The role of exhaled nitric oxide assessment in children with bronchial asthma

BACKGROUND: Exhaled nitric oxide (eNO) assessment in children with bronchial asthma (BA) is an easy and non-invasive test that provides informations on the presence of bronchial inflammation. METHODS: The study included 110 children aged between 5–18 years with a diagnosis of BA. The patients were assessed clinically (objective examination, questionnaire regarding the disease control) and by medical tests (exhaled breath analysis for nitric oxide, induced sputum, spirometry). RESULTS: Of the 33 patients with non-atopic BA, 9 (27.27%) presented normal eNO values, and 24 (72.72%) had higher than normal levels. There were 26 patients with controlled BA, 59 with partially controlled BA and 25 with uncontrolled BA, the levels of eNO demonstrating the existence of the statistically significant differences between the mean values of the variables obtained in the studied groups (p=0.003). Increased individual values were more frequently noted in patients with an exacerbation of asthma in the last month (70% vs 56.6%), but the differences were not statistically significant. Of the 77 patients with atopic BA, 35 (45.45%) had normal eNO, while 42 (54.54%) had increased values. The normal values of the eNO were most frequently noted in patients undergoing treatment with inhaled glucocorticoids (IGC). Patients with low percent of eosinophils in sputum had increased eNO values (p=0.03). CONCLUSIONS: The investigation of the airways by measuring the eNO levels is a useful method of assessing bronchial inflammation in children with bronchial asthma, in order to establish the disease responsiveness and therapy.