Diagnostic value of exhaled nitric oxide in childhood asthma and allergy

Sachs‐Olsen C, Lødrup Carlsen KC, Mowinckel P, Håland G, Devulapalli CS, Munthe‐Kaas MC, Carlsen K‐H. Diagnostic value of exhaled nitric oxide in childhood asthma and allergy.
Pediatr Allergy Immunol 2010: 21: e213–e221.
© 2010 John Wiley & Sons A/S Fractional exhaled nitric oxide (FENO) has bee...

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Published in:Pediatric allergy and immunology 2010-02, Vol.21 (1-Part-II), p.e213-e221
Main Authors: Sachs-Olsen, C., Lødrup Carlsen, K. C., Mowinckel, P., Håland, G., Devulapalli, C. S., Munthe-Kaas, M. C., Carlsen, K.-H.
Format: Article
Language:English
Subjects:
allergic sensitization
Asthma - diagnosis
Asthma - physiopathology
birth cohort
Breath Tests
Child
Exhalation
exhaled nitric oxide
Feasibility Studies
Female
Follow-Up Studies
Humans
Hypersensitivity - diagnosis
Hypersensitivity - physiopathology
Immunization
Male
Methacholine Chloride - administration & dosage
Nitric Oxide - metabolism
predictive probability
Sensitivity and Specificity
Skin Tests
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creator Sachs-Olsen, C.
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Carlsen, K.-H.
description Sachs‐Olsen C, Lødrup Carlsen KC, Mowinckel P, Håland G, Devulapalli CS, Munthe‐Kaas MC, Carlsen K‐H. Diagnostic value of exhaled nitric oxide in childhood asthma and allergy.
Pediatr Allergy Immunol 2010: 21: e213–e221.
© 2010 John Wiley & Sons A/S Fractional exhaled nitric oxide (FENO) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FENO as a diagnostic tool. The 10‐yr follow up of the Environment and Childhood Asthma Study in Oslo included 616 children representative of the prospective birth cohort. Both FENO (single breath technique) and skin prick test (SPT) were measured in 331, limited at the time by equipment availability. Structural parental interview, spirometry, methacholine challenge and exercise test were performed. FENO was significantly elevated in children with current asthma (geometric mean 9.6 (95% confidence interval (CI) (6.9, 13.4) p.p.b.) compared with healthy children (5.8 (5.4, 6.3) p.p.b.; p 
doi_str_mv 10.1111/j.1399-3038.2009.00965.x
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Pediatr Allergy Immunol 2010: 21: e213–e221.
© 2010 John Wiley &amp; Sons A/S Fractional exhaled nitric oxide (FENO) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FENO as a diagnostic tool. The 10‐yr follow up of the Environment and Childhood Asthma Study in Oslo included 616 children representative of the prospective birth cohort. Both FENO (single breath technique) and skin prick test (SPT) were measured in 331, limited at the time by equipment availability. Structural parental interview, spirometry, methacholine challenge and exercise test were performed. FENO was significantly elevated in children with current asthma (geometric mean 9.6 (95% confidence interval (CI) (6.9, 13.4) p.p.b.) compared with healthy children (5.8 (5.4, 6.3) p.p.b.; p &lt; 0.001). FENO was highest among children with current allergic asthma (asthma and positive SPT) (14.0 (8.9, 22.1) p.p.b.), whereas children with non‐allergic asthma (6.1 (4.0, 9.2) p.p.b.) had comparable FENO levels to healthy children (p = 0.99). Allergic sensitization was most closely associated with FENO. A FENO cut‐off value of 20.4 p.p.b. had a high specificity (0.97), but a low sensitivity (0.41) and a Positive Likelihood Ratio of 16.1 for current allergic asthma. In the present childhood population‐based study, high FENO levels were closely associated with current allergic asthma and not with current asthma without allergic sensitization. Estimating the individual predictive probability of having asthma by use of FENO, improves the diagnostic utility of the test.</description><identifier>ISSN: 0905-6157</identifier><identifier>EISSN: 1399-3038</identifier><identifier>DOI: 10.1111/j.1399-3038.2009.00965.x</identifier><identifier>PMID: 21083852</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>allergic sensitization ; Asthma - diagnosis ; Asthma - physiopathology ; birth cohort ; Breath Tests ; Child ; Exhalation ; exhaled nitric oxide ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Hypersensitivity - diagnosis ; Hypersensitivity - physiopathology ; Immunization ; Male ; Methacholine Chloride - administration &amp; dosage ; Nitric Oxide - metabolism ; predictive probability ; Sensitivity and Specificity ; Skin Tests</subject><ispartof>Pediatric allergy and immunology, 2010-02, Vol.21 (1-Part-II), p.e213-e221</ispartof><rights>2010 John Wiley &amp; Sons A/S</rights><rights>2010 John Wiley &amp; Sons A/S.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4055-67b0ed7b25bb5e4723b22f573fab331c9200eb090427f7e5e0c6d066d65f65203</citedby><cites>FETCH-LOGICAL-c4055-67b0ed7b25bb5e4723b22f573fab331c9200eb090427f7e5e0c6d066d65f65203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21083852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sachs-Olsen, C.</creatorcontrib><creatorcontrib>Lødrup Carlsen, K. C.</creatorcontrib><creatorcontrib>Mowinckel, P.</creatorcontrib><creatorcontrib>Håland, G.</creatorcontrib><creatorcontrib>Devulapalli, C. S.</creatorcontrib><creatorcontrib>Munthe-Kaas, M. C.</creatorcontrib><creatorcontrib>Carlsen, K.-H.</creatorcontrib><title>Diagnostic value of exhaled nitric oxide in childhood asthma and allergy</title><title>Pediatric allergy and immunology</title><addtitle>Pediatr Allergy Immunol</addtitle><description>Sachs‐Olsen C, Lødrup Carlsen KC, Mowinckel P, Håland G, Devulapalli CS, Munthe‐Kaas MC, Carlsen K‐H. Diagnostic value of exhaled nitric oxide in childhood asthma and allergy.
Pediatr Allergy Immunol 2010: 21: e213–e221.
© 2010 John Wiley &amp; Sons A/S Fractional exhaled nitric oxide (FENO) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FENO as a diagnostic tool. The 10‐yr follow up of the Environment and Childhood Asthma Study in Oslo included 616 children representative of the prospective birth cohort. Both FENO (single breath technique) and skin prick test (SPT) were measured in 331, limited at the time by equipment availability. Structural parental interview, spirometry, methacholine challenge and exercise test were performed. FENO was significantly elevated in children with current asthma (geometric mean 9.6 (95% confidence interval (CI) (6.9, 13.4) p.p.b.) compared with healthy children (5.8 (5.4, 6.3) p.p.b.; p &lt; 0.001). FENO was highest among children with current allergic asthma (asthma and positive SPT) (14.0 (8.9, 22.1) p.p.b.), whereas children with non‐allergic asthma (6.1 (4.0, 9.2) p.p.b.) had comparable FENO levels to healthy children (p = 0.99). Allergic sensitization was most closely associated with FENO. A FENO cut‐off value of 20.4 p.p.b. had a high specificity (0.97), but a low sensitivity (0.41) and a Positive Likelihood Ratio of 16.1 for current allergic asthma. In the present childhood population‐based study, high FENO levels were closely associated with current allergic asthma and not with current asthma without allergic sensitization. Estimating the individual predictive probability of having asthma by use of FENO, improves the diagnostic utility of the test.</description><subject>allergic sensitization</subject><subject>Asthma - diagnosis</subject><subject>Asthma - physiopathology</subject><subject>birth cohort</subject><subject>Breath Tests</subject><subject>Child</subject><subject>Exhalation</subject><subject>exhaled nitric oxide</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypersensitivity - diagnosis</subject><subject>Hypersensitivity - physiopathology</subject><subject>Immunization</subject><subject>Male</subject><subject>Methacholine Chloride - administration &amp; dosage</subject><subject>Nitric Oxide - metabolism</subject><subject>predictive probability</subject><subject>Sensitivity and Specificity</subject><subject>Skin Tests</subject><issn>0905-6157</issn><issn>1399-3038</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNqNkF1P2zAUhq1paBTGX5h8t6uEY7u2E2k3bccoEgKEhuDOcpKT1p2bdHHK0n8_d4Vez5LlI5_3PR8PIZRByuK5XKVM5HkiQGQpB8jTeJVMhw9kdEx8JCPIQSaKSX1KzkJYATAtFPtETjmDTGSSj8j8u7OLpg29K-mr9VukbU1xWFqPFW1c38X_dnAVUtfQcul8tWzbitrQL9eW2iaG3mO32H0mJ7X1AS_e3nPy9OPq52ye3N5f38wmt0k5Bhmn0QVgpQsui0LiWHNRcF5LLWpbCMHKPK6DRRx8zHWtUSKUqgKlKiVrJTmIc_L1UHfTtb-3GHqzdqFE722D7TaYDLKxkiBFVGYHZdm1IXRYm03n1rbbGQZmj9GszJ6W2dMye4zmH0YzROuXtybbYo3V0fjOLQq-HQR_nMfdfxc2D5ObGER7crC70ONwtNvul1FaaGme767NI8xmL3M1NVPxF1wvjr0</recordid><startdate>201002</startdate><enddate>201002</enddate><creator>Sachs-Olsen, C.</creator><creator>Lødrup Carlsen, K. 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C.</creatorcontrib><creatorcontrib>Mowinckel, P.</creatorcontrib><creatorcontrib>Håland, G.</creatorcontrib><creatorcontrib>Devulapalli, C. S.</creatorcontrib><creatorcontrib>Munthe-Kaas, M. C.</creatorcontrib><creatorcontrib>Carlsen, K.-H.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric allergy and immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sachs-Olsen, C.</au><au>Lødrup Carlsen, K. C.</au><au>Mowinckel, P.</au><au>Håland, G.</au><au>Devulapalli, C. S.</au><au>Munthe-Kaas, M. 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Pediatr Allergy Immunol 2010: 21: e213–e221.
© 2010 John Wiley &amp; Sons A/S Fractional exhaled nitric oxide (FENO) has been proposed as a diagnostic test of asthma. We aimed to investigate in a population based birth cohort of children the usefulness of FENO as a diagnostic tool. The 10‐yr follow up of the Environment and Childhood Asthma Study in Oslo included 616 children representative of the prospective birth cohort. Both FENO (single breath technique) and skin prick test (SPT) were measured in 331, limited at the time by equipment availability. Structural parental interview, spirometry, methacholine challenge and exercise test were performed. FENO was significantly elevated in children with current asthma (geometric mean 9.6 (95% confidence interval (CI) (6.9, 13.4) p.p.b.) compared with healthy children (5.8 (5.4, 6.3) p.p.b.; p &lt; 0.001). FENO was highest among children with current allergic asthma (asthma and positive SPT) (14.0 (8.9, 22.1) p.p.b.), whereas children with non‐allergic asthma (6.1 (4.0, 9.2) p.p.b.) had comparable FENO levels to healthy children (p = 0.99). Allergic sensitization was most closely associated with FENO. A FENO cut‐off value of 20.4 p.p.b. had a high specificity (0.97), but a low sensitivity (0.41) and a Positive Likelihood Ratio of 16.1 for current allergic asthma. In the present childhood population‐based study, high FENO levels were closely associated with current allergic asthma and not with current asthma without allergic sensitization. Estimating the individual predictive probability of having asthma by use of FENO, improves the diagnostic utility of the test.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21083852</pmid><doi>10.1111/j.1399-3038.2009.00965.x</doi><tpages>9</tpages></addata></record>
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subjects allergic sensitization
Asthma - diagnosis
Asthma - physiopathology
birth cohort
Breath Tests
Child
Exhalation
exhaled nitric oxide
Feasibility Studies
Female
Follow-Up Studies
Humans
Hypersensitivity - diagnosis
Hypersensitivity - physiopathology
Immunization
Male
Methacholine Chloride - administration & dosage
Nitric Oxide - metabolism
predictive probability
Sensitivity and Specificity
Skin Tests
title Diagnostic value of exhaled nitric oxide in childhood asthma and allergy
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