Asthma and lower airway diseaseDeterminants of exhaled nitric oxide levels in healthy, nonsmoking African American adults
Section snippets
Subject recruitment and enrollment
Healthy subjects between the ages of 18 and 40 years were recruited from students and employees at 4 local university campuses. The study was originally powered to target an enrollment of 1000 African American subjects (994 were actually enrolled, and 99 were excluded because of smoking; n = 895). Informed consent was obtained as part of a protocol approved by the Duke University Institutional Review Board.
After obtaining informed consent, subjects were asked to provide their birth dates and
Subject characteristics and reproducibility of FeNO measurements
The characteristics of the 895 subjects enrolled in the study are listed in Table I. FeNO measurements were repeated for 84 of these subjects between 5 and 850 days apart (median, 143 days apart). There was an excellent correlation between the first and second FeNO measurements for each subject (intraclass correlation coefficient, 0.81; Fig 1).
Factors associated with variability of FeNO levels
We used univariate analyses to determine the relationship of FeNO levels to the factors listed in Table I. There were significant differences in FeNO
Discussion
We believe that our study represents the largest analysis to date of factors associated with FeNO levels in healthy African Americans. We found significant associations of sex, serum total IgE and ECP levels, and URI symptoms with FeNO levels (Table I, Table II). The modest associations of these factors, which together accounted for less than 50% of the variability in FeNO levels, suggest that other unknown factors might contribute substantially to the variability of FeNO levels. Therefore we
References (58)
- et al.
National trends in the morbidity and mortality of asthma in the US. Prevalence, hospitalization and death from asthma over two decades: 1965-1984
Chest
(1987) - et al.
Prevalence of asthma and other allergic diseases in an adolescent population: association with gender and race
Ann Allergy Asthma Immunol
(2001) - et al.
Induction of nitric oxide synthase in asthma
Lancet
(1993) - et al.
Eosinophils, T-lymphocytes, mast cells, neutrophils, and macrophages in bronchial biopsy specimens from atopic subjects with asthma: comparison with biopsy specimens from atopic subjects without asthma and normal control subjects and relationship to bronchial hyperresponsiveness
J Allergy Clin Immunol
(1991) - et al.
Exhaled nitric oxide as a marker of airway inflammation for an epidemiologic study in schoolchildren
J Allergy Clin Immunol
(2004) - et al.
Atopy influences exhaled nitric oxide levels in adult asthmatics
Chest
(2000) - et al.
Relationship of exhaled nitric oxide to clinical and inflammatory markers of persistent asthma in children
J Allergy Clin Immunol
(2003) - et al.
Measuring exhaled nitric oxide levels in adults: the importance of atopy and airway responsiveness
Chest
(2004) - et al.
Respiratory nitric oxide levels in experimental human influenza
Chest
(1998) - et al.
Intravenous nitrate vasodilators and exhaled nitric oxide
Lancet
(1997)
Height, age, and atopy are associated with fraction of exhaled nitric oxide in a large adult general population sample
Chest
Selective augmenting effects of nitric oxide on antigen-specific IgE response in mice
Immunopharmacology
Recognition of commensal microflora by toll-like receptors is required for intestinal homeostasis
Cell
Genetic epidemiology of health disparities in allergy and clinical immunology
J Allergy Clin Immunol
Interleukin-1beta-induced nitric oxide production in rat aortic endothelial cells: inhibition by estradiol in normal and high glucose cultures
Life Sci
Effects of estrogen on nitric oxide synthase expression in rat aorta allograft and smooth muscle cells
J Heart Lung Transplant
A novel NOS2 promoter polymorphism associated with protection from severe malaria in children from Tanzania and Kenya
Lancet
Increased amount of nitric oxide in exhaled air of asthmatics
Eur Respir J
Exhaled nitric oxide measurements in a population sample of young adults
Am J Respir Crit Care Med
A community study of exhaled nitric oxide in healthy children
Am J Respir Crit Care Med
Identification of activated T lymphocytes and eosinophils in bronchial biopsies in stable atopic asthma
Am Rev Respir Dis
Changes in the dose of inhaled steroid affect exhaled nitric oxide levels in asthmatic patients
Eur Respir J
Use of exhaled nitric oxide measurements to guide treatment in chronic asthma
N Engl J Med
NO chemical events in the human airway during the immediate and late antigen-induced asthmatic response
Proc Natl Acad Sci U S A
Protection from experimental asthma by an endogenous bronchodilator
Science
S-nitrosothiols regulate cell-surface pH buffering by airway epithelial cells during the human immune response to rhinovirus
Am J Physiol Lung Cell Mol Physiol
ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005
Am J Respir Crit Care Med
Exhaled nitric oxide measurements: clinical application and interpretation
Thorax
Total and allergen-specific IgE levels in serum reflect blood eosinophilia and fractional exhaled nitric oxide concentrations but not pulmonary functions in allergic asthmatic children sensitized to house dust mites
Pediatr Allergy Immunol
Cited by (36)
Fraction of exhaled nitric oxide in healthy elderly Tunisian subjects
2015, Nitric Oxide - Biology and ChemistryCitation Excerpt :Previous studies [8–10,12,13] showed a significant correlation between FeNO values and atopy. For that reason, and as done by other authors [21,34–38], the atopic status of the present study subjects was determined (using questionnaire) and only healthy non-atopic subjects were included. According to Jacinto et al. [15], the methodology of establishing normal FeNO values should be uniform and the formulation of norms should be based on a predetermined physiological model with endogenous and stable factors such as sex, age, and height.
The importance of atopy on exhaled nitric oxide levels in African American children
2015, Annals of Allergy, Asthma and ImmunologyThe role of fractional exhaled nitric oxide in asthma management
2014, Otolaryngologic Clinics of North AmericaReference values and factors associated with exhaled nitric oxide: U.S. youth and adults
2013, Respiratory MedicineCitation Excerpt :Gender was an independent predictor in adolescents and adults, but not for the children. Gender has also been widely reported as a determinant of FeNO with higher levels among males compared with females, especially in studies of adults [20,22–25,42,43], however; there are inconsistent results with some studies showing no association of FeNO with gender [19,26,30,35,44]. Height was a significant predictor of FeNO levels in all three age groups, independent of all other covariates, including gender.
Supported by the Sandler Program for Asthma Research; ES011185 from the National Institute of Environmental Health Sciences; and MO1-RR-30 from the National Center for Research Resources, Clinical Research Centers Program, National Institutes of Health.
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.