Journal
CLINICAL AND EXPERIMENTAL ALLERGY
Volume 52, Issue 2, Pages 297-311Publisher
WILEY
DOI: 10.1111/cea.14019
Keywords
asthma; exhaled nitric oxide; FeNO; nasal polyposis; population-based; rhinitis
Categories
Funding
- Medical Research Council [92091]
- Australia: National Health & Medical Research Council
- Belgium: Antwerp South, Antwerp City-Research Foundation Flanders (FWO) [G.0.410.08.N.10]
- Estonia: Estonian Ministry of Education [Tartu-SF0180060s09]
- Estonian Research Council [562]
- France: Ministere de la Sante, Programme Hospitalier de Recherche Clinique (PHRC)
- Bordeaux-INSERM U897 Universite Bordeaux Segalen
- Grenoble-Comite Scientifique AGIRadom 2011
- Paris-Agence Nationale de la Sante, Region Ile de France, domaine d'interet majeur (DIM)
- Germany: Erfurt-German Research Foundation [HE 3294/10-1]
- Hamburg-German Research Foundation [MA 711/6-1, NO 262/7-1]
- Iceland: Reykjavik-The Landspitali University Hospital Research Fund
- Iceland: Iceland Research Fund
- Iceland: ResMed Foundation, California, USA
- Iceland: Orkuveita Reykjavikur (Geothermal plant), Vegageroin (The Icelandic Road Administration (ICERA)
- Italy: Italian Ministry of Health
- Italy: Chiesi Farmaceutici SpA
- Cariverona Foundation
- Education Ministry (MIUR)
- Norway: Norwegian Research Council [214123]
- Norway: Western Norway Regional Health Authorities grant [911631]
- Norway: Bergen Medical Research Foundation
- Spain: Fondo de Investigacion Sanitaria [PS09/02457, PS09/00716, PS09/01511, PS09/02185, PS09/03190]
- Spain: Servicio Andaluz de Salud
- Spain: Sociedad Espanola de Neumologia y Cirurgia Toracica [SEPAR 1001/2010]
- Galdakao-Fondo de Investigacion Sanitaria [FIS 09/01511]
- Huelva-Fondo de Investigacion Sanitaria [FIS PS09/02185]
- Huelva-Servicio Andaluz de Salud
- Oviedo-Fondo de Investigacion Sanitaria [FIS PS09/03190]
- Spanish Ministry of Science and Innovation through the Centro de Excelencia Severo Ochoa 2019-2023 Program [CEX2018-000806-S]
- Generalitat de Catalunya through the CERCA Program
- Sweden: Swedish Heart and Lung Foundation
- Sweden: Swedish Asthma and Allergy Association
- Sweden: Swedish Association against Lung and Heart Disease
- Sweden: Swedish Research Council for Health, Working Life and Welfare (FORTE)
- Swedish Council for Working Life and Social Research
- Vasterbotten County Council ALF grant
- Switzerland: The Swiss National Science Foundation [33CSCO-134276/1, 33CSCO-108796, 3247BO-104283, 3247BO-104288, 3247BO-104284, 3247-065896, 3100-059302, 3200-052720, 3200-042532, 4026-028099]
- Switzerland: Federal Office for Forest, Environment and Landscape
- Switzerland: Federal Office of Public Health
- Switzerland: Federal Office of Roads and Transport
- Switzerland: canton government of Aargan
- Switzerland: canton government of Basel-Stadt
- Switzerland: canton government of Basel-Land
- Switzerland: canton government of Geneva
- Switzerland: canton government of Luzern
- Switzerland: canton government of Ticino
- Switzerland: canton government of Valais
- Switzerland: canton government of Zurich
- Switzerland: Swiss Lung League
- Switzerland: Lung Leagues of the canton Basel Stadt/Basel
- Switzerland: Lung Leagues of the canton Landschaft
- Switzerland: Lung Leagues of the canton Geneva
- Switzerland: Lung Leagues of the canton Ticino
- Switzerland: Lung Leagues of the canton Valais
- Switzerland: Lung Leagues of the canton Zurich
- Switzerland: SUVA
- Switzerland: Freiwillige Akademische Gesellschaft
- Switzerland: UBS Wealth Foundation
- Switzerland: Talecris Biotherapeutics GmbH
- Switzerland: Abbott Diagnostics
- Switzerland: European Commission [018996]
- Switzerland: Wellcome Trust [WT 084703MA]
- UK: Medical Research Council [92091]
- National Institute for Health Research through the Primary Care Research Network
Ask authors/readers for more resources
In a multi-center population-based study, an independent association between upper airway inflammatory disorders (UAID) and elevated fractional exhaled nitric oxide (FeNO) levels was found. There was a significant interaction with perennial sensitization and asthma, highlighting the concept of united airway disease.
Background Fractional exhaled nitric oxide (FeNO) is a well-known marker of type-2 inflammation. FeNO is elevated in asthma and allergic rhinitis, with IgE sensitization as a major determinant. Objective We aimed to see whether there was an independent association between upper airway inflammatory disorders (UAID) and FeNO, after adjustment for asthma and sensitization, in a multi-centre population-based study. Methods A total of 741 subjects with current asthma and 4155 non-asthmatic subjects participating in the second follow-up of the European Community Respiratory Health Survey (ECRHS III) underwent FeNO measurements. Sensitization status was based on measurement of IgE against airborne allergens; information on asthma, UAID and medication was collected through interview-led questionnaires. Independent associations between UAID and FeNO were assessed in adjusted multivariate regression models and test for interaction with perennial sensitization and asthma on the relation between UAID and FeNO were made. Results UAID were associated with higher FeNO after adjusting for perennial sensitization, asthma and other confounders: with 4.4 (0.9-7.9) % higher FeNO in relation to current rhinitis and 4.8 (0.7-9.2) % higher FeNO in relation to rhinoconjunctivitis. A significant interaction with perennial sensitization was found in the relationship between current rhinitis and FeNO (p = .03) and between rhinoconjunctivitis and FeNO (p = .03). After stratification by asthma and perennial sensitization, the association between current rhinitis and FeNO remained in non-asthmatic subjects with perennial sensitization, with 12.1 (0.2-25.5) % higher FeNO in subjects with current rhinitis than in those without. Conclusions & Clinical Relevance Current rhinitis and rhinoconjunctivitis was associated with higher FeNO, with an interaction with perennial sensitization. This further highlights the concept of united airway disease, with correlations between symptoms and inflammation in the upper and lower airways and that sensitization needs to be accounted for in the relation between FeNO and rhinitis.
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