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Exhaled Nitric Oxide Concentration in Children with Asthma and Allergic Rhinitis : Association with Atopy and Bronchial Hyperresponsiveness

Journal of the Korean Pediatric Society 2003;46(3):284-290.
Published online March 15, 2003.
Exhaled Nitric Oxide Concentration in Children with Asthma and Allergic Rhinitis : Association with Atopy and Bronchial Hyperresponsiveness
Kyu Min Nah1, Yang Park2, Eun Kyeong Kang1, Hee Kang1, Young Yull Koh1, Sun Wha Lee3, Domyung Paek4
2Department of Pediatrics, Kunpo Medical Center, Wonkwang University College of Medicine, Iksan, Korea
3Institute of Health and Environment, School of Public Health, Seoul National University, Seoul, Korea
4Department of Environmental Health, School of Public Health, Seoul National University, Seoul, Korea
천식 및 알레르기성 비염 환아에서의 호기 일산화질소 농도 : 아토피 및 기도과민성과의 연관성
나규민1, 박양2, 강은경1, 강희1, 고영률1, 이선화3, 백도명4
2원광대학교 의과대학 군포병원 소아과
3서울대학교 보건대학원 보건환경연구소
4서울대학교 보건대학원 환경보건학과
Correspondence: 
Young Yull Koh, Email: kohyy@plaza.snu.ac.kr
Abstract
Purpose
: A new airway inflammatory marker, exhaled nitric oxide(ENO) has been reported to correlate with bronchial hyperresponsiveness(BHR) and atopy. The purpose of this study was to analyze the relationship of ENO with BHR or atopy in patients with asthma and with allergic rhinitis.
Methods
: The subjects consisted of 55 children with asthma, 17 with allergic rhinitis, and 14 healthy controls. The asthma group was subdivided into the atopic asthma group(n=37) and the nonatopic asthma group(n=18) and the allergic rhinitis group into BHR group(n=7) and non-BHR group(n=10). All were investigated with spirometry and measurements of ENO concentration. The correlations between ENO concentration and both methacholine PC20(provocative concentration causing a 20% decrease in forced expiratory volume in one second) and the number of allergen skin test positivity were analyzed.
Results
: ENO concentrations of both asthma and allergic rhinitis groups were significantly greater than that of control(P<0.01). ENO concentration of atopic asthma was significantly greater than that of nonatopic asthma(P<0.01). In allergic rhinitis, ENO concentration did not differ according to the presence or absence of BHR(P=0.50). ENO concentrations correlated significantly with the number of skin test positivity(r=0.32, P=0.02) or methacholine PC20(r=-0.38, P<0.01) in asthma group, but not in the allergic rhinitis group(r=0.42, P=0.09; r=-0.06, P=0.83).
Conclusion
: In asthma patients, some pathogenetic mechanisms associated with atopy and BHR seem to influence ENO concentration. In allergic rhinitis patients, some factors other than BHR may be important in determining ENO concentration.
Key Words: Exhaled nitric oxide, Asthma, Allergic rhinitis, Bronchial hyperresponsiveness, Atopy


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