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      우리나라 소아 알레르기비염 환자에서 호기산화질소의 측정 = Fractional exhaled nitric oxide in Korean children with allergic rhinitis

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      Purpose: Fractional exhaled nitric oxide (FeNO) is useful for the diagnosis of allergic rhinitis (AR) as well as bronchial asthma (BA). However, FeNO may differ according to race, age, and other determinants. There have been few studies about FeNO in Korean children with AR. The aims of this study were to evaluate the value of FeNO in AR and to compare FeNO, and determinants of FeNO levels between AR, BA, and combined AR and BA. Methods: This study included 647 children aged 5 to 17. The children were classified into 5 groups after performing the skin test, FeNO measurement, the pulmonary function test, and the methacholine challenge test: those with nonallergic rhinitis (NAR), those with AR, those with BA, and those with combined AR and BA, and healthy controls,. Results: The values of FEV1 (forced expiratory volume in one second) %predicted were 94.4%±12.6%, 93.8%±20.7%, 90.0%±17.4% in AR, BA, and combined AR and BA, respectively. The values of FeNO in AR (32.3±25.0 ppb), BA (31.1±20.5 ppb), and combined AR and BA (34.5±30.4 ppb) were significantly higher compared to those of NAR (16.8±13.5 ppb) and controls (15.9±12.5 ppb). There was no significant difference in FeNO among AR, BA, and combined AR and BA. FeNO was significantly higher in patients with ≥4 positive results (36.6±29.2 ppb) than in those with <4 positive skin test results (27.6±20.7 ppb). When the receiver operating characteristic curve analysis for prediction of AR showed 0.756 of area under the curve, the cutoff level of FeNO was 16 ppb. Conclusion: In this study, children with AR had increased levels of FeNO. It is suggested that AR may have eosinophilic bronchial inflammation without BHR or clinical asthma. (Allergy Asthma Respir Dis 2015;3:439-445)
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      Purpose: Fractional exhaled nitric oxide (FeNO) is useful for the diagnosis of allergic rhinitis (AR) as well as bronchial asthma (BA). However, FeNO may differ according to race, age, and other determinants. There have been few studies about FeNO in ...

      Purpose: Fractional exhaled nitric oxide (FeNO) is useful for the diagnosis of allergic rhinitis (AR) as well as bronchial asthma (BA). However, FeNO may differ according to race, age, and other determinants. There have been few studies about FeNO in Korean children with AR. The aims of this study were to evaluate the value of FeNO in AR and to compare FeNO, and determinants of FeNO levels between AR, BA, and combined AR and BA. Methods: This study included 647 children aged 5 to 17. The children were classified into 5 groups after performing the skin test, FeNO measurement, the pulmonary function test, and the methacholine challenge test: those with nonallergic rhinitis (NAR), those with AR, those with BA, and those with combined AR and BA, and healthy controls,. Results: The values of FEV1 (forced expiratory volume in one second) %predicted were 94.4%±12.6%, 93.8%±20.7%, 90.0%±17.4% in AR, BA, and combined AR and BA, respectively. The values of FeNO in AR (32.3±25.0 ppb), BA (31.1±20.5 ppb), and combined AR and BA (34.5±30.4 ppb) were significantly higher compared to those of NAR (16.8±13.5 ppb) and controls (15.9±12.5 ppb). There was no significant difference in FeNO among AR, BA, and combined AR and BA. FeNO was significantly higher in patients with ≥4 positive results (36.6±29.2 ppb) than in those with <4 positive skin test results (27.6±20.7 ppb). When the receiver operating characteristic curve analysis for prediction of AR showed 0.756 of area under the curve, the cutoff level of FeNO was 16 ppb. Conclusion: In this study, children with AR had increased levels of FeNO. It is suggested that AR may have eosinophilic bronchial inflammation without BHR or clinical asthma. (Allergy Asthma Respir Dis 2015;3:439-445)

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      참고문헌 (Reference)

      1 손병관, "알레르기 피부시험" 대한소아과학회 50 (50): 409-415, 2007

      2 고한석, "소아 기관지 천식 환자의 비염 발병 예측에서 호기산화질소의 역할" 대한 소아알레르기 호흡기학회 22 (22): 180-187, 2012

      3 Bousquet J, "Togias A, Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)" 86 (86): 8-160, 2008

      4 van Amsterdam JG, "The relationship between exhaled nitric oxide and allergic sensitization in a random sample of school children" 33 : 187-191, 2003

      5 Passalacqua G, "The nose-lung interaction in allergic rhinitis and asthma : united airways disease" 1 : 7-13, 2001

      6 Miller MR, "Standardisation of spirometry" 26 : 319-338, 2005

      7 Togias A, "Rhinitis and asthma : evidence for respiratory system integration" 111 : 1171-1183, 2003

      8 Yao TC, "Reference values of exhaled nitric oxide in healthy Asian children aged 5 to 18 years" 39 : 378-384, 2012

      9 조현주, "Reference Values and Determinants of Fractional Concentration of Exhaled Nitric Oxide in Healthy Children" 대한천식알레르기학회 6 (6): 169-174, 2014

      10 Hanson JR, "Office-based exhaled nitric oxide measurement in children 4 years of age and older" 111 : 358-363, 2013

      1 손병관, "알레르기 피부시험" 대한소아과학회 50 (50): 409-415, 2007

      2 고한석, "소아 기관지 천식 환자의 비염 발병 예측에서 호기산화질소의 역할" 대한 소아알레르기 호흡기학회 22 (22): 180-187, 2012

      3 Bousquet J, "Togias A, Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)" 86 (86): 8-160, 2008

      4 van Amsterdam JG, "The relationship between exhaled nitric oxide and allergic sensitization in a random sample of school children" 33 : 187-191, 2003

      5 Passalacqua G, "The nose-lung interaction in allergic rhinitis and asthma : united airways disease" 1 : 7-13, 2001

      6 Miller MR, "Standardisation of spirometry" 26 : 319-338, 2005

      7 Togias A, "Rhinitis and asthma : evidence for respiratory system integration" 111 : 1171-1183, 2003

      8 Yao TC, "Reference values of exhaled nitric oxide in healthy Asian children aged 5 to 18 years" 39 : 378-384, 2012

      9 조현주, "Reference Values and Determinants of Fractional Concentration of Exhaled Nitric Oxide in Healthy Children" 대한천식알레르기학회 6 (6): 169-174, 2014

      10 Hanson JR, "Office-based exhaled nitric oxide measurement in children 4 years of age and older" 111 : 358-363, 2013

      11 van den Nieuwenhof L, "Is physician-diagnosed allergic rhinitis a risk factor for the development of asthma?" 65 : 1049-1055, 2010

      12 Clark AT, "Interpretation of tests for nut allergy in one thousand patients, in relation to allergy or tolerance" 33 : 1041-1045, 2003

      13 Malinovschi A, "Increased exhaled nitric oxide predicts new-onset rhinitis and persistent rhinitis in adolescents without allergic symptoms" 42 : 433-440, 2012

      14 Crapo RO, "Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999" 161 : 309-329, 2000

      15 김윤희, "Fractional Exhaled Nitric Oxide and Impulse Oscillometry in Children With Allergic Rhinitis" 대한천식알레르기학회 6 (6): 27-32, 2014

      16 Cirillo I, "Exhaled nitric oxide may predict bronchial hyperreactivity in patients with allergic rhinitis" 160 : 322-328, 2013

      17 Ciprandi G, "Exhaled nitric oxide in children with allergic rhinitis and/or asthma : a relationship with bronchial hyperreactivity" 47 : 1142-1147, 2010

      18 Cobos Barroso N, "Exhaled nitric oxide in children : a noninvasive marker of airway inflammation" 44 : 41-51, 2008

      19 Linn WS, "Exhaled nitric oxide in a population-based study of southern California schoolchildren" 10 : 28-, 2009

      20 Kovesi T, "Exhaled nitric oxide concentration is affected by age, height, and race in healthy 9- to 12-year-old children" 133 : 169-175, 2008

      21 Stewart L, "Exhaled nitric oxide" 32 : 347-362, 2012

      22 Sonnappa S, "Ethnic differences in fraction of exhaled nitric oxide and lung function in healthy young children" 140 : 1325-1331, 2011

      23 La Grutta S, "Environmental effects on fractional exhaled nitric oxide in allergic children" 2012 : 916926-, 2012

      24 Linhares D, "Effects of atopy and rhinitis on exhaled nitric oxide values : a systematic review" 1 : 8-, 2011

      25 Kalpaklioglu AF, "Comparison of orally exhaled nitric oxide in allergic versus nonallergic rhinitis" 26 : e50-e54, 2012

      26 Chawes BL, "Children with allergic and nonallergic rhinitis have a similar risk of asthma" 126 : 567-573.e1-8, 2010

      27 Makinen T, "Bronchial diffusing capacity of nitric oxide is increased in patients with allergic rhinitis" 148 : 154-160, 2009

      28 Rouhos A, "Atopic sensitization to common allergens without symptoms or signs of airway disorders does not increase exhaled nitric oxide" 2 : 141-148, 2008

      29 van Weel C, "Asthma management pocket reference 2008" 63 : 997-1004, 2008

      30 Leynaert B, "Association between asthma and rhinitis according to atopic sensitization in a population-based study" 113 : 86-93, 2004

      31 Dweik RA, "An official ATS clinical practice guideline : interpretation of exhaled nitric oxide levels(FENO)for clinical applications" 184 : 602-615, 2011

      32 Aronsson D, "Allergic rhinitis with or without concomitant asthma : difference in perception of dyspnoea and levels of fractional exhaled nitric oxide" 35 : 1457-1461, 2005

      33 American Thoracic Society, "ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005" 171 : 912-930, 2005

      34 지혜미, "2006년 초등학생의 알레르기 질환 유병률의 전국적 역학조사" 대한 소아알레르기 호흡기학회 19 (19): 165-172, 2009

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      외국어명 : THE Korean Academy of Pediatric Allergy and Respiratory Disease -> 알레르기 천식 호흡기질환
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