Asthma and lower airway diseaseFluctuation phenotyping based on daily fraction of exhaled nitric oxide values in asthmatic children
Section snippets
Study population and design
We retrospectively analyzed data from the Childhood Asthma Respiratory Inflammatory Status Monitoring (CHARISM) study,12 a prospective, open-label, randomized, multicenter, parallel-group study in Italy and The Netherlands. Asthma was monitored daily over 30 weeks in 151 children aged 6 to 18 years with mild-to-moderate atopic asthma. The aim of the original study was to investigate whether ICS doses are better titrated based on Feno values and symptom scores rather than symptom scores only. We
Results
Forty-one children met the inclusion criterion of less than 10% data missing of daily Feno values and symptom scores of the first 192 days of the study, resulting in a total of 7820 measurements of Feno for analysis. Table I summarizes the subjects’ characteristics stratified by severe, moderate, or no asthma exacerbation during the study period. In the whole study group Feno values measured over 192 days displayed a considerable amount of fluctuation. Two examples of a Feno time series over
Discussion
In our study of Feno values recorded daily over 192 days in atopic asthmatic children,12 we found that fluctuations in Feno values were not random but were correlated over time scales of more than a month (long-range correlation). The long-range correlation exponent α was found to be lower in those subjects requiring higher ICS doses at study entry. Thus fluctuations in Feno values were more random in children requiring higher ICS doses. However, the α value was not related to mean asthma
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Supported by Swiss National Foundation grant 3200-B0-1 12099 and a Swiss Federal Office of Public Health (Tobacco Prevention Fund) research grant. The data collection was financially supported by Aerocrine AB, Solna, Sweden. R.v.d.V. was supported by a travel grant from the Erasmus MC–Sophia Foundation for Scientific Research.
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.