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Author Buchvald, F.; Eiberg, H.; Bisgaard, H. url  openurl
  Title Heterogeneity of FeNO response to inhaled steroid in asthmatic children Type
  Year (down) 2003 Publication Clinical and Experimental Allergy Abbreviated Journal Clin Exp Allergy  
  Volume 33 Issue 12 Pages 1735-1740  
  Keywords Administration, Inhalation; Adolescent; Anti-Inflammatory Agents/*administration & dosage/therapeutic use; Asthma/*drug therapy/*metabolism; Biomarkers/analysis; Breath Tests; Budesonide/*administration & dosage/therapeutic use; Case-Control Studies; Child; Cross-Over Studies; Double-Blind Method; Female; Humans; Lung/metabolism; Male; Nebulizers and Vaporizers; Nitric Oxide/*analysis; Regression Analysis  
  Abstract BACKGROUND: Nitric oxide in exhaled air is regarded as an inflammation marker, and may be used to monitor the anti-inflammatory control from inhaled corticosteroids (ICSs). However, this response to ICSs exhibits a heterogeneous pattern. OBJECTIVE: The study aimed to describe the independent variables associated with the heterogeneity in the response of exhaled nitric oxide to ICSs. METHODS: Exhaled nitric oxide (FeNO), lung function, bronchial hyper-responsiveness (BHR), specific IgE to common inhalant allergens, blood eosinophils, other atopic manifestations and variants in nitric oxide synthethase 1 (NOS1) gene were studied in a double-blind, placebo-controlled crossover comparison of budesonide (BUD) Turbohaler 1600 mcg daily vs. placebo in asthmatic schoolchildren. RESULTS: Forty children were included in the study from a screening of 184 asthmatic children with moderately persistent asthma, well controlled on regular BUD 400 mcg daily: 20 children with normal FeNO and 20 with raised FeNO. FeNO, BHR and forced expiratory volume in 1 s improved significantly after BUD 1600 mcg (BUD1600). However, FeNO after ICS treatment exhibited a Gaussian distribution and FeNO was significantly raised in 15 children. Allergy and BHR, but none of the other independent variables under study were significantly related to FeNO after BUD1600. CONCLUSION: Exhaled nitric oxide exhibited a heterogeneous response to ICS in asthmatic schoolchildren. Allergy and BHR were driving FeNO level independently of high-dose steroid treatment. This should be considered when using FeNO for steroid dose titration and monitoring of ICS anti-inflammatory control in asthmatic children.  
  Address Department of Paediatrics, Rigshospitalet, National University Hospital, Copenhagen, Denmark  
  Corporate Author Thesis  
  Impact Factor 04,769 First Author Buchvald, F. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Bisgaard, H.  
  ISSN 0954-7894 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:14656363 Approved no  
  Call Number Serial 167  
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