RELATIONSHIP BETWEEN EXHALED NITRIC-OXIDE AND CHILDHOOD ASTHMA

The purpose of the study was to determine if exhaled nitric oxide leve ls in children varied according to their asthmatic and atopic status. Exhaled nitric oxide was measured in a sample of 93 children attending the North West Lung Centre, Manchester, United Kingdom, for the clini cal evaluation of a respiratory questionnaire being developed as a scr eening tool in general practice. The clinical assessment included full lung function, skin prick testing, and exercise challenge. Children w ere said to be asthmatic either by consensus decision of three indepen dent consultant pediatricians, who reviewed all the clinical results e xcept the nitric oxide measurements, or by positive exercise test. Ato pic asthmatic children had higher geometric mean exhaled nitric oxide levels (consensus decision, 12.5 ppb [parts per billion] 95% CI, 8.3 t o 18.8; positive exercise test, 12.2 ppb 95% CI, 7.6 to 19.7) than did nonatopic asthmatic children (3.2 ppb 95% CI, 2.3 to 4.6; 3.2 ppb 95% CI, 2.0 to 5.0), atopic nonasthmatic children (3.8 ppb 95% CI, 2.7 to 5.5; 5.7 ppb 95% CI, 4.1 to 8.0), or nonatopic nonasthmatic children (3.4 ppb 95% CI, 2.8 to 4.1; 3.5 ppb 95% CI, 3.0 to 4.1). Thus, exhale d nitric oxide was raised in atopic asthmatics but not in nonatopic as thmatics, and these nonatopic asthmatics had levels of exhaled nitric oxide similar to those of the nonasthmatics whether atopic or not.