Environmental Effects on Fractional Exhaled Nitric Oxide in Allergic Children

Overview

Journal J Allergy (Cairo)

Specialty Allergy & Immunology

Date 2011 Dec 14

PMID 22162708

Citations 14

Authors

Stefania La Grutta

Giuliana Ferrante

Velia Malizia

Fabio Cibella

Giovanni Viegi

Affiliations

Soon will be listed here.

Abstract

Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation in asthma and respiratory allergy. Environmental factors, especially indoor and outdoor air quality, may play an important role in triggering acute exacerbations of respiratory symptoms. The authors have reviewed the literature reporting effects of outdoor and indoor pollutants on FeNO in children. Although the findings are not consistent, urban and industrial pollution-mainly particles (PM(2.5) and PM(10)), nitrogen dioxide (NO(2)), and sulfur dioxide (SO(2))-as well as formaldehyde and electric baseboard heating have been shown to increase FeNO, whilst ozone (O(3)) tends to decrease it. Among children exposed to Environmental Tobacco Smoke (ETS) with a genetic polymorphisms in nitric oxide synthase genes (NOS), a higher nicotine exposure was associated with lower FeNO levels. Finally, although more studies are needed in order to better investigate the effect of gene and environment interactions which may affect the interpretation of FeNO values in the management of children with asthma, clinicians are recommended to consider environmental exposures when taking medical histories for asthma and respiratory allergy. Further research is also needed to assess the effects of remedial interventions aimed at reducing/abating environmental exposures in asthmatic/allergic patients.

Citing Articles

The association of exhaled nitric oxide with air pollutants in young infants of asthmatic mothers.

Percival E, Collison A, Da Silva Sena C, De Queiroz Andrade E, de Gouveia Belinelo P, Martins Costa Gomes G Environ Health. 2023; 22(1):84.

PMID: 38049853 PMC: 10696885. DOI: 10.1186/s12940-023-01030-6.

A cross-sectional analysis of medical conditions and environmental factors associated with fractional exhaled nitric oxide (FeNO) in women and children from the ISA birth cohort, Costa Rica.

Werthmann D, van Wendel de Joode B, Cuffney M, Reich B, Soto-Martinez M, Corrales-Vargas A Environ Res. 2023; 233:116449.

PMID: 37356534 PMC: 10529647. DOI: 10.1016/j.envres.2023.116449.

Longitudinal hierarchical Bayesian models of covariate effects on airway and alveolar nitric oxide.

Weng J, Molshatzki N, Marjoram P, Gauderman W, Gilliland F, Eckel S Sci Rep. 2023; 13(1):5346.

PMID: 37005426 PMC: 10067946. DOI: 10.1038/s41598-023-31774-7.

Long-term exposures to air pollutants affect in children: a longitudinal study.

Zhang Y, Eckel S, Berhane K, Garcia E, Muchmore P, Molshatzki N Eur Respir J. 2021; 58(5).

PMID: 34503981 PMC: 9618404. DOI: 10.1183/13993003.00705-2021.

Hierarchical Bayesian estimation of covariate effects on airway and alveolar nitric oxide.

Weng J, Molshatzki N, Marjoram P, Gauderman W, Gilliland F, Eckel S Sci Rep. 2021; 11(1):17180.

PMID: 34433846 PMC: 8387480. DOI: 10.1038/s41598-021-96176-z.

References

Raja S, Xu Y, Ferro A, Jaques P, Hopke P . Resuspension of indoor aeroallergens and relationship to lung inflammation in asthmatic children. Environ Int. 2009; 36(1):8-14. DOI: 10.1016/j.envint.2009.09.001. View

Berhane K, Zhang Y, Linn W, Rappaport E, Bastain T, Salam M . The effect of ambient air pollution on exhaled nitric oxide in the Children's Health Study. Eur Respir J. 2010; 37(5):1029-36. PMC: 4340653. DOI: 10.1183/09031936.00081410. View

Spanier A, Hornung R, Kahn R, Lierl M, Lanphear B . Seasonal variation and environmental predictors of exhaled nitric oxide in children with asthma. Pediatr Pulmonol. 2008; 43(6):576-83. PMC: 3483596. DOI: 10.1002/ppul.20816. View

Laoudi Y, Nikasinovic L, Sahraoui F, Grimfeld A, Momas I, Just J . Passive smoking is a major determinant of exhaled nitric oxide levels in allergic asthmatic children. Allergy. 2009; 65(4):491-7. DOI: 10.1111/j.1398-9995.2009.02190.x. View

Bodini A, Peroni D, Loiacono A, Costella S, Pigozzi R, Baraldi E . Exhaled nitric oxide daily evaluation is effective in monitoring exposure to relevant allergens in asthmatic children. Chest. 2007; 132(5):1520-5. DOI: 10.1378/chest.07-1025. View

Franklin P, DINGLE P, Stick S . Raised exhaled nitric oxide in healthy children is associated with domestic formaldehyde levels. Am J Respir Crit Care Med. 2000; 161(5):1757-9. DOI: 10.1164/ajrccm.161.5.9905061. View

Nicolai T, Carr D, Weiland S, Duhme H, von Ehrenstein O, Wagner C . Urban traffic and pollutant exposure related to respiratory outcomes and atopy in a large sample of children. Eur Respir J. 2003; 21(6):956-63. DOI: 10.1183/09031936.03.00041103a. View

Kim J, Hauser R, Wand M, Herrick R, Amarasiriwardena C, Christiani D . The association of expired nitric oxide with occupational particulate metal exposure. Environ Res. 2003; 93(2):158-66. DOI: 10.1016/s0013-9351(03)00017-3. View

Franklin P, Taplin R, Stick S . A community study of exhaled nitric oxide in healthy children. Am J Respir Crit Care Med. 1999; 159(1):69-73. DOI: 10.1164/ajrccm.159.1.9804134. View

10.

Vahlkvist S, Sinding M, Skamstrup K, Bisgaard H . Daily home measurements of exhaled nitric oxide in asthmatic children during natural birch pollen exposure. J Allergy Clin Immunol. 2006; 117(6):1272-6. DOI: 10.1016/j.jaci.2006.03.018. View

11.

Leuppi J, Downs S, Downie S, Marks G, Salome C . Exhaled nitric oxide levels in atopic children: relation to specific allergic sensitisation, AHR, and respiratory symptoms. Thorax. 2002; 57(6):518-23. PMC: 1746345. DOI: 10.1136/thorax.57.6.518. View

12.

Viegi G, Simoni M, Scognamiglio A, Baldacci S, Pistelli F, Carrozzi L . Indoor air pollution and airway disease. Int J Tuberc Lung Dis. 2005; 8(12):1401-15. View

13.

Jansen K, Larson T, Koenig J, Mar T, Fields C, Stewart J . Associations between health effects and particulate matter and black carbon in subjects with respiratory disease. Environ Health Perspect. 2005; 113(12):1741-6. PMC: 1314915. DOI: 10.1289/ehp.8153. View

14.

Kharitonov S, Robbins R, Yates D, Keatings V, Barnes P . Acute and chronic effects of cigarette smoking on exhaled nitric oxide. Am J Respir Crit Care Med. 1995; 152(2):609-12. DOI: 10.1164/ajrccm.152.2.7543345. View

15.

Verini M, Consilvio N, Di Pillo S, Cingolani A, Spagnuolo C, Rapino D . FeNO as a Marker of Airways Inflammation: The Possible Implications in Childhood Asthma Management. J Allergy (Cairo). 2010; 2010. PMC: 2948939. DOI: 10.1155/2010/691425. View

16.

Delfino R, Staimer N, Gillen D, Tjoa T, Sioutas C, Fung K . Personal and ambient air pollution is associated with increased exhaled nitric oxide in children with asthma. Environ Health Perspect. 2006; 114(11):1736-43. PMC: 1665398. DOI: 10.1289/ehp.9141. View

17.

Spanier A, Kahn R, Hornung R, Wang N, Sun G, Lierl M . Environmental exposures, nitric oxide synthase genes, and exhaled nitric oxide in asthmatic children. Pediatr Pulmonol. 2009; 44(8):812-9. PMC: 2857409. DOI: 10.1002/ppul.21071. View

18.

Strunk R, Szefler S, Phillips B, Zeiger R, Chinchilli V, Larsen G . Relationship of exhaled nitric oxide to clinical and inflammatory markers of persistent asthma in children. J Allergy Clin Immunol. 2003; 112(5):883-92. DOI: 10.1016/j.jaci.2003.08.014. View

19.

Franklin P, Stick S . The value of FeNO measurement in asthma management: the motion against FeNO to help manage childhood asthma--reality bites. Paediatr Respir Rev. 2008; 9(2):122-6. DOI: 10.1016/j.prrv.2007.12.004. View

20.

Spanier A, Hornung R, Lierl M, Lanphear B . Environmental exposures and exhaled nitric oxide in children with asthma. J Pediatr. 2006; 149(2):220-6. DOI: 10.1016/j.jpeds.2006.04.001. View