Elevated Exhaled Nitric Oxide in High-Risk Neonates Precedes Transient Early but Not Persistent Wheeze
Male
Infant, Newborn
Mothers
Cell Count
Immunoglobulin E
Nitric Oxide
Asthma
Respiratory Function Tests
3. Good health
Eosinophils
Breath Tests
Exhalation
Recurrence
Humans
Female
Tobacco Smoke Pollution
Prospective Studies
Child
Follow-Up Studies
Respiratory Sounds
DOI:
10.1164/rccm.200909-1377oc
Publication Date:
2010-07-16T05:43:24Z
AUTHORS (8)
ABSTRACT
Elevated fractional exhaled nitric oxide (Fe(NO)) concentration has been suggested to predict early childhood wheeze and sensitization.To investigate the association between Fe(NO) in asymptomatic neonates and the development of wheeze patterns and atopic intermediary phenotypes in the first 6 years of life.We measured Fe(NO) in 253 healthy 1-month-old neonates from the Copenhagen Prospective Study on Asthma in Childhood birth cohort and monitored prospectively wheezy episodes by daily diary cards during the first 6 years of life. Total IgE, specific IgE, and blood eosinophil count were assessed at age 6 months, 4 years, and 6 years. Associations were studied by Cox regression, logistic regression, and generalized linear models.Increased neonatal Fe(NO) level was significantly associated with the development of recurrent wheeze in the first year of life (hazard ratio, 2.63; 95% confidence interval, 1.1 to 6.2; P = 0.026) but not thereafter. The association was unaffected by environmental tobacco smoke exposure. Fe(NO) was not associated with elevated levels of total IgE, specific IgE, or blood eosinophil count at any age point and was unrelated to neonatal lung function.An elevated Fe(NO) level in asymptomatic neonates born to mothers with asthma preceded the development of transient early wheezing, but not persistent wheezing during preschool age, and was unrelated to atopy. This suggests an early disease process other than small airway caliber contributing to the transient wheezing phenotype.
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