Allergen avoidance is associated with a fall in exhaled nitric oxide in asthmatic children,☆☆,

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Patients

Twenty asthmatic children (6 to 15 years) sensitized to HDM were evaluated at the Istituto Pio XII (Misurina BL, Italy) at 1756 m on the Italian Alps. None of them had respiratory infections in the 2 months before and during the study period.

The study was approved by the local ethics committee, and both children and their parents gave informed consent.

Study design

The children had been living with their families for at least 3 months before admission to the residential home (T0). FE NO was measured daily,

RESULTS

The mean levels of HDM group 1 (Der p 1 and Der f 1) antigen in the dust from beds were 13.8 and less than 0.05 μg/g of dust in the family houses and in the residential home, respectively, as measured by means of ELISA.3

FE NO decreased (P = .014 at T1) with a significant effect of the time in the first 2 weeks (P = .0026), remained unchanged from T1 to T2, and at T3 returned approximately to T0 level (P = .004, T2 vs T3; Fig 1).

. Changes in FE NO levels (geometric mean and upper and lower limits

DISCUSSION

The results of this study suggest that FE NO is modifiable by changes in environmental conditions in asthmatic children. A reduction in other inciters of asthma (eg, air pollution, passive smoke exposure, viral infection, or stress) could also have caused the fall in FE NO, although we believe that HDM reduction is the major factor.

After a significant reduction in the first 2 weeks of avoidance, FE NO did not significantly change from T1 to T2, despite the withdrawal of steroids. Because FE NO

Acknowledgements

We thank Christer Peterson, Pharmacia & Upjohn, Uppsala Sweden, for performing ECP assays.

References (5)

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Reprint requests: Giorgio L. Piacentini, MD, Clinica Pediatrica, Policlinico Borgo Roma, 37134 Verona, Italy.

☆☆

J Allergy Clin Immunol 1999;104:1323-4.

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