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Contributions of asthma, rhinitis and IgE to exhaled nitric oxide in adolescents

Bess M. Flashner, Sheryl L. Rifas-Shiman, Emily Oken, Carlos A. Camargo Jr, Thomas A.E. Platts-Mills, Lisa Workman, Augusto A. Litonjua, Diane R. Gold, Mary B. Rice
ERJ Open Research 2021 7: 00945-2020; DOI: 10.1183/23120541.00945-2020
Bess M. Flashner
1Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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  • ORCID record for Bess M. Flashner
  • For correspondence: bflashne@bidmc.harvard.edu
Sheryl L. Rifas-Shiman
2Division of Chronic Disease Research Across the Lifecourse, Dept of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Emily Oken
2Division of Chronic Disease Research Across the Lifecourse, Dept of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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Carlos A. Camargo Jr
3Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA
4Dept of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
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Thomas A.E. Platts-Mills
5Dept of Allergy and Immunology, University of Virginia Health System, Charlottesville, VA, USA
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Lisa Workman
5Dept of Allergy and Immunology, University of Virginia Health System, Charlottesville, VA, USA
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Augusto A. Litonjua
6Pediatric Pulmonary Division, Dept of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY, USA
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Diane R. Gold
3Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA
7Dept of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Mary B. Rice
1Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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  • FIGURE 1
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    FIGURE 1

    Percent difference in exhaled nitric oxide fraction (FeNO) relative to reference group a) without detectable aeroallergen immunoglobulin (Ig)E and b) with aeroallergen IgE. AR: allergic rhinitis.

Tables

  • Figures
  • Supplementary Materials
  • TABLE 1

    Participant characteristics (N=929)

    Subjects n929
    Child
     Sex
      Male466 (50)
      Female463 (50)
     Race/ethnicity
      Black154 (17)
      Hispanic40 (4)
      Asian28 (3)
      White593 (64)
      Other or >1 race/ethnicity113 (12)
    Early teen visit
     Age years13±1
     Age at visit years
      11.9 to <13505 (54.4)
      13.0 to <15.0374 (40.3)
      15.0 to 16.650 (5.4)
     Height cm160±9
     BMI percentile category %
      <5th30 (3)
      5−<85th634 (68)
      >85th262 (28)
     Exhaled nitric oxide ppb26±27
     Exhaled nitric oxide
      <20 ppb553 (60)
      20−≤35 ppb196 (21)
      >35 ppb180 (19)
     Current asthma
      No682 (86)
      Yes115 (14)
     Ever allergic rhinitis
      No690 (79)
      Yes179 (21)
     Any aeroallergen IgE >0.35 kU·L−1
      No247 (42)
      Yes345 (58)
     Annual household income at early teen visit $1000109±44
     Any smokers at home at early teen visit114 (12)
    Mother/family
     Pregnancy smoking status
      Never653 (71)
      Former188 (20)
      During pregnancy85 (9)
     College graduate
      No264 (29)
      Yes662 (71)
     Median value owner-occupied housing $1000#263±149
     Percent with education higher than a bachelor's degree#42±20

    Data are presented as n (%) or mean±sd, unless otherwise stated. BMI: body mass index; Ig: immunoglobulin. #: based on census tract, mid-childhood.

    • TABLE 2

      Associations of asthma, allergic rhinitis (AR) and aeroallergen immunoglobulin (Ig)E with exhaled nitric oxide fraction (FeNO) using linear and multinomial logistic regression models

      Model 1#Model 2¶
      Linear regression
      % difference in
      FeNO (95% CI)
      Logistic regression+
      OR (95% CI)
      Linear regression
      % difference in
      FeNO (95% CI)
      Logistic regression+
      OR (95% CI)
      20–≤35 ppb>35 ppb20–≤35 ppb>35 ppb
      Asthma versus no asthma97 (73–124)3 (2–5)8 (5–13)97 (70–128)3 (1–5)8 (5–14)
      AR versus no AR48 (32–66)2 (1–3)3 (2–5)45 (28–65)2 (1–3)3 (2–5)
      Aeroallergen IgE versus no aeroallergen IgE99 (79–121)4 (3–7)26 (12–59)102 (80–126)4 (3–7)28 (12–63)

      Current asthma: ever having an asthma diagnosis plus wheezing in the past year or taking asthma medications in the past month; no asthma: no asthma: no wheezing and no use of asthma medications or wheezing in the past 12 months; AR: ever having a diagnosis of hay fever or AR; no AR: never having a diagnosis of hay fever or AR; aeroallergen IgE; having any aeroallergen IgE >0.35 IU·mL−1; no aeroallergen IgE: IgE≤0.35 IU·mL−1. #: adjusted for sex and current age and height; ¶: model 1 additionally adjusted for race/ethnicity, maternal education and smoking during pregnancy, median value owner-occupied housing and percent≥bachelor's degree (census tract, mid-childhood), and household income and any smokers at home at early teen visit; +: reference group is <20 ppb.

      Supplementary Materials

      • Figures
      • Tables
      • Supplementary Material

        Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.

        TABLE S1 Associations of overlapping aeroallergen IgE, allergic rhinitis, and asthma with FENO 00945-2020.tableS1

        TABLE S2 Associations of asthma, allergic rhinitis, and aeroallergen IgE with FENO using linear regression models, stratified by sex 00945-2020.tableS2

        TABLE S3 Associations of asthma, allergic rhinitis, and aeroallergen IgE with FENO using linear and multinomial logistic regression models 00945-2020.tableS3

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      Contributions of asthma, rhinitis and IgE to exhaled nitric oxide in adolescents
      Bess M. Flashner, Sheryl L. Rifas-Shiman, Emily Oken, Carlos A. Camargo, Thomas A.E. Platts-Mills, Lisa Workman, Augusto A. Litonjua, Diane R. Gold, Mary B. Rice
      ERJ Open Research Apr 2021, 7 (2) 00945-2020; DOI: 10.1183/23120541.00945-2020

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      Contributions of asthma, rhinitis and IgE to exhaled nitric oxide in adolescents
      Bess M. Flashner, Sheryl L. Rifas-Shiman, Emily Oken, Carlos A. Camargo, Thomas A.E. Platts-Mills, Lisa Workman, Augusto A. Litonjua, Diane R. Gold, Mary B. Rice
      ERJ Open Research Apr 2021, 7 (2) 00945-2020; DOI: 10.1183/23120541.00945-2020
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