Siyu Zhu

and 4 more

Background Fractional exhaled nitric oxide has been used as a marker of airway inflammation. The concentration of nitric oxide in the central and peripheral airway can be measured by different exhalation flow rates to evaluate inflammation in different divisions within the respiratory tract. We hypothesized that fractional exhaled nitric oxide could be used as an evaluation tool for airway inflammation in different allergic types of pediatric asthma. Methods We recruited 487 subjects into the study: 238 children with single inhalant allergic asthma, 36 children with single food allergic asthma, 181 children with mixed allergic asthma, and 32 allergen-negative controls. Fractional exhaled nitric oxide including FeNO50 (exhaled NO at a flow rate of 50mL/s), FeNO200 and CaNO (peripheral concentration of NO) were measured among the recruited participants. We compared the differences of fractional exhaled nitric oxide levels between the groups. Results Differences in the concentration of FeNO50 and FeNO200 between various groups were statistically significant (P<0.001). CaNO could not differentiate the allergen-negative group from allergic groups (P>0.05). The concentration of FeNO50 and FeNO200 were significantly higher in the inhalation group and the mixed group than in the food group and controls(P<0.05). The concentration of CaNO was higher in the inhalation group and mixed group than in the food group among the children with well-controlled asthma (P<0.05). Conclusions The concentration of FeNO50 and FeNO200 were significantly elevated in children with inhalant and mixed allergic asthma, which suggests these children have more serious airway inflammation. Therefore, fractional exhaled nitric oxide better reflects and monitors the severity of airway inflammation in children with inhalant allergy and mixed allergy asthma. It could be a guide for adjusting diagnostic and therapeutic strategies.