV1 65% predicted) receiving inhaled GC, and with no radiographic evidence of acute sinusitis, were studied before and after a course of oral GC. Measurements of [eNO], ECP and sIL2R levels, and FEV1% were obtained before and after a course of GC. Six atopic nonasthmatic subjects (mean age 12 years; mean FEV1 94% predicted) and seven normal subjects (mean age 13 years; mean FEV1 100% predicted) were studied. The mean peak [eNO] level (parts per billion: ppb) for the asthma subjects before treatment (52 ± 5 ppb SEM) was greater than the value for both nonasthmatic atopic and normal subjects (16 ± 2 ppb and 14 ± 2 ppb SEM, respectively; P < 0.0001). There was no significant difference in ECP or sIL2R values between asthmatic subjects and either atopic or normal subjects ( P > 0.05). Baseline pre‐GC treatment ECP levels in the asthmatic subjects were significantly higher ( P < 0.002) than post‐GC treatment values. The mean peak [eNO] level in the asthmatic subjects declined after oral GC treatment to 14 ± 1 ppb ( P < 0.0002) and was less than 2 ppb different from either control group ( P > 0.75). We conclude that [eNO] is a more sensitive marker of asthma disease activity than ECP and sIL2R levels. In addition, [eNO] appears to be a more useful indicator of the beneficial response to GC therapy than these other measurements in pediatric asthma. Pediatr. Pulmonol. 1997; 24:305–311. © 1997 Wiley‐Liss, Inc.