Bronchial and alveolar nitric oxide in exercise-induced bronchoconstriction in asthmatic children

Clin Exp Allergy. 2012 Aug;42(8):1190-6. doi: 10.1111/j.1365-2222.2012.03973.x.


Background: Epidemiological studies have shown an association between the severity of exercise-induced bronchoconstriction (EIB) and fractional exhaled nitric oxide at the flow of 50 mL/s (FeNO(50)). However, no study has assessed the correlation between alveolar production (C(alv)) and bronchial flux (J(NO)) of nitric oxide (NO) and EIB in asthmatic children.

Objective: To identify the relationship between severity of EIB and bronchial or alveolar nitric oxide.

Methods: Our group included 36 allergic children with intermittent asthma. The EIB was determined by a standard exercise challenge and the severity was expressed as the maximum change in percentage from the baseline value of lung function (ΔFEV(1)%, ΔFEF(25-75)%) after exercising. A chemiluminescence analyser at multiple flows was used to calculate FeNO(50), J(NO) and C(alv,) which reflect large airways, J(NO) and alveolar concentration of NO respectively.

Results: Sixteen (44.4%) children presented a ∆FEV(1) ≥ 10%, eight (22.2%) had ∆FEV(1) ≥ 15% and nine (25%) children had a ∆FEF(25-75) ≥ 26%. A significant correlation was observed between severity of EIB and FeNO(50) , J(NO) and C(alv.) EIB was significantly more severe in children sensitive to indoor allergens compared with outdoor allergens only (P = 0.014); those children showed also higher levels of C(alv) (P = 0.003) and of J(NO) (P = 0.044).

Conclusions and clinical relevance: Our results suggest that inflammation is present in the central and peripheral airways and that it is associated with the severity of EIB. NCT00952835.

Publication types

  • Clinical Trial

MeSH terms

  • Asthma, Exercise-Induced / metabolism
  • Asthma, Exercise-Induced / physiopathology*
  • Bronchi / metabolism
  • Bronchi / physiopathology*
  • Bronchoconstriction*
  • Child
  • Exercise Test
  • Exhalation
  • Female
  • Humans
  • Male
  • Nitric Oxide* / metabolism
  • Pulmonary Alveoli / metabolism
  • Pulmonary Alveoli / physiopathology*
  • Spirometry


  • Nitric Oxide

Associated data