PT  - JOURNAL ARTICLE
AU  - Daan Caudri
AU  - Alet H Wijga
AU  - Maarten O Hoekstra
AU  - Marjan Kerkhof
AU  - Gerard H Koppelman
AU  - Bert Brunekreef
AU  - Henriette A Smit
AU  - Johan C de Jongste
TI  - Prediction of asthma in symptomatic preschool children using exhaled nitric oxide, Rint and specific IgE
AID  - 10.1136/thx.2009.126912
DP  - 2010 Sep 01
TA  - Thorax
PG  - 801--807
VI  - 65
IP  - 9
4099  - http://thorax.bmj.com/content/65/9/801.short
4100  - http://thorax.bmj.com/content/65/9/801.full
SO  - Thorax2010 Sep 01; 65
AB  - Rationale For clinicians it remains very difficult to predict whether preschool children with symptoms suggestive of asthma will develop asthma in later childhood.Objective To investigate whether measurement of fraction of exhaled nitric oxide (FENO), interrupter resistance (Rint) or specific immunoglobulin E (IgE) in 4-year-old children with suggestive symptoms can predict asthma symptoms up to age 8 years.Methods Children were recruited from the PIAMA birth cohort. All children with symptoms suggestive of asthma at age 3 or 4 years, who were invited for medical examination at age 4 (n=848), were eligible. Associations of FENO (n=308), Rint (n=482) and specific IgE (n=380) at 4 years with wheezing and asthma at the ages of 5–8 years were assessed using repeated measurement analyses. The added predictive value of these objective tests was then investigated by including parameters for clinical history in the model.Results FENO and specific IgE measured at 4 years were associated with wheezing and asthma at 8 years. Both tests also remained significant predictors after mutual adjustment and adjustment for clinical history: OR on wheezing at 8 years for FENO (10log-scale, per IQR) 1.6 (95% CI 1.1 to 2.2) and for specific IgE 2.8 (95% CI 1.9 to 4.1). Rint was significantly associated with wheezing at age 6, but not at 7 and 8 years.Conclusions In preschool children with symptoms suggestive of asthma, both FENO and specific IgE measured at age 4, but not Rint, improved the prediction of asthma symptoms until the age of 8 years, independent of clinical history.