Fraction of exhaled nitric oxide and wheezing phenotypes in preschool children

Mi Ae Oh, Jung Yeon Shim, Young Ho Jung, Ju Hee Seo, Hyung Young Kim, Ji Won Kwon, Byoung Ju Kim, Hyo Bin Kim, Woo Kyung Kim, So Yeon Lee, Gwang Cheon Jang, Dae Jin Song, Ha Jung Kim, Yee Jin Shin, Jung Won Park, Sang Heon Cho, Joo Shil Lee, Soo Jong Hong

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


Background Asthma is a chronic lower airway inflammatory disease. Nitric oxide is an inflammatory mediator produced endogenously in the airway. Previous studies have demonstrated that the fractional concentration of exhaled nitric oxide (FeNO) is increased in asthma. Objectives To investigate if FeNO concentrations were correlated with wheezing phenotypes in preschool children and to compare the FeNO results with airway hyperresponsiveness (AHR) and pulmonary function test (PFT) results. Methods We performed skin prick tests, methacholine provocation tests, PFT, impulse oscillometry bronchodilator response (IOS BDR) tests, and FeNO measurements in 372 preschool children between the ages of 4 and 6 years. Wheezing phenotypes were defined according to the age of onset and persistency. Results Persistent wheezers had higher FeNO levels than transient wheezers and non-wheezers. Among persistent wheezers, those with atopy and AHR had significantly higher FeNO levels than those without atopy or AHR. FeNO levels were significantly higher in late-onset wheezers than early-onset wheezers and non-wheezers. Among late-onset wheezers, those with atopy and AHR had a significantly higher FeNO concentration than those without atopy or AHR as well as those with either atopy or AHR. However, there were no significant differences in AHR, PFT, or IOS BDR between persistent and transient wheezers or between late-onset wheezers and early-onset wheezers. Conclusion FeNO may be a better marker for asthma phenotypes in preschool children than AHR and PFT results. Pediatr Pulmonol. 2013; 48:563-570. © 2012 Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)563-570
Number of pages8
JournalPediatric Pulmonology
Issue number6
Publication statusPublished - 2013 Jun
Externally publishedYes


  • airway hyperresponsiveness
  • atopy
  • exhaled nitric oxide
  • preschool children
  • wheezing phenotype

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine


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