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2267824 
Journal Article 
Abstract 
Exhaled nitric oxide in acute RSV bronchiolitis 
Sivan, Y; Gadish, T; Fireman, E; Merimovitch, T; Soferman, R 
2010 
Yes 
American Journal of Respiratory and Critical Care Medicine
ISSN: 1073-449X
EISSN: 1535-4970 
181 
A3310 
English 
WOS:000208771002421 
is part of a larger document 3452678 Proceedings of the American Thoracic Society 2010 International Conference, May 14-19, 2010, New Orleans
Background: Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in infants. Severe RSV bronchiolitis contributes substantially to the risk of recurrent wheezing and asthma in childhood. Fractional exhaled nitric oxide (FeNO) is a marker of eosinophilic airway inflammation and has been shown to be high in asthmatics compared to controls. We measured FeNO in infants with acute RSV bronchiolitis in comparison to non-RSV recurrent wheezy babies and healthy controls.

Methods: FeNO was compared between infants with laboratory confirmed acute RSV bronchiolitis and two control groups: healthy infants and infants with recurrent wheezing. FeNO levels were followed in two visits over four months after the acute RSV bronchiolitis.

Results: The study included 44 infants with acute RSV bronchiolitis (mean age 6.83+7.33 months), 21 infants with recurrent wheezing (10.85+7.59 months) and 32 healthy age-matched controls (6.88+9.07 months). Mean FeNO levels were: 1.8+1.7 ppb, 4.86+7.49 ppb and 6.29+3.3 ppb, respectively (P < 0.001 for RSV positive infants vs. healthy controls). FeNO levels at the 2 and 4-months follow-up visits increased to 7.8+5.7 ppb and 11.3+6.3 ppb, respectively (P = 0.001) (Fig 1).

Conclusions: FeNO levels are temporarily reduced during acute RSV bronchiolitis and increase during convalescence to normal levels and above. The mechanisms for this suppression and its relation for future wheezing and asthma should be further investigated.

Figure 1: FeNO levels in the RSV bronchiolitis group over time
*figure in pdf 
American Thoracic Society 2010 International Conference 
New Orleans, LA 
May 14-19, 2010 
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