Original ArticleLower Airway Nitric Oxide is Increased in Children with Sickle Cell Disease
Section snippets
Methods
Ethics approval for this study was obtained from the Hospital for Sick Children institutional research ethics board. A convenience sample of patients with either SCD or PCD were consecutively recruited during routine ambulatory clinic visits at the Hospital for Sick Children, Toronto, Ontario, Canada. Children with SCD included those with hemoglobin “sickle” “sickle” (HbSS), hemoglobin “sickle”/beta thalassemia (HbSβthal), or hemoglobin “sickle”/Caribbean (HbSC) on hemoglobin electrophoresis.
Results
Forty-eight subjects were included in the study; 16 with SCD, 10 with PCD, and 22 healthy control subjects (Table). All children with SCD, but none of the patients with PCD, were of African descent. The healthy control group included 15 Caucasian subjects, 5 subjects of African descent, and two subjects of Southeast Asian ethnicity. There was no difference in FENO, J’awNO, and CaNO between the 5 subjects of African descent and the remaining healthy control subjects. In the subjects with SCD, 13
Discussion
We assessed NO in subjects with SCD by using multiple exhalation flows and comprehensive methods to measure flow-dependent and -independent airway NO parameters. This study showed that when using standard techniques (exhalation flow of 50 mL/sec), FENO in children with SCD without atopy or asthma was well within published reference ranges.33, 34 However, with multiple flow analyses, FENO was revealed to be significantly higher in patients with SCD compared with healthy control subjects.
There
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Lower Airway Nitrogen Oxide Levels in Children with Primary Ciliary Dyskinesia Is Linked to Neutrophilic Inflammation
2022, Journal of PediatricsCitation Excerpt :This may be related to the severity of the PEx events and/or the intensity of the therapeutic intervention. Other investigators have shown that nasal and exhaled NO are decreased in PCD,8,9 but NO deficiency could not be explained by the absence of NOS in airway epithelium or cilia.10,11 However, one study suggested absent or delayed expression of inducible NOS (NOS2) in airway epithelium during early infection in PCD.12
Exhaled nitric oxide: Not associated with asthma, symptoms, or spirometry in children with sickle cell anemia
2016, Journal of Allergy and Clinical ImmunologyCitation Excerpt :This study has a number of strengths, including ascertainment of Feno levels by using standardized ATS criteria, use of objective measurements of lung function with centralized standardized overreading of lung function, and prospective ascertainment of SCA-specific morbidity. Although this is the largest study to date of Feno in patients with SCA, a limitation is measuring Feno levels at one flow rate.17,40 SAC chose to measure Feno levels according to current ATS guidelines because this is the method widely available to clinicians rather than using methods available only as part of a research protocol.
Age-stratified comparison of large and peripheral airway/alveolar nitric oxide levels in children and young adults
2013, Journal of Allergy and Clinical ImmunologySickle cell disease does not decrease pulmonary nitric oxide
2012, Journal of PediatricsManagement of chronic respiratory complications in children and adolescents with sickle cell disease
2020, European Respiratory ReviewAirway Inflammation and Lung Function in Sickle Cell Disease
2019, Pediatric, Allergy, Immunology, and Pulmonology
Funded by the Hospital for Sick Children pediatric consultants. The authors declare no conflicts of interest.