Additive effect of eosinophilia and atopy on exhaled nitric oxide levels in children with or without a history of respiratory symptoms
Additive effect of eosinophilia and atopy on exhaled nitric oxide levels in children with or without a history of respiratory symptoms
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DOI：
10.1111/j.1399-3038.2005.00220.x
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发表时间：
2005-02-01
影响因子：
4.4
通讯作者：
Ronchetti, R
中科院分区：
文献类型：
--
作者：
Barreto, M;Villa, MP;Ronchetti, R
虽然特应性和血嗜酸性粒细胞增多症都影响呼出的一氧化氮（eNO）的测量，没有研究量化其单一或联合作用。我们评估了特应性和血嗜酸性粒细胞增多对学龄儿童eNO的综合影响。对356名（男/女：168/188）年龄在9.0-11.5岁的学龄儿童进行了eNO、血清总IgE、血嗜酸性粒细胞计数、皮肤点刺试验（SPT）和肺功能测定。家长们填写了一份关于他们孩子目前或过去呼吸道症状的问卷。特应性由SPT > 3 mm定义，嗜酸性粒细胞增多由血细胞计数高于第80百分位数（>310个细胞/ml）定义。特应性-嗜酸性粒细胞受试者的eNO水平约为低血嗜酸性粒细胞的特应性受试者的两倍[24.3 p.p.b.]。（十亿分之一）vs. 14.1 p.p.b.]并且比具有高或低血液嗜酸性粒细胞的非特应性受试者（24.3p.b.，对比12.2 p.p.b.和10.9 p.p.b.）（两个比较的p < 0.001）。当受试者分别按性别或喘息阳性史（n = 60）、除喘息外的呼吸道症状（n = 107）或无呼吸道症状（n = 189）进行分析时，特应性和高嗜酸性粒细胞计数对eNO水平的累加效应保持不变。过敏性紫癜患儿中，对尘螨（Dpt或Dpf）致敏的频率与无嗜酸性粒细胞增多的儿童相似（分别为66.2%和67.4%）;嗜酸性粒细胞增多显著增加了对尘螨致敏的儿童以及对其他过敏原致敏的儿童的eNO水平。在多元线性回归分析中，eNO水平主要由阳性SPT风团和高血嗜酸性粒细胞计数的总和（t = 4.8和4.3，p = 0.000）解释，但也由呼吸道症状（特别是喘息）和男性性别的存在（t = 2.6和2.0，p = 0.009和0.045，分别）。测量eNO可能是一种简单的，非侵入性的方法，用于确定受试者在哮喘的风险，在学龄前人群。
Although atopy and blood eosinophilia both influence exhaled nitric oxide (eNO) measurements, no study has quantified their single or combined effect. We assessed the combined effect of atopy and blood eosinophilia on eNO in unselected schoolchildren. In 356 schoolchildren (boys/girls: 168/188) aged 9.0-11.5 yr, we determined eNO, total serum IgE, blood eosinophil counts and did skin prick tests (SPT) and spirometry. Parents completed a questionnaire on their children's current or past respiratory symptoms. Atopy was defined by a SPT > 3 mm and eosinophilia by a blood cell count above the 80th percentile (>310 cells/ml). eNO levels were about twofold higher in atopic-eosinophilic subjects than in atopic subjects with low blood eosinophils [24.3 p.p.b. (parts per billion) vs. 14.1 p.p.b.] and than non-atopic subjects with high or low blood eosinophils (24.3 p.p.b. vs. 12.2 p.p.b. and 10.9 p.p.b.) (p < 0.001 for both comparisons). The additive effect of atopy and high eosinophil count on eNO levels remained unchanged when subjects were analyzed separately by sex or by a positive history of wheeze (n = 60), respiratory symptoms other than wheeze (n = 107) or without respiratory symptoms (n = 189). The frequency of sensitization to Dermatophagoides (Dpt or Dpf) was similar in atopic children with and without eosinophilia (66.2% and 67.4%, respectively); eosinophilia significantly increased eNO levels in Dp-sensitized children as well in children sensitized to other allergens. In a multiple linear regression analysis, eNO levels were mainly explained by the sum of positive SPT wheals and a high blood eosinophil count (t = 4.8 and 4.3, p = 0.000), but also by the presence of respiratory symptoms (especially wheeze) and male sex (t = 2.6 and 2.0, p = 0.009 and 0.045, respectively). Measuring eNO could be a simple, non-invasive method for identifying subjects at risk of asthma in unselected school populations.