TY - JOUR
T1 - Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitization
AU - the European Community Respiratory Health Survey III
AU - Krantz, Christina
AU - Accordini, Simone
AU - Alving, Kjell
AU - Corsico, Angelo G.
AU - Demoly, Pascal
AU - Ferreira, Diogenes S.
AU - Forsberg, Bertil
AU - Garcia-Aymerich, Judith
AU - Gislason, Thorarinn
AU - Heinrich, Joachim
AU - Jõgi, Rain
AU - Johannessen, Ane
AU - Leynaert, Bénédicte
AU - Marcon, Alessandro
AU - Martínez-Moratalla Rovira, Jesús
AU - Nerpin, Elisabet
AU - Nowak, Dennis
AU - Olin, Anna Carin
AU - Olivieri, Mario
AU - Pereira-Vega, Antonio
AU - Raherison-Semjen, Chantal
AU - Real, Francisco Gómez
AU - Sigsgaard, Torben
AU - Squillacioti, Guilia
AU - Janson, Christer
AU - Malinovschi, Andrei
N1 - Funding Information:
The coordination of ECRHS III was supported by the Medical Research Council (Grant Number 92091), and the following grants contributed to funding ECRHS III: Australia: National Health & Medical Research Council. Belgium: Antwerp South, Antwerp City—Research Foundation Flanders (FWO), grant code G.0.410.08.N.10 (both sites). Estonia: Tartu—SF0180060s09 from the Estonian Ministry of Education. Estonian Research Council Personal Research Grant no 562. France: (All) Ministère de la Santé, Programme Hospitalier de Recherche Clinique (PHRC) national 2010. Bordeaux—INSERM U897 Université Bordeaux Segalen. Grenoble—Comité Scientifique AGIRadom 2011. Paris—Agence Nationale de la Santé, Région Ile de France, domaine d’intérêt 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 Landspítali University Hospital Research Fund, University of Iceland Research Fund, ResMed Foundation, California, USA, Orkuveita Reykjavíkur (Geothermal plant), Vegagerðin (The Icelandic Road Administration (ICERA). Italy: All Italian centres were funded by the Italian Ministry of Health, Chiesi Farmaceutici SpA. Verona received additional funding from the Cariverona Foundation, Education Ministry (MIUR). Norway: Norwegian Research Council grant no 214123, Western Norway Regional Health Authorities grant no 911631, Bergen Medical Research Foundation. Spain: Fondo de Investigación Sanitaria (PS09/02457, PS09/00716, PS09/01511, PS09/02185, PS09/03190), Servicio Andaluz de Salud, Sociedad Española de Neumología y Cirurgía Torácica (SEPAR 1001/2010), Fondo de Investigación Sanitaria (PS09/02457). Barcelona—Fondo de Investigación Sanitaria (FIS PS09/00716). Galdakao—Fondo de Investigación Sanitaria (FIS 09/01511). Huelva—Fondo de Investigación Sanitaria (FIS PS09/02185) and Servicio Andaluz de Salud. Oviedo—Fondo de Investigación Sanitaria (FIS PS09/03190). ‘ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019‐2023” Program (CEX2018‐000806‐S), and support from the Generalitat de Catalunya through the CERCA Program.’ Sweden: All centres were funded by the Swedish Heart and Lung Foundation, the Swedish Asthma and Allergy Association, the Swedish Association against Lung and Heart Disease, and the Swedish Research Council for Health, Working Life and Welfare (FORTE). Göteborg also received further funding from the Swedish Council for Working Life and Social Research. Umeå also received funding from a Västerbotten County Council ALF grant. Switzerland: The Swiss National Science Foundation (grants no 33CSCO‐134276/1, 33CSCO‐108796, 3247BO‐104283, 3247BO‐104288, 3247BO‐104284, 3247‐065896, 3100‐059302, 3200‐052720, 3200‐042532, 4026‐028099), The Federal Office for Forest, Environment and Landscape, The Federal Office of Public Health, The Federal Office of Roads and Transport, the canton governments of Aargan, Basel‐Stadt, Basel‐Land, Geneva, Luzern, Ticino, Valais, and Zürich, the Swiss Lung League, the Lung Leagues of the cantons Basel Stadt/Basel, Landschaft, Geneva, Ticino, Valais, and Zurich, SUVA, Freiwillige Akademische Gesellschaft, UBS Wealth Foundation, Talecris Biotherapeutics GmbH, Abbott Diagnostics, European Commission 018996 (GABRIEL), Wellcome Trust WT 084703MA. UK: Medical Research Council (Grant Number 92091). Support was also provided by the National Institute for Health Research through the Primary Care Research Network.
Publisher Copyright:
© 2021 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - asthma
KW - exhaled nitric oxide
KW - FeNO
KW - nasal polyposis
KW - population-based
KW - rhinitis
UR - http://www.scopus.com/inward/record.url?scp=85116724624&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85116724624&partnerID=8YFLogxK
U2 - 10.1111/cea.14019
DO - 10.1111/cea.14019
M3 - Article
C2 - 34536262
AN - SCOPUS:85116724624
JO - Clinical and Experimental Allergy
JF - Clinical and Experimental Allergy
SN - 0954-7894
ER -