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Fractional Exhaled Nitric Oxide (FeNO) is a Marker of Allergic Inflammation in High Risk 5 Year Old Children
S216 Abstracts
Fractional Exhaled Nitric Oxide (FeNO) is a Marker of Allergic Inflammation in High Risk 5 Year Old Children L. E. Pleiss, M. Evans, E. L. Anderson, D. F. DaSilva, T. E. Pappas, K. A. Roberg, K. Sullivan - Dillie, C. J. Tisler, R. Gangnon, J. E. Gern, R. F. Lemanske; Medical School, University of Wisconsin- Madison, Madison, WI. RATIONALE: Fractional exhaled nitric oxide (FeNO) could be useful as a biomarker of lower airway inflammation in young children, but relationships with atopic characteristics are incompletely understood. METHODS: Study subjects were 141 five-year-old children in the Childhood Origins of ASThma (COAST) project, a prospective birth cohort study of children at high risk of developing allergies and/or asthma based on parental histories. Measurements of FeNO were completed using the online technique with the NIOX® system (Aerocrine, AB, Stockholm, Sweden). FeNO was calculated from three maneuvers that were within 2.5 ppb or 10%. Total and specific IgE levels were determined by fluoroenzyme immunoassay (FEIA, Pharmacia), and values > 0.35 kU/L were considered positive. RESULTS: Children with one or more positive RAST results to food or aeroallergens at age 5 had significantly higher FeNO values than children who had negative RAST results ((geometric mean) 7.5 vs 5.6 ppb, p = 0.02). FeNO was significantly greater in girls compared to boys (7.4 vs 6.0 ppb, p=0.05). In addition, FeNO was positively associated with total IgE at age 5 (rs = +0.21, p = 0.01). A history of wheezing was not associated with increased FeNO. CONCLUSIONS: In high-risk preschool aged children, levels of exhaled nitric oxide are significantly associated with total and specific IgE levels, but not with a history of episodic wheezing. We also found evidence of a possible effect of gender on FeNO in early childhood. Funding: National Institutes of Health
832
Prevalence and Severity of Asthma among Adolescents and its Relationship with the Body Mass Index V. E. Cassol1, T. M. Rizzato1, S. P. Teche1, D. F. Basso2, V. N. Hirata3, M. Maldonado4, E. Colpo5, D. Solé6; 1Pediatrics/Division of Pediatric Pneumology, Federal University of Santa Maria, Santa Maria, BRAZIL, 2Nutrition, Federal University of Santa Catarina, Florianópolis, BRAZIL, 3Epidemiology, Federal University of Pelotas, Pelotas, BRAZIL, 4Physiology of Exercise, Federal University of Santa Maria, Santa Maria, BRAZIL, 5Nutrition, Federal University of Santa Maria, Santa Maria, BRAZIL, 6Pediatrics/Division of Allergy and Clinical Immunology, Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, BRAZIL. RATIONALE: there are evidences that relate the increase of body mass index (BMI) and the increase of the prevalence and severity of asthma between children and adolescents. Our objective was to investigate the relationship between increase of BMI and prevalence and severity of asthma in adolescents from Santa Maria and surroundings (state of Rio Grande do Sul). METHODS: observational cross-sectional study of populational base of 4,010 schoochildren aged 13 and 14 years without restrictions as for sex, filled in the written questionnaire (WQ) of the International Study of Asthma and Allergies (ISAAC) phase III (asthma core). BMI was used (kg/m2) as recommended by World Health Organization, with the following percentiles to define nutritional state: below 5th (underweight), equal or superior to 5th and inferior to 85th (normal weight), equal or superior to 85th and inferior to 95th (overweight) equal or superior to 95th (obesity). Relationship between IMC and the prevalence, and severity of asthma, was analyzed using the Chi-square test for tendency (statistical significance: p 0.05). RESULTS: there was a significant statistical association between BMI increase and prevalence of “wheezing ever” (p=0,036), and “wheezing with exercise” (p=0,008). When stratified by sex, there was positive association just for “wheezing ever” (p=0,028) for boys and “wheezing with exercise” (p=0,03) for girls. CONCLUSIONS: BMI increase was associated with the increase of prevalence of wheezing ever, but not with the increase of the prevalence and severity of the asthma in adolescents.
833
J ALLERGY CLIN IMMUNOL FEBRUARY 2006
Funding: Federal University of Santa Maria and Federal University of São Paulo
834
IgE to Cockroach Allergens and Asthma
A. Togias1, J. Poyser1, S. Satinover2, D. Collins1, T. Richards1, T. Green1, E. Horowitz1, J. Woodfolk2; 1Johns Hopkins University, Baltimore, MD, 2University of Virginia, Charlottesville, VA. RATIONALE: Although allergy to cockroach has been strongly associated with asthma severity, only one study has found an association between cockroach allergy and asthma. Our goal was to examine whether such an association also exists within a homogeneous community that has ubiquitous exposure to cockroaches. Furthermore, we wanted to identify which cockroach allergens are the most common sensitizers. METHODS: We measured cockroach and dust mite serum IgE using CAP in 47 public housing residents from two Baltimore City communities. We also measured specific IgE levels to various cockroach allergens. Our subjects underwent extensive clinical evaluation including methacholine bronchoprovocation or albuterol reversibility testing for asthma phenotyping. RESULTS: Based on the clinical evaluation, we categorized the cohort in 3 groups: asthma (A, N=13), possible asthma (PA, N=11) and no asthma (NA, N=23). Cockroach IgE (IU/ml, mean ±SEM): 17.4±8.1 (A), 2.28±1.4 (PA), 3.0±2.0 (NA), p = 0.039. In contrast to cockroach, we found no difference between the 3 groups in D. pteronyssinus or D. farinae serum IgE. Positive IgE against Bla g 5 was the most common finding with Bla g 4, Blag 1, Bla g 2 and Per a 7 following in rank order. CONCLUSIONS: In Baltimore public housing residents, serum IgE against cockroach is a strong risk factor for asthma whereas IgE against dust mites is not. Bla g 5, a glutathione transferase protein, appears to be the major allergen in this population. Funding: NIAID
MONDAY
A Clinical-Based Retrospective Cohort Study of Incidence Asthma in Adults with Allergic Rhinitis: Importance of Cigarette Smoking R. Polosa; Dipartimento di Medicina Interna, University of Catania, Catania, ITALY. RATIONALE: Several studies have suggested that rhinitis usually precedes asthma. Sensitization to allergen has been shown to be one of the strongest determinants of incident asthma, but little is known about the effects of common modifiable risk factors such as cigarette smoking among individuals with allergic rhintis. METHODS: The present study was carried out in a cohort of hospitalreferred non-asthmatic adult subjects with allergic rhinitis to define the importance of cigarette smoking as an additional risk factor for incident asthma during follow-up. Non-asthmatic allergic rhinitics aged 18-40 years between 1990 and 1991 with a detailed smoking history were retrospectively followed up until January and April 2000. We used the categories of smokers, ex-smokers, and never smokers in the analyses. We also used pack/years as a continuous variable to calculate the level of cumulative exposure. At the end of follow up, subjects were clinically examined for asthma diagnosis. There were 331 participants who completed the follow up (108 smokers, 76 ex-smokers, 147 non smokers). RESULTS: In a multivariate analysis, an increased risk of developing asthma among current smokers compared to never smokers (OR, 5.9; 95%CI, 3.4-10.2) and among as ex-smokers (OR, 4.5; 95%CI, 2.5-8.1) was observed. In the multivariate model adjusting for other asthma risk factors, the OR of developing asthma for the increase in each pack/years unit was OR 1.44 (1.21-1.61). CONCLUSIONS: The current findings support the hypothesis that cigarette smoking is an important independent risk factor for the development of new asthma cases in adults with allergic rhinitis. Funding: University of Catania
835
Fractional Exhaled Nitric Oxide (FeNO) is a Marker of Allergic Inflammation in High Risk 5 Year Old Children L. E. Pleiss, M. Evans, E. L. Anderson, D. F. DaSilva, T. E. Pappas, K. A. Roberg, K. Sullivan - Dillie, C. J. Tisler, R. Gangnon, J. E. Gern, R. F. Lemanske; Medical School, University of Wisconsin- Madison, Madison, WI. RATIONALE: Fractional exhaled nitric oxide (FeNO) could be useful as a biomarker of lower airway inflammation in young children, but relationships with atopic characteristics are incompletely understood. METHODS: Study subjects were 141 five-year-old children in the Childhood Origins of ASThma (COAST) project, a prospective birth cohort study of children at high risk of developing allergies and/or asthma based on parental histories. Measurements of FeNO were completed using the online technique with the NIOX® system (Aerocrine, AB, Stockholm, Sweden). FeNO was calculated from three maneuvers that were within 2.5 ppb or 10%. Total and specific IgE levels were determined by fluoroenzyme immunoassay (FEIA, Pharmacia), and values > 0.35 kU/L were considered positive. RESULTS: Children with one or more positive RAST results to food or aeroallergens at age 5 had significantly higher FeNO values than children who had negative RAST results ((geometric mean) 7.5 vs 5.6 ppb, p = 0.02). FeNO was significantly greater in girls compared to boys (7.4 vs 6.0 ppb, p=0.05). In addition, FeNO was positively associated with total IgE at age 5 (rs = +0.21, p = 0.01). A history of wheezing was not associated with increased FeNO. CONCLUSIONS: In high-risk preschool aged children, levels of exhaled nitric oxide are significantly associated with total and specific IgE levels, but not with a history of episodic wheezing. We also found evidence of a possible effect of gender on FeNO in early childhood. Funding: National Institutes of Health
832
Prevalence and Severity of Asthma among Adolescents and its Relationship with the Body Mass Index V. E. Cassol1, T. M. Rizzato1, S. P. Teche1, D. F. Basso2, V. N. Hirata3, M. Maldonado4, E. Colpo5, D. Solé6; 1Pediatrics/Division of Pediatric Pneumology, Federal University of Santa Maria, Santa Maria, BRAZIL, 2Nutrition, Federal University of Santa Catarina, Florianópolis, BRAZIL, 3Epidemiology, Federal University of Pelotas, Pelotas, BRAZIL, 4Physiology of Exercise, Federal University of Santa Maria, Santa Maria, BRAZIL, 5Nutrition, Federal University of Santa Maria, Santa Maria, BRAZIL, 6Pediatrics/Division of Allergy and Clinical Immunology, Federal University of São Paulo-Escola Paulista de Medicina, São Paulo, BRAZIL. RATIONALE: there are evidences that relate the increase of body mass index (BMI) and the increase of the prevalence and severity of asthma between children and adolescents. Our objective was to investigate the relationship between increase of BMI and prevalence and severity of asthma in adolescents from Santa Maria and surroundings (state of Rio Grande do Sul). METHODS: observational cross-sectional study of populational base of 4,010 schoochildren aged 13 and 14 years without restrictions as for sex, filled in the written questionnaire (WQ) of the International Study of Asthma and Allergies (ISAAC) phase III (asthma core). BMI was used (kg/m2) as recommended by World Health Organization, with the following percentiles to define nutritional state: below 5th (underweight), equal or superior to 5th and inferior to 85th (normal weight), equal or superior to 85th and inferior to 95th (overweight) equal or superior to 95th (obesity). Relationship between IMC and the prevalence, and severity of asthma, was analyzed using the Chi-square test for tendency (statistical significance: p 0.05). RESULTS: there was a significant statistical association between BMI increase and prevalence of “wheezing ever” (p=0,036), and “wheezing with exercise” (p=0,008). When stratified by sex, there was positive association just for “wheezing ever” (p=0,028) for boys and “wheezing with exercise” (p=0,03) for girls. CONCLUSIONS: BMI increase was associated with the increase of prevalence of wheezing ever, but not with the increase of the prevalence and severity of the asthma in adolescents.
833
J ALLERGY CLIN IMMUNOL FEBRUARY 2006
Funding: Federal University of Santa Maria and Federal University of São Paulo
834
IgE to Cockroach Allergens and Asthma
A. Togias1, J. Poyser1, S. Satinover2, D. Collins1, T. Richards1, T. Green1, E. Horowitz1, J. Woodfolk2; 1Johns Hopkins University, Baltimore, MD, 2University of Virginia, Charlottesville, VA. RATIONALE: Although allergy to cockroach has been strongly associated with asthma severity, only one study has found an association between cockroach allergy and asthma. Our goal was to examine whether such an association also exists within a homogeneous community that has ubiquitous exposure to cockroaches. Furthermore, we wanted to identify which cockroach allergens are the most common sensitizers. METHODS: We measured cockroach and dust mite serum IgE using CAP in 47 public housing residents from two Baltimore City communities. We also measured specific IgE levels to various cockroach allergens. Our subjects underwent extensive clinical evaluation including methacholine bronchoprovocation or albuterol reversibility testing for asthma phenotyping. RESULTS: Based on the clinical evaluation, we categorized the cohort in 3 groups: asthma (A, N=13), possible asthma (PA, N=11) and no asthma (NA, N=23). Cockroach IgE (IU/ml, mean ±SEM): 17.4±8.1 (A), 2.28±1.4 (PA), 3.0±2.0 (NA), p = 0.039. In contrast to cockroach, we found no difference between the 3 groups in D. pteronyssinus or D. farinae serum IgE. Positive IgE against Bla g 5 was the most common finding with Bla g 4, Blag 1, Bla g 2 and Per a 7 following in rank order. CONCLUSIONS: In Baltimore public housing residents, serum IgE against cockroach is a strong risk factor for asthma whereas IgE against dust mites is not. Bla g 5, a glutathione transferase protein, appears to be the major allergen in this population. Funding: NIAID
MONDAY
A Clinical-Based Retrospective Cohort Study of Incidence Asthma in Adults with Allergic Rhinitis: Importance of Cigarette Smoking R. Polosa; Dipartimento di Medicina Interna, University of Catania, Catania, ITALY. RATIONALE: Several studies have suggested that rhinitis usually precedes asthma. Sensitization to allergen has been shown to be one of the strongest determinants of incident asthma, but little is known about the effects of common modifiable risk factors such as cigarette smoking among individuals with allergic rhintis. METHODS: The present study was carried out in a cohort of hospitalreferred non-asthmatic adult subjects with allergic rhinitis to define the importance of cigarette smoking as an additional risk factor for incident asthma during follow-up. Non-asthmatic allergic rhinitics aged 18-40 years between 1990 and 1991 with a detailed smoking history were retrospectively followed up until January and April 2000. We used the categories of smokers, ex-smokers, and never smokers in the analyses. We also used pack/years as a continuous variable to calculate the level of cumulative exposure. At the end of follow up, subjects were clinically examined for asthma diagnosis. There were 331 participants who completed the follow up (108 smokers, 76 ex-smokers, 147 non smokers). RESULTS: In a multivariate analysis, an increased risk of developing asthma among current smokers compared to never smokers (OR, 5.9; 95%CI, 3.4-10.2) and among as ex-smokers (OR, 4.5; 95%CI, 2.5-8.1) was observed. In the multivariate model adjusting for other asthma risk factors, the OR of developing asthma for the increase in each pack/years unit was OR 1.44 (1.21-1.61). CONCLUSIONS: The current findings support the hypothesis that cigarette smoking is an important independent risk factor for the development of new asthma cases in adults with allergic rhinitis. Funding: University of Catania
835