Tidal breathing nasal nitric oxide in preschool children aged 3 to 5 years / 中华实用儿科临床杂志

Objective:To explore the threshold of tidal breathing nasal nitric oxide (TB-nNO) in diagnosing primary ciliary dyskinesia (PCD) in children aged 3 to 5 years.Methods:Retrospective study.The TB-nNO values were examined of 165 healthy children aged 3-5 in a kindergarten in Xicheng District, Beijing, from March 27 to March 29, 2018, which were also measured in children aged 3-5 years who were diagnosed as PCD, cystic fibrosis, bronchiolitis obliterans, bronchiectasis caused by other diseases and asthma in the Second Department of Pediatric Pneumology, Beijing Children′s Hospital, Capital Medical University from January 2018 to December 2021.Relevant factors associated with TB-nNO in normal children were screened by a multiple linear regression model.The cut-off value of TB-nNO in diagnosing PCD in preschool children aged 3-5 years was determined by calculating the maximum area under the receiver operating characteristic (ROC) curve.Results:TB-nNO value in healthy children aged 3, 4 and 5 years were (94.8±36.4) nL/min, (103.3±50.7) nL/min and (106.9±61.5) nL/min, respectively.The mean TB-nNO value in 9 children with PCD was (18.9±10.8) nL/min.TB-nNO values in 49 children with asthma, 19 children with bronchiolitis obliterans, 17 children with bronchiectasis and 6 children with cystic fibrosis were (97.7±51.1) nL/min, (93.2±49.2) nL/min, (93.7±75.3) nL/min and (45.4±18.2) nL/min, respectively.Using 30 nL/min of TB-nNO as the cut-off point, the sensitivity and specificity of TB-nNO in diagnosing PCD were 88.9% (8/9) and 96.9%, respectively.The area under the ROC curve was 98.3% (95% CI: 95.3%-100.0%). Conclusions:TB-nNO value of 30 nL/min can be used as the cut-off point in the diagnosis screening of PCD in children aged 3-5 years.Its diagnostic value in this age group should be further evaluated.

Application of fractional exhaled nitric oxide and nasal nitric oxide in control evaluation of bronchial asthma and diagnosis of allergic rhinitis in children / 中国当代儿科杂志

OBJECTIVES@#To study the association of fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (nNO) with asthma control and their value in the diagnosis of allergic rhinitis in children.@*METHODS@#A total of 186 children aged 5-12 years, who attended the outpatient service of the Department of Respiration, Shanghai Children's Hospital due to bronchial asthma and/or allergic rhinitis or who underwent physical examination, were enrolled as subjects, with 52 children in the asthma group, 60 children in the asthma+allergic rhinitis group, 36 children in the allergic rhinitis group, and 38 children in the control group. FeNO, nNO, and pulmonary function were compared between groups.@*RESULTS@#The asthma+allergic rhinitis, asthma, and allergic rhinitis groups had a significantly higher level of FeNO than the control group (P<0.05). The asthma+allergic rhinitis and allergic rhinitis groups had a significantly higher level of nNO than the asthma and control groups (P<0.05). The uncontrolled asthma and partially controlled asthma groups had significantly higher levels of FeNO and nNO than the completely controlled asthma group (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that nNO had an area under the ROC curve of 0.91, with a sensitivity of 80.0% and a specificity of 89.5% in the diagnosis of allergic rhinitis in children with asthma (P<0.05).@*CONCLUSIONS@#The combined measurement of nNO and FeNO can be used to evaluate the control of asthma, and the measurement of nNO can help with the diagnosis of allergic rhinitis in children with bronchial asthma.

Nasal and Exhaled Nitric Oxide in Allergic Rhinitis

OBJECTIVES: The primary aim of this study was to assess whether one can use levels of nasal nitric oxide (nNO) and exhaled nitric oxide (eNO) as a means of evaluation in allergic rhinitis. METHODS: We used a chemiluminescence analyzer to measure nNO and eNO in normal controls (n=34) and allergic rhinitis patients (n=35), and compared these measurements with various parameters of clinical symptoms and laboratory data. RESULTS: Mean nNO (389+/-119 ppb) in allergic rhinitis patients was significantly higher than normal controls (276+/-88 ppb). Without asthma, mean eNO (64.8+/-55.9 ppb) in allergic rhinitis patients was significantly higher than normal controls (33.0+/-24.0 ppb). In the persistent allergic rhinitis group, eNO concentration was significantly higher, while nNO concentration was significantly lower than the intermittent group. CONCLUSION: We can use nNO and eNO levels for evaluation of allergic rhinitis. However, we should consider the fact that nNO levels can be reduced, when symptoms are severe and long-lasting. Additionally, in allergic rhinitis, eNO can be elevated without asthma.