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Open AccessArticle

Evolution of Airway Inflammation in Preschoolers with Asthma—Results of a Two-Year Longitudinal Study

1
Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 11527 Athens, Greece
2
Upper Airways Research Laboratory, Ghent University Hospital, 9000 Ghent, Belgium
3
Department of Molecular Pneumology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
4
Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, 20520 Turku, Finland
5
Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, 92213 Lodz, Poland
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Department of Rheumatology, Medical University of Lodz, 92213 Lodz, Poland
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Department of Pediatrics and Adolescent Medicine, Dept of Allergy and Pneumology, Children’s Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
8
Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester M13 9PL, UK
*
Author to whom correspondence should be addressed.
Equally contributing authors.
J. Clin. Med. 2020, 9(1), 187; https://doi.org/10.3390/jcm9010187 (registering DOI)
Received: 26 November 2019 / Revised: 4 January 2020 / Accepted: 6 January 2020 / Published: 9 January 2020
Fractional exhaled nitric oxide (FeNO) is a non-invasive marker for eosinophilic airway inflammation and has been used for monitoring asthma. Here, we assess the characteristics of FeNO from preschool to school age, in parallel with asthma activity. A total of 167 asthmatic children and 66 healthy, age-matched controls were included in the 2-year prospective PreDicta study evaluating wheeze/asthma persistence in preschool-aged children. Information on asthma/rhinitis activity, infections and atopy was recorded at baseline. Follow-up visits were performed at 6-month intervals, as well as upon exacerbation/cold and 4–6 weeks later in the asthmatic group. We obtained 539 FeNO measurements from asthmatics and 42 from controls. At baseline, FeNO values did not differ between the two groups (median: 3.0 ppb vs. 2.0 ppb, respectively). FeNO values at 6, 12, 18 and 24 months (4.0, CI: 0.0–8.6; 6.0, CI: 2.8–12.0; 8.0, CI: 4.0–14.0; 8.5, CI: 4.4–14.5 ppb, respectively) increased with age (correlation p ≤ 0.001) and atopy (p = 0.03). FeNO was non-significantly increased from baseline to the symptomatic visit, while it decreased after convalescence (p = 0.007). Markers of disease activity, such as wheezing episodes and days with asthma were associated with increased FeNO values during the study (p < 0.05 for all). Age, atopy and disease activity were found to be important FeNO determinants in preschool children. Longitudinal and individualized FeNO assessment may be valuable in monitoring asthmatic children with recurrent wheezing or mild asthma. View Full-Text
Keywords: asthma; PreDicta; preschool; FeNO; spirometry asthma; PreDicta; preschool; FeNO; spirometry
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Xepapadaki, P.; Korovessi, P.; Bachert, C.; Finotto, S.; Jartti, T.; Lakoumentas, J.; Kowalski, M.L.; Lewandowska-Polak, A.; Lukkarinen, H.; Zhang, N.; Zimmermann, T.; Papadopoulos, N.G. Evolution of Airway Inflammation in Preschoolers with Asthma—Results of a Two-Year Longitudinal Study. J. Clin. Med. 2020, 9, 187.

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