By Frederik F Buchvald, MD, PhD
Chairman: Vibeke Backer
Opponent: Peter Oluf Schiøtz
Opponent: Søren Pedersen
The aims of the ph.d. thesis were to:
- Develop and validate a method for FeNO measurements in pre-school children [Study I]
- Compare the effects of a leukotriene antagonist (montelukast) and a longacting beta 2 agonist (salmeterol) on FeNO in asthmatic school children taking regular inhaled steroids [Study II]
- Describe independent variables associated with FeNO response to inhaledsteroids in asthmatic school children [Study III]
- FeNO can be measured in pre-school children and our newly developedmethod shows better agreement with the standard method FeNO (SBOL) thanFeNO collected in reservoirs (mixed). Airway inflammation is present early in life as FeNO co-varies with asthmadisease severity and steroid dose.
- FeNO is therefore suggested as a noninvasive diagnostic tool for monitoring asthma disease activity in young preschool children.
FeNO was significantly higher after salmeterol add-on treatment compared with both placebo and montelukast add-on treatment. Montelukast failed to reduce FeNO further in comparison with placebo in asthmatic school children on regular budesonide 400 mcg.
- A heterogeneous response of FeNO to ICS was demonstrated in asthmaticschoolchildren. Allergy and BHR were driving FeNO levels independently of high-dose steroid treatment. This should be considered when using FeNO for steroid dose titration and monitoring of asthma disease control.