Expired nitric oxide and airway reactivity in infants at risk for asthma.
Expired nitric oxide and airway reactivity in infants at risk for asthma.
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DOI：
10.1016/j.jaci.2008.07.022
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发表时间：
2008-10
影响因子：
14.2
通讯作者：
Swigonski, Nancy
中科院分区：
文献类型：
--
作者：
Tepper, Robert S.;Llapur, Conrado J.;Jones, Marcus H.;Tiller, Christina;Coates, Cathy;Kimmel, Risa;Kisling, Jeffrey;Katz, Barry;Ding, Yan;Swigonski, Nancy
特应性家族史，以及特应性皮炎和食物过敏史，是婴儿患哮喘的重要危险因素。虽然特应性致敏似乎有助于哮喘的发展，但气道何时参与特应性过程以及气道功能是否与婴儿的特应性特征有关尚不清楚。我们试图评估以前没有喘息发作的特应性婴儿是否有增加的过期一氧化氮（eNO）水平和气道反应性增高。研究人员招募了湿疹患儿，通过对食物或空气过敏原的特定IgE水平和总IgE水平来确定他们的特应性状态。在镇静婴儿中测量eNO、75%呼气量时的用力呼气流量（FEF75）和气道对吸入甲基胆碱的反应性。通过刺激浓度使FEF75降低30%来量化气道反应性。114名被评估婴儿的中位年龄为10.7个月（范围为2.6-19.1个月）。与既不吃鸡蛋也不吃牛奶致敏的婴儿相比，对鸡蛋或牛奶致敏的婴儿流量更低（FEF75: 336 vs 285 mL/s, P < 0.003）， lnPC30 （mg/mL）刺激浓度更低，使FEF75降低30% (- 0.6 vs - 1.2, P < 0.02)，但eNO水平无差异。血清总IgE水平大于20 IU/mL的婴儿与IgE水平为20 IU/mL或更低的婴儿相比，eNO水平更高（14.6 vs 11.2 ppb, P < 0.023），但在强迫血流或气道反应性方面没有差异。我们的研究结果表明，婴儿的特应性特征可能是用力呼气流量、气道反应性和eNO的气道生理学的重要决定因素。
Family histories of atopy, as well as histories of atopic dermatitis and food allergy, are important risk factors for an infant to have asthma. Although atopic sensitization appears to contribute to the development of asthma, it is unclear when the airways become involved with the atopic process and whether airway function relates to the atopic characteristics of the infant. We sought to evaluate whether atopic infants without prior episodes of wheezing have increased expired nitric oxide (eNO) levels and heightened airway reactivity. Infants with eczema were recruited, and atopic status was defined by specific IgE levels to foods or aeroallergens and total IgE levels. eNO, forced expiratory flow at 75% exhaled volume (FEF75), and airway reactivity to inhaled methacholine were measured in sedated infants. Airway reactivity was quantified by using the provocative concentration to decrease FEF75 by 30%. Median age for the 114 infants evaluated was 10.7 months (range, 2.6–19.1 months). Infants sensitized to egg or milk compared with infants sensitized to neither egg nor milk had lower flows (FEF75: 336 vs 285 mL/s, P < .003) and lower lnPC30 (mg/mL) provocative concentrations to decrease FEF75 by 30% (−0.6 vs −1.2, P < .02) but no difference in eNO levels. Infants with total serum IgE levels of greater than 20 IU/mL had higher eNO levels compared with infants with IgE levels of 20 IU/mL or less (14.6 vs 11.2 ppb, P < .023) but no difference in forced flows or airway reactivity. Our findings suggest that atopic characteristics of the infant might be important determinants of the airway physiology of forced expiratory flows, airway reactivity, and eNO.
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