RT Journal Article
SR Electronic
T1 Influence of atopy and asthma on exhaled nitric oxide in an unselected birth cohort study
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 258
OP 262
DO 10.1136/thx.2009.125443
VO 65
IS 3
A1 Scott, Martha
A1 Raza, Abid
A1 Karmaus, Wilfried
A1 Mitchell, Frances
A1 Grundy, Jane
A1 Kurukulaaratchy, Ramesh J
A1 Arshad, S Hasan
A1 Roberts, Graham
YR 2010
UL http://thorax.bmj.com/content/65/3/258.abstract
AB Background Asthma is considered to be associated with elevated levels of exhaled nitric oxide (FeNO). The nature of this relationship and how it is influenced by atopy are still not resolved.Methods The Isle of Wight birth cohort (N=1456) was reassessed at 18 years of age. Participants able to attend the research centre were assessed by questionnaires, skin prick testing and FeNO in order to explore the interrelationship between asthma, atopy and FeNO.Results Atopy was significantly associated with higher levels of FeNO. However, the level of FeNO for non-atopic asthmatic participants was no different to the non-atopic no-asthma group. The highest levels of FeNO were seen in subjects with both atopy and asthma. In addition, FeNO was positively associated with increasing atopic burden as evidenced by increasing FeNO with increasing skin prick testing positivity, and with increasing severity of atopic asthma as evidenced by the number of attacks of wheezing. FeNO and current inhaled corticosteroid use were not significantly associated.Conclusions FeNO behaves as a biomarker of atopy and the “allergic asthma” phenotype rather than asthma itself. This may explain why FeNO-guided asthma treatment outcomes have proved to be of limited success where atopic status has not been considered and accounted for.