European Journal of Pediatrics

, Volume 155, Issue 8, pp 698–701 | Cite as

Exhaled nitric oxide in childhood asthma

  • A. Artlich
  • J. -U. Hagenah
  • S. Jonas
  • P. Ahrens
  • L. Gortner
Pneumology

Abstract

Endogenous synthesis of nitric oxide (NO) and its presence in exhaled air was observed in various species including humans. Particularly high levels were found in adults with bronchial asthma, possibly because of the underlying pulmonary inflammatory activity. We studied oral and nasal exhaled NO by chemiluminescence in 47 children aged between 6 and 10 years. Thirty children had bronchial asthma, 17 were healthy controls. In asthmatic children oral exhaled NO was 13.4±1.4 parts per billion (ppb) (mean±SEM), nasal exhaled NO was 21.7±1.5 ppb. In healthy controls oral exhaled NO was 7.2±1.0 ppb, nasal exhaled NO was 18.2±2.2 ppb. Oral exhaled NO was significantly higher in asthmatic children compared to healthy controls (P=0.0017). Nasal exhaled NO did not differ significantly in the two groups. There was a significant negative correlation between oral exhaled NO and forced expiratory volume in 1 s (FeV1). No significant correlation between oral or nasal exhaled NO and other markers of obstructive lung function impairment, oral minute ventilation, the body mass index and the presence of upper respiratory tract infection could be found.

Key words

Nitric oxid Asthma Inflammation Childhood 

Abbreviations

FeV1

forced expiratory volume in 1 s

i. d.

inner diameter

NO

nitric oxide

NOS

nitric oxide synthase

ppb

parts per billion

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References

  1. 1.
    Alving K, Weitzberg E, Lundberg JM (1993) Increased amount of nitric oxide in exhaled air of asthmatics Eur Respir J 6: 1368–1370PubMedGoogle Scholar
  2. 2.
    Änggård E (1994) Nitric oxide: mediator, murderer and medicine. Lancet 343: 1199–1206PubMedGoogle Scholar
  3. 3.
    Barnes PJ, Belsivi MG (1993) Nitric oxide and lung disease. Thorax 48: 1034–1043PubMedGoogle Scholar
  4. 4.
    Bames PJ, Liew FY (1995) Nitric oxide and asthmatic inflammation. Immunology Today 16: 128–130PubMedGoogle Scholar
  5. 5.
    Gerlach H, Rossaint R, Pappert D, Knorr M, Falke KJ (1994) Autoinhalation of nitric oxide after endogenous synthesis in nasopharynx. Lancet 343, 518–519PubMedGoogle Scholar
  6. 6.
    Gustafsson LE, Leone AM, Persson MG, Wiklund NP, Moncada S (1991) Endogenous nitric oxide is present in the exhaled air of rabbits, guinea pigs and humans. Biochem Biophys Res Commun 181: 852–857PubMedGoogle Scholar
  7. 7.
    Hamid Q, Springall DR, Riveros-Moreno V, Chanez P, Howarth P, Redington A, Bousquet J, Godard P, Holgate S, Polak J (1993) Induction of nitric oxide synthase in asthma. Lancet 342: 1510–1513PubMedGoogle Scholar
  8. 8.
    Jorens PG, Overveld FJ van, Bult H, Vermeira PA, Herman AG (1991) Larginine-dependent production of nitrogen oxides by pulmonary macrophages. Eur J Pharmacol 200: 205–209PubMedGoogle Scholar
  9. 9.
    Kharitonov SA, Yates D, Robbins RA, Logan-Sinclair R, Shinebourne EA, Barnes PJ (1994) Increased nitric oxide in exhaled air of asthmatic patients. Lancet 343: 133–135PubMedGoogle Scholar
  10. 10.
    Kharitonov SA, Yates D, Barnes PJ (1995) Increased nitric oxide in exhaled air of normal human subjects with upper respiratory tract infections. Eur Respir J 8: 295–297PubMedGoogle Scholar
  11. 11.
    Kobzik L, Bredt DS, Lowenstein CJ, Drazen J, Gaston B, Sugarbaker D, Stamler JS (1993) Nitric oxide synthase in human and rat lung: immunocytochemical and histochemical localization. Am J Respir Cell Mol Biol 9:371–377PubMedGoogle Scholar
  12. 12.
    Lundberg JON, Weitzberg E, Nordvall, SL, Kuylenstierna R, Lundberg JM, Alving K (1994) Primarily nasal origin of exhaled nitric oxide and absence in Kartagener's syndrome. Eur Respir J 7: 1501–1504PubMedGoogle Scholar
  13. 13.
    Lundberg JON, Farkas-Szallasi T, Weitzberg E, Rinder J, Lidholm J, Änggård A, Hökfelt T, Lundberg JM, Alving K (1995) High nitric oxide production in human paranasal sinuses. Nature Medicine 1: 370–373PubMedGoogle Scholar
  14. 14.
    National Institutes of Health (1992) International consensus report on diagnosis and treatment of asthma. Eur Respir J 5: 601–641Google Scholar
  15. 15.
    Persson MG, Wiklund NP, Gustafsson LE (1993) Endogenous nitric oxide in single exhalations and the change during exercise. Am Rev Respir Dis 148: 1210–1214PubMedGoogle Scholar
  16. 16.
    Persson MG, Zetterström O, Agrenius V, Ihre E, Gustafsson LE (1994) Single-breath nitric oxide measurements in asthmatic patients and smokers. Lancet 343: 146–147PubMedGoogle Scholar
  17. 17.
    Radomski MW, Palmer RMJ, Moncada S (1990) Glucocorticoids inhibit the expression of an inducible, but not constitutive nitric oxide synthase in vascular endothelial cells Proc Natl Acad Sci USA 87: 10043–10049PubMedGoogle Scholar
  18. 18.
    Robbins RA, Springall DR, Warren JB, Kwon OJ, Buttery LDK, Wilson AJ, Adcock IM, Riveros-Moreno V, Moncada S, Polak J, Barnes PJ (1994a) Inducible nitric oxide synthase is increased in murine lung epithelial cells by cytokine stimulation. Biochem Biophys Res Commun 198: 835–843PubMedGoogle Scholar
  19. 19.
    Robbins RA, Barnes PJ, Springall DR, Warren JB, Kwon OJ, Buttery LDK, Wilson AJ, Geller DA, Polak JM (1994b) Expression of inducible nitric oxide in human lung epithelial cells. Biochem Biophys Res Commun 203: 209–218PubMedGoogle Scholar
  20. 20.
    Schedin U, Frostell C, Persson MG, Jakobsson J, Andersson G, Gustafsson LE (1995) Contribution from upper and lower airways to exhaled endogenous nitric oxide in humans. Acta Anaesthesiol Scand 39: 327–332PubMedGoogle Scholar
  21. 21.
    Zapletal A, Paul T, Ŝamánek M (1977) Die Bedeutung heutiger Methoden der Lungenfunktionsdiagnostik zur Feststellung einer Obstruktion der Atemwege bei Kindem und Jugendlichen. Z Erkr Atmungsorgane 149: 343–371PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • A. Artlich
    • 1
  • J. -U. Hagenah
    • 2
  • S. Jonas
    • 1
  • P. Ahrens
    • 1
  • L. Gortner
    • 1
  1. 1.Klinik für PädiatrieLubeckGermany
  2. 2.Dräger-Werke AGLübeckGermany

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