Istituto di Fisiologia Clinica     
Cibella F., Cuttitta G., Stefania L. G., Passalacqua G., Viegi G. Factors that influence exhaled nitric oxide in Italian schoolchildren. In: ANNALS OF ALLERGY, ASTHMA & IMMUNOLOGY, vol. 101 pp. 407 - 412. Elsevier, 2008.
Background: Conflicting results exist about the meaning of exhaled nitric oxide (eNO) in epidemiologic studies, mainly because of the numerous factors that may affect the measurement. Objectives: To evaluate the role of the factors that influence eNO levels in a sample of schoolchildren with or without respiratory diseases. We studied 335 schoolchildren, ages 10 to 16 years, from 8 schools in Palermo, Italy. After a respiratory questionnaire was completed, spirometry, skin tests, and eNO measurements were performed. Results: Among 335 children, 13.7% reported symptoms of bronchial asthma, 46.9% reported symptoms of rhinitis, and 39.4% were asymptomatic. The ratio of forced expiratory volume in 1 second to forced vital capacity was 87.6% (SD, 6.4%) in the bronchial asthma group, 90.6% (SD, 5.0%) in the rhinitis group, and 90.4% (SD, 5.1%) in the asymptomatic group (P <.002). Atopic children constituted 52.2% of the bronchial asthma group, 40.1% of the rhinitis group, and 28.8% of the asymptomatic group. Among atopic children, 102 (82%) had a positive skin test result for Dermatophagoides. Median eNO was 12.6 ppb in nonatopic children and 21.2 ppb in atopic children (P < .001, by Mann-Whitney U test). Among asymptomatic children, atopic children had significantly higher eNO levels than did nonatopic children (P < .001). In nonatopic children, no difference was found in log transformation eNO among healthy, rhinitic, or asthmatic children. Log transformation eNO increased with the number of positive skin test results (P <.001). Atopy, asthma, male sex, and indoor allergens were predictors of increased eNO in a logistic model. Conclusions: Atopy (in particular, sensitization to indoor and perennial allergens) is strongly associated with higher eNO levels. Such association is enhanced by asthma.
Subject schoolchildren
indoor allergens

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