Noninvasive methods for the detection of upper and lower airway inflammation in atopic children

Profita, Mirella; La Grutta, Stefania; Carpagnano, Elisiana; Riccobono, Loredana; Di Giorgi, Rossana; Bonanno, Anna; Pace, Elisabetta; Bonsignore, Giovanni; Bousquet, Jean; Vignola, Antonio Maurizio; Gjomarkaj, Mark

doi:10.1016/j.jaci.2006.07.028

« Previous Next »The Journal of Allergy and Clinical Immunology
Volume 118, Issue 5 , Pages 1068-1074, November 2006

Noninvasive methods for the detection of upper and lower airway inflammation in atopic children

Mirella Profita, PhD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo
- Reprint requests: Mirella Profita, PhD, IBIM: Sezione di Immunopatologia e Farmacologia, Clinica e Sperimentale dell'Apparato Respiratorio, Via Ugo La Malfa 153, 90146 Palermo, Italy.
Stefania La Grutta, MD
- Allergy Unit, Children Hospital, ARNAS, Palermo
Elisiana Carpagnano, MD
- Institute of Respiratory Diseases, University of Bari
Loredana Riccobono, PhD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo
Rossana Di Giorgi, PhD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo
Anna Bonanno, PhD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo
Elisabetta Pace, MD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo
Giovanni Bonsignore, MD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo
Jean Bousquet, MD
- Institut National de la Santè et de la Recherche Medical U-454, Montpellier
Antonio Maurizio Vignola, MD, PhD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo
- During the course of this study, Prof Maurizio Vignola died from a malignant leukemia. We wish to dedicate this work to his memory.
Mark Gjomarkaj, MD
- From the Institute of Biomedicine and Molecular Immunology, Section of Immunopathology and Clinical and Experimental Pharmacology of the Respiratory System, Italian National Research Council, Palermo

Received 8 July 2005; received in revised form 12 July 2006; accepted 13 July 2006. published online 15 September 2006.

Palermo and Bari, Italy, and Montpellier, France

Background

Exhaled nitric oxide (FE_NO) and exhaled breath condensate (EBC) are noninvasive methods to assess inflammation.

Objective

To investigate the role of the FE_NO and of the EBC pH and IL-5 levels in atopic children.

Methods

We evaluated oral and nasal FE_NO and the pH and IL-5 of oral and nasal EBC in children with atopic dermatitis (AD; n = 18), allergic rhinitis (AR; n = 18), intermittent asthma (n = 21), moderate persistent asthma (n = 18), and healthy controls (HCs; n = 16).

Results

Oral FE_NO was significantly increased in asthma, whereas the nasal values were increased in AR and asthma in comparison with HCs. The pH of oral EBC was lower in AD and asthma than in AR and HCs, whereas the nasal levels were lower in AD, AR, and asthma than in HCs. The oral IL-5 was higher in AD, AR, and asthma in comparison with HCs, whereas the nasal IL-5 concentrations were higher in asthma and AR than in HCs. In AR, the nasal FE_NO correlated with the IL-5 values and with the disease duration. In intermittent asthma, oral and nasal pH inversely correlated with the exacerbations, whereas in moderate asthma, the nasal IL-5 positively correlated with exacerbations. In AD, the oral and nasal IL-5 positively correlated with the serum IgE.

Conclusion

These markers of nasal and bronchial inflammation, accessible with noninvasive techniques, might be useful to identify patients with uncontrolled diseases and to verify the usefulness of new therapeutic approaches.