Corticosteroids decrease exhaled nitric oxide in children with acute asthma
Nitric oxide (NO) produced in human airways seems to have both homeostatic and proinflammatory actions m the respiratory system. NO production has been shown to be higher in the exhaled air of asthmatic adults than in normal subjects. The aim of this study was to evaluate exhaled NO production durin...
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| Veröffentlicht in: | The Journal of pediatrics 1997-09, Vol.131 (3), p.381-385 |
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| creator | Baraldi, Eugenio Azzolin, Nicoletta M. Zanconato, Stefania Dario, Cinzia Zaccbello, Franco |
| description | Nitric oxide (NO) produced in human airways seems to have both homeostatic and proinflammatory actions m the respiratory system. NO production has been shown to be higher in the exhaled air of asthmatic adults than in normal subjects. The aim of this study was to evaluate exhaled NO production during asthma exacerbation in children and the effect of a rescue course of oral steroid therapy.
We measured NO in the exhaled air of 16 children (8 girls and 8 boys, aged 6 to 13 years) with an acute asthmatic episode before and after 5 days of therapy with prednisone, and in 16 healthy children. To measure NO, children inhaled NO-free air and, breathing at tidal volume, exhaled in a circuit from which a chemiluminescence analyzer sampled continuously. To assess the effect of acute changes m bronchial caliber on exhaled NO levels, we measured NO before and after a positive bronchodilation test result with albuterol in seven children with asthma whose disease was stable.
In the group with acute asthma (forced expiratory volume in 1 second 62% ±4.4%predicted, mean ±SEM), NO levels were significantly higher (31.3 ±4.2 parts per billion [ppb]) than in healthy children (5.4 ±0.4 ppb, p < 0.001). Administration of prednisone (1 mg/kg per day orally) for 5 days resulted m a mean decrease of 46% ±4% in exhaled NO concentrations (16.5 ±2.3 ppb, p < 0.001) compared with baseline, accompanied by a significant improvement in lung function (forced expiratory volume in 1 second 90.7% ±4.3% predicted). However, in patients with asthma exhaled NO levels remained significantly higher than in control children (p < 0.001) after steroid treatment. When exhaled NO was measured before and after a positive result after bronchodilator reversibility testing, we found no difference in exhaled NO levels (24 ±3.8 ppb vs 23.8 ±3 ppb; difference not significant). This demonstrates that inhaled albuterol and acute changes in bronchial caliber do not affect exhaled NO measurement.
These data show that children with asthma exacerbation have high levelsof exhaled NO that rapidly decrease with oral steroid therapy. We suggest that measurement of exhaled NO may represent a noninvasive method of monitoring airway inflammation in children with asthma. |
| doi_str_mv | 10.1016/S0022-3476(97)80062-5 |
| format | Article |
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We measured NO in the exhaled air of 16 children (8 girls and 8 boys, aged 6 to 13 years) with an acute asthmatic episode before and after 5 days of therapy with prednisone, and in 16 healthy children. To measure NO, children inhaled NO-free air and, breathing at tidal volume, exhaled in a circuit from which a chemiluminescence analyzer sampled continuously. To assess the effect of acute changes m bronchial caliber on exhaled NO levels, we measured NO before and after a positive bronchodilation test result with albuterol in seven children with asthma whose disease was stable.
In the group with acute asthma (forced expiratory volume in 1 second 62% ±4.4%predicted, mean ±SEM), NO levels were significantly higher (31.3 ±4.2 parts per billion [ppb]) than in healthy children (5.4 ±0.4 ppb, p < 0.001). Administration of prednisone (1 mg/kg per day orally) for 5 days resulted m a mean decrease of 46% ±4% in exhaled NO concentrations (16.5 ±2.3 ppb, p < 0.001) compared with baseline, accompanied by a significant improvement in lung function (forced expiratory volume in 1 second 90.7% ±4.3% predicted). However, in patients with asthma exhaled NO levels remained significantly higher than in control children (p < 0.001) after steroid treatment. When exhaled NO was measured before and after a positive result after bronchodilator reversibility testing, we found no difference in exhaled NO levels (24 ±3.8 ppb vs 23.8 ±3 ppb; difference not significant). This demonstrates that inhaled albuterol and acute changes in bronchial caliber do not affect exhaled NO measurement.
These data show that children with asthma exacerbation have high levelsof exhaled NO that rapidly decrease with oral steroid therapy. We suggest that measurement of exhaled NO may represent a noninvasive method of monitoring airway inflammation in children with asthma.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/S0022-3476(97)80062-5</identifier><identifier>PMID: 9329413</identifier><identifier>CODEN: JOPDAB</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Acute Disease ; Administration, Oral ; Adolescent ; Anti-Inflammatory Agents - therapeutic use ; Asthma - drug therapy ; Asthma - immunology ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; Breath Tests ; Bronchial Provocation Tests ; Case-Control Studies ; Child ; Chronic obstructive pulmonary disease, asthma ; Female ; Forced Expiratory Volume ; Humans ; Male ; Medical sciences ; Nitric Oxide - analysis ; Pharmacology. Drug treatments ; Pneumology ; Prednisone - therapeutic use ; Tidal Volume</subject><ispartof>The Journal of pediatrics, 1997-09, Vol.131 (3), p.381-385</ispartof><rights>1997 Mosby-Year Book, Inc.</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-4616fc1c9ad9048880723a2bb1d361061b869371f40a98eb753dff01aed1167c3</citedby><cites>FETCH-LOGICAL-c389t-4616fc1c9ad9048880723a2bb1d361061b869371f40a98eb753dff01aed1167c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-3476(97)80062-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2044722$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9329413$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baraldi, Eugenio</creatorcontrib><creatorcontrib>Azzolin, Nicoletta M.</creatorcontrib><creatorcontrib>Zanconato, Stefania</creatorcontrib><creatorcontrib>Dario, Cinzia</creatorcontrib><creatorcontrib>Zaccbello, Franco</creatorcontrib><title>Corticosteroids decrease exhaled nitric oxide in children with acute asthma</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Nitric oxide (NO) produced in human airways seems to have both homeostatic and proinflammatory actions m the respiratory system. NO production has been shown to be higher in the exhaled air of asthmatic adults than in normal subjects. The aim of this study was to evaluate exhaled NO production during asthma exacerbation in children and the effect of a rescue course of oral steroid therapy.
We measured NO in the exhaled air of 16 children (8 girls and 8 boys, aged 6 to 13 years) with an acute asthmatic episode before and after 5 days of therapy with prednisone, and in 16 healthy children. To measure NO, children inhaled NO-free air and, breathing at tidal volume, exhaled in a circuit from which a chemiluminescence analyzer sampled continuously. To assess the effect of acute changes m bronchial caliber on exhaled NO levels, we measured NO before and after a positive bronchodilation test result with albuterol in seven children with asthma whose disease was stable.
In the group with acute asthma (forced expiratory volume in 1 second 62% ±4.4%predicted, mean ±SEM), NO levels were significantly higher (31.3 ±4.2 parts per billion [ppb]) than in healthy children (5.4 ±0.4 ppb, p < 0.001). Administration of prednisone (1 mg/kg per day orally) for 5 days resulted m a mean decrease of 46% ±4% in exhaled NO concentrations (16.5 ±2.3 ppb, p < 0.001) compared with baseline, accompanied by a significant improvement in lung function (forced expiratory volume in 1 second 90.7% ±4.3% predicted). However, in patients with asthma exhaled NO levels remained significantly higher than in control children (p < 0.001) after steroid treatment. When exhaled NO was measured before and after a positive result after bronchodilator reversibility testing, we found no difference in exhaled NO levels (24 ±3.8 ppb vs 23.8 ±3 ppb; difference not significant). This demonstrates that inhaled albuterol and acute changes in bronchial caliber do not affect exhaled NO measurement.
These data show that children with asthma exacerbation have high levelsof exhaled NO that rapidly decrease with oral steroid therapy. We suggest that measurement of exhaled NO may represent a noninvasive method of monitoring airway inflammation in children with asthma.</description><subject>Acute Disease</subject><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Anti-Inflammatory Agents - therapeutic use</subject><subject>Asthma - drug therapy</subject><subject>Asthma - immunology</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Breath Tests</subject><subject>Bronchial Provocation Tests</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nitric Oxide - analysis</subject><subject>Pharmacology. Drug treatments</subject><subject>Pneumology</subject><subject>Prednisone - therapeutic use</subject><subject>Tidal Volume</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMlOwzAQhi0EgrI8ApIPCMEhMLZTOz4hVLGJShyAs-XYE9UoTcB2Wd6elFa9cprDfP8sHyHHDC4YMHn5DMB5IUolz7Q6rwAkL8ZbZMRAq0JWQmyT0QbZI_spvQGALgF2ya4WXJdMjMjjpI85uD5ljH3wiXp0EW1Cit8z26KnXcgxONp_B480dNTNQusjdvQr5Bm1bpGR2pRnc3tIdhrbJjxa1wPyenvzMrkvpk93D5PraeFEpXNRSiYbx5y2XkNZVRUoLiyva-aFZCBZXUktFGtKsLrCWo2FbxpgFj1jUjlxQE5Xc99j_7HAlM08JIdtazvsF8mo4TtQSg3geAW62KcUsTHvMcxt_DEMzFKi-ZNoloaMVuZPohkPueP1gkU9R79Jra0N_ZN13yZn2ybazoW0wTiUpeJ8wK5WGA4yPgNGk1zAzqEPEV02vg__HPILew-NcQ</recordid><startdate>19970901</startdate><enddate>19970901</enddate><creator>Baraldi, Eugenio</creator><creator>Azzolin, Nicoletta M.</creator><creator>Zanconato, Stefania</creator><creator>Dario, Cinzia</creator><creator>Zaccbello, Franco</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19970901</creationdate><title>Corticosteroids decrease exhaled nitric oxide in children with acute asthma</title><author>Baraldi, Eugenio ; Azzolin, Nicoletta M. ; Zanconato, Stefania ; Dario, Cinzia ; Zaccbello, Franco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-4616fc1c9ad9048880723a2bb1d361061b869371f40a98eb753dff01aed1167c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Acute Disease</topic><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Anti-Inflammatory Agents - therapeutic use</topic><topic>Asthma - drug therapy</topic><topic>Asthma - immunology</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Breath Tests</topic><topic>Bronchial Provocation Tests</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nitric Oxide - analysis</topic><topic>Pharmacology. Drug treatments</topic><topic>Pneumology</topic><topic>Prednisone - therapeutic use</topic><topic>Tidal Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baraldi, Eugenio</creatorcontrib><creatorcontrib>Azzolin, Nicoletta M.</creatorcontrib><creatorcontrib>Zanconato, Stefania</creatorcontrib><creatorcontrib>Dario, Cinzia</creatorcontrib><creatorcontrib>Zaccbello, Franco</creatorcontrib><collection>Pascal-Francis</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>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baraldi, Eugenio</au><au>Azzolin, Nicoletta M.</au><au>Zanconato, Stefania</au><au>Dario, Cinzia</au><au>Zaccbello, Franco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Corticosteroids decrease exhaled nitric oxide in children with acute asthma</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>1997-09-01</date><risdate>1997</risdate><volume>131</volume><issue>3</issue><spage>381</spage><epage>385</epage><pages>381-385</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><coden>JOPDAB</coden><abstract>Nitric oxide (NO) produced in human airways seems to have both homeostatic and proinflammatory actions m the respiratory system. NO production has been shown to be higher in the exhaled air of asthmatic adults than in normal subjects. The aim of this study was to evaluate exhaled NO production during asthma exacerbation in children and the effect of a rescue course of oral steroid therapy.
We measured NO in the exhaled air of 16 children (8 girls and 8 boys, aged 6 to 13 years) with an acute asthmatic episode before and after 5 days of therapy with prednisone, and in 16 healthy children. To measure NO, children inhaled NO-free air and, breathing at tidal volume, exhaled in a circuit from which a chemiluminescence analyzer sampled continuously. To assess the effect of acute changes m bronchial caliber on exhaled NO levels, we measured NO before and after a positive bronchodilation test result with albuterol in seven children with asthma whose disease was stable.
In the group with acute asthma (forced expiratory volume in 1 second 62% ±4.4%predicted, mean ±SEM), NO levels were significantly higher (31.3 ±4.2 parts per billion [ppb]) than in healthy children (5.4 ±0.4 ppb, p < 0.001). Administration of prednisone (1 mg/kg per day orally) for 5 days resulted m a mean decrease of 46% ±4% in exhaled NO concentrations (16.5 ±2.3 ppb, p < 0.001) compared with baseline, accompanied by a significant improvement in lung function (forced expiratory volume in 1 second 90.7% ±4.3% predicted). However, in patients with asthma exhaled NO levels remained significantly higher than in control children (p < 0.001) after steroid treatment. When exhaled NO was measured before and after a positive result after bronchodilator reversibility testing, we found no difference in exhaled NO levels (24 ±3.8 ppb vs 23.8 ±3 ppb; difference not significant). This demonstrates that inhaled albuterol and acute changes in bronchial caliber do not affect exhaled NO measurement.
These data show that children with asthma exacerbation have high levelsof exhaled NO that rapidly decrease with oral steroid therapy. We suggest that measurement of exhaled NO may represent a noninvasive method of monitoring airway inflammation in children with asthma.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>9329413</pmid><doi>10.1016/S0022-3476(97)80062-5</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Administration, Oral Adolescent Anti-Inflammatory Agents - therapeutic use Asthma - drug therapy Asthma - immunology Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Breath Tests Bronchial Provocation Tests Case-Control Studies Child Chronic obstructive pulmonary disease, asthma Female Forced Expiratory Volume Humans Male Medical sciences Nitric Oxide - analysis Pharmacology. Drug treatments Pneumology Prednisone - therapeutic use Tidal Volume |
| title | Corticosteroids decrease exhaled nitric oxide in children with acute asthma |
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