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Krantz C, Accordini S, Alving K, et al. Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization. Clin Exp Allergy. 2021;doi: 10.1111/cea.14019.
Krantz, C., Accordini, S., Alving, K., Corsico, A. G., Demoly, P., Ferreira, D. S., Forsberg, B., Garcia-Aymerich, J., Gislason, T., Heinrich, J., Jõgi, R., Johannessen, A., Leynaert, B., Marcon, A., Martínez-Moratalla Rovira, J., Nerpin, E., Nowak, D., Olin, A. C., Olivieri, M., Pereira-Vega, A., Raherison-Semjen, C., Real, F. G., Sigsgaard, T., Squillacioti, G., Janson, C., Malinovschi, A. (2021). Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, . https://doi.org/10.1111/cea.14019
Krantz, Christina, et al. "Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization." Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology vol. (2021). doi: https://doi.org/10.1111/cea.14019
Krantz C, Accordini S, Alving K, Corsico AG, Demoly P, Ferreira DS, Forsberg B, Garcia-Aymerich J, Gislason T, Heinrich J, Jõgi R, Johannessen A, Leynaert B, Marcon A, Martínez-Moratalla Rovira J, Nerpin E, Nowak D, Olin AC, Olivieri M, Pereira-Vega A, Raherison-Semjen C, Real FG, Sigsgaard T, Squillacioti G, Janson C, Malinovschi A. Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization. Clin Exp Allergy. 2021 Sep 18; doi: 10.1111/cea.14019. Epub 2021 Sep 18. PMID: 34536262.
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Clin Exp Allergy. 2021 Sep 18; doi: 10.1111/cea.14019. Epub 2021 Sep 18.

Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

Christina Krantz, Simone Accordini, Kjell Alving, Angelo G Corsico, Pascal Demoly, Diogenes S Ferreira, Bertil Forsberg, Judith Garcia-Aymerich, Thorarinn Gislason, Joachim Heinrich, Rain Jõgi, Ane Johannessen, Bénédicte Leynaert, Alessandro Marcon, Jesús Martínez-Moratalla Rovira, Elisabet Nerpin, Dennis Nowak, Anna-Carin Olin, Mario Olivieri, Antonio Pereira-Vega, Chantal Raherison-Semjen, Francisco Gómez Real, Torben Sigsgaard, Guilia Squillacioti, Christer Janson, Andrei Malinovschi,

Affiliations

  1. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
  2. Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
  3. Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
  4. Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
  5. Département de Pneumologie et Addictologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
  6. Hôpital Arnaud de Villeneuve, IDESP, INSERM-Univ Montpellier, Montpellier, France.
  7. School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
  8. Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Parana, Curitiba, Brazil.
  9. Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
  10. ISGlobal, Barcelona, Spain.
  11. Universitat Pompeu Fabra (UPF), Barcelona, Spain.
  12. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
  13. Department of Sleep, Landspitali_the National University Hospital, Reykjavik, Iceland.
  14. Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
  15. Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Clinic, Comprehensive Pneumology Center (CPC), Munich, Germany.
  16. German Center for Lung Research (DZL), Gießen, Germany.
  17. Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia.
  18. Lung Clinic, Tartu University Hospital, Tartu, Estonia.
  19. Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
  20. Université Paris-Saclay, UVSQ, Univ. Paris-Sud, INSERM, Équipe d'Épidémiologie respiratoire intégrative, CESP, Villejuif, France.
  21. Pneumology Service of the University Hospital of Albacete, Albacete, Spain.
  22. Faculty of Medicine of Albacete, Castilla-La Mancha University, Albacete, Spain.
  23. Department of Medical Sciences, Respiratory Medicine, Allergy and Sleep, Uppsala University, Uppsala, Sweden.
  24. Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
  25. Department of Medicine, Health and Social Studies, Dalarna University, Falun, Sweden.
  26. Section of Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
  27. Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
  28. Pneumology Service, Juan Ramón Jiménez Hospital in Huelva, Huelva, Spain.
  29. Univ. Bordeaux, INSERM, Bordeaux, France.
  30. Service des Maladies Respiratoires, Pole cardio-thoracique, CHU, Bordeaux, France.
  31. Research Unit for Health Surveys (RUHS), Department of Clinical Sciences, University of Bergen, Bergen, Norway.
  32. Department of Gynaecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.
  33. Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark.
  34. Department of Public Health and Pediatrics, University of Turin, Turin, Italy.

PMID: 34536262 DOI: 10.1111/cea.14019

Abstract

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.

© 2021 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

Keywords: FeNO; asthma; exhaled nitric oxide; nasal polyposis; population-based; rhinitis

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