Abstract
Nitric oxide (NO) from upper (nasal NO, nNO) or lower airways (fractional exhaled NO, FeNO) is considered a surrogate marker for Th2-type inflammation, which is influenced by atopy. The aim of this study was to analyze nNO and FeNO in regard to qualitative and quantitative aspects of sensitization. We evaluated 244 non-smoking young adults. All of them were first-year students recruited for a longitudinal study. An inhalation allergy screening tool was used for atopy definition (specific immunoglobulin E (sIgE) to sx1 ≥ 0.35 kU/L), and also sIgE response to three inhalant perennial allergens, house dust mite (HDM, d1), cat (e1), and dog (e5), was determined in the non-pollen season. With respect to sx1, 100 subjects could be classified as atopic. Sensitization to one, two, or three perennial allergens could be demonstrated in 46, 10, and 16 students, respectively. The subjects with positive IgE response to sx1, but not sensitized to HDM, cat, and/or dog, had FeNO levels comparable to those of non-atopic subjects (13.5 vs. 13.0 ppb, respectively; p = 0.485). These levels were significantly lower compared to atopic subjects being sensitized to any perennial allergen (19.0 ppb; p = 0.0003). After grouping the atopic subjects for perennial sensitization patterns, significantly higher FeNO could be detected in subjects with poly-sensitization (n = 26; 26.0 ppb) compared to the mono-sensitized ones (n = 46; 18.0 ppb; p = 0.023). Regarding nNO, no differences could be observed. Applying a two-way ANOVA, we could reveal a significant correlation of specific HDM-IgE CAP-class with FeNO (p < 0.0001) and nNO levels (p = 0.007). Finally, a significant relationship was found between nNO and FeNO for the whole cohort (p < 0.0001). In summary, our findings support the argument that atopy and perennial sensitization should be considered for the interpretation of NO.
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Acknowledgments
This study was part of the IPA project 109-AllergoVet funded by the DGUV (German Social Accident Insurance, St. Augustin, Germany). Practical realization of the study was supported by the Unfallkasse Hessen (especially I. Thullner) and the University for Veterinary Medicine, Giessen (especially Prof. Dr. St. Arnhold, Prof. Dr. S. Tacke). The authors express a gratitude to all students participating in the study. We thank Ursula Meurer for her excellent serological testing.
Conflicts of Interest
The authors declare no conflicts of interest in relation to this article.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Ruhr University Bochum in Germany. The participants received financial compensation for taking part in the study.
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Written informed consent was obtained from all individual participants included in the study.
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Hoffmeyer, F. et al. (2020). The Pattern of Sensitization Influences Exhaled and Nasal Nitric Oxide Levels in Young Adults. In: Pokorski, M. (eds) Health and Medicine. Advances in Experimental Medicine and Biology(), vol 1279. Springer, Cham. https://doi.org/10.1007/5584_2020_509
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