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Ciprandi G.,Azienda Ospedaliera Universitaria San Martino | Tosca M.A.,Irccs Institute G Gaslini | Capasso M.,Ospedale Civile Ave Gratia Plena
Journal of Asthma

Background. Allergic asthma and rhinitis may be associated. Airway inflammation is shared by both disorders. The measure of the fractional concentration of exhaled nitric oxide (FeNO) may be considered as a surrogate marker for airway inflammation, mainly in allergic patients. Reversibility to bronchodilation (BD) testing is a functional characteristic of asthma. Objective. The aim of this study was to evaluate whether FeNO may predict reversibility to BD in a pediatric cohort of allergic subjects with asthma (180) or rhinitis (150). Methods. Lung function (including forced expiratory volume at the first second (FEV1), forced volume capacity (FVC), forced expiratory flow at 25-75% of volume capacity (FEF 25-75)), FeNO measurement, and BD testing were performed in all children. Results. Lung function, FeNO, and sensitization type were significantly different in the two groups. A strong correlation was found between FeNO and ΔFEV1 after BD. Two main predictors of reversibility were FeNO values >34 ppb [Odds RatioAdj (ORAdj) = 1.9] and sensitization to perennial allergens (ORAdj = 1.7). Conclusions. This study provided evidence that FeNO was strongly related with the response to BD testing and could predict bronchial reversibility in children with allergic rhinitis or asthma. Therefore, a simple FeNO measurement could suggest releVant information about bronchial reversibility. © 2013 Informa Healthcare USA, Inc. Source

Ciprandi G.,University of Genoa | Capasso M.,Ospedale Civile Ave Gratia Plena | Tosca M.A.,Irccs Institute G Gaslini
American Journal of Rhinology and Allergy

Background: Allergic rhinitis (AR) may be frequently associated with asthma or precede it. Bronchial involvement in AR is usually detected by spirometry. Forced expiratory volume in 1 second (FEV 1) is considered a reliable parameter for asthma diagnosis. However, forced expiratory flow at 25-75% (FEF 25-75) could be considered a possible marker of early bronchial involvement in AR; indeed, it has been proposed that FEF 25-75 values <70% of predicted may predict this evolution. The aim of this study was to evaluate a large cohort of children with AR to define an FEV 1 value corresponding to impaired FEF 25-75 values. Methods: Eight hundred fifty AR children (555 boys; median age, 10 years) were studied. Spirometry and skin-prick test were performed in all of them. Descriptive statistic and multivariate analysis were considered. Results: Three-hundred (35.3%) patients had FEF 25-75 values <70% of predicted. Still, normal FEV 1 values were associated with overt impaired FEF 25-75 values and the cutoff value was 83%. Conclusion: Spirometry should be adequately interpreted in AR patients; indeed, an FEV 1 cutoff value of 83% detects with good efficiency AR children with early bronchial impairment. Copyright © 2011, OceanSide Publications, Inc. Source

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