Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthma

ObjectiveTo investigate the correlation between tidal breathing pulmonary function parameters combined with mixed exhaled gas nitric oxide values and the degree of airway hyperresponsiveness (AHR) in children aged 0–3 years with suspected asthma.MethodsIn this retrospective study, we collected basel...

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Main Authors: Jiangjiao Qin, Fangjun Liu, Ting Wang, Zhou Fu, Ying Lin, Xia Wang, Jing Zhao, Sha Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1388951/full
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author Jiangjiao Qin
Jiangjiao Qin
Fangjun Liu
Fangjun Liu
Ting Wang
Ting Wang
Zhou Fu
Zhou Fu
Ying Lin
Ying Lin
Xia Wang
Xia Wang
Jing Zhao
Jing Zhao
Sha Liu
Sha Liu
author_facet Jiangjiao Qin
Jiangjiao Qin
Fangjun Liu
Fangjun Liu
Ting Wang
Ting Wang
Zhou Fu
Zhou Fu
Ying Lin
Ying Lin
Xia Wang
Xia Wang
Jing Zhao
Jing Zhao
Sha Liu
Sha Liu
author_sort Jiangjiao Qin
collection DOAJ
description ObjectiveTo investigate the correlation between tidal breathing pulmonary function parameters combined with mixed exhaled gas nitric oxide values and the degree of airway hyperresponsiveness (AHR) in children aged 0–3 years with suspected asthma.MethodsIn this retrospective study, we collected baseline clinical data, tidal breathing pulmonary function parameters (measured before methacholine inhalation), fractional exhaled nitric oxide (FeNO) levels, and methacholine challenge test (MCT) results from 818 pediatric asthma patients treated at the Children's Hospital of Chongqing Medical University between January 2021 and June 2023. Baseline data, tidal respiratory pulmonary function parameters, and FeNO values were used to analyze their correlation with AHR. Ordinal multiclass logistic regression analysis was used to identify factors influencing AHR. The receiver operating characteristic (ROC) curve was performed to evaluate the efficacy of predicting AHR using tidal breathing pulmonary function parameters and FeNO values.ResultsIntergroup comparisons showed significant differences in age, weight, height, FeNO, TPTEF/TE, RR, TI/TE, TEF50/TIF50, and PTFE/TEF25 (P < 0.05). Further ordinal multiclass logistic regression analysis revealed that increases in FeNO, RR, and PTEF/TEF25 were significantly positively correlated with AHR severity (P < 0.001), while age was significantly negatively correlated (P < 0.001). FeNO showed reasonable accuracy in predicting AHR at methacholine concentrations of 8 mg/ml (AUC=0.774) and a cut-off value of 14 ppb (sensitivity 88.5%, specificity 63.8%). The combined parameters (FeNO, RR, PTFE/TEF25, and age) showed high accuracy in predicting AHR at methacholine concentrations of 0.5 mg/ml (AUC=0.847).ConclusionsOur study revealed that Current airway inflammation and airway obstruction predicted AHR at this point.FeNO, RR, PTEF/TEF25, and age were effective predictive parameters for the degree of AHR in children aged 0–3 years with suspected asthma; FeNO >14 ppb served as an independent factor suggesting AHR in children at methacholine concentrations of 8 mg/ml, and the combined parameters showed better predictive efficacy.
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spelling doaj-art-16abc0d39f9744d09656d23ce86b06652025-08-20T03:55:48ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.13889511388951Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthmaJiangjiao Qin0Jiangjiao Qin1Fangjun Liu2Fangjun Liu3Ting Wang4Ting Wang5Zhou Fu6Zhou Fu7Ying Lin8Ying Lin9Xia Wang10Xia Wang11Jing Zhao12Jing Zhao13Sha Liu14Sha Liu15Department of Pulmonary Function, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary Function, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Respiratory Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary Function, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary Function, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary Function, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Pulmonary Function, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaNational Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, ChinaObjectiveTo investigate the correlation between tidal breathing pulmonary function parameters combined with mixed exhaled gas nitric oxide values and the degree of airway hyperresponsiveness (AHR) in children aged 0–3 years with suspected asthma.MethodsIn this retrospective study, we collected baseline clinical data, tidal breathing pulmonary function parameters (measured before methacholine inhalation), fractional exhaled nitric oxide (FeNO) levels, and methacholine challenge test (MCT) results from 818 pediatric asthma patients treated at the Children's Hospital of Chongqing Medical University between January 2021 and June 2023. Baseline data, tidal respiratory pulmonary function parameters, and FeNO values were used to analyze their correlation with AHR. Ordinal multiclass logistic regression analysis was used to identify factors influencing AHR. The receiver operating characteristic (ROC) curve was performed to evaluate the efficacy of predicting AHR using tidal breathing pulmonary function parameters and FeNO values.ResultsIntergroup comparisons showed significant differences in age, weight, height, FeNO, TPTEF/TE, RR, TI/TE, TEF50/TIF50, and PTFE/TEF25 (P < 0.05). Further ordinal multiclass logistic regression analysis revealed that increases in FeNO, RR, and PTEF/TEF25 were significantly positively correlated with AHR severity (P < 0.001), while age was significantly negatively correlated (P < 0.001). FeNO showed reasonable accuracy in predicting AHR at methacholine concentrations of 8 mg/ml (AUC=0.774) and a cut-off value of 14 ppb (sensitivity 88.5%, specificity 63.8%). The combined parameters (FeNO, RR, PTFE/TEF25, and age) showed high accuracy in predicting AHR at methacholine concentrations of 0.5 mg/ml (AUC=0.847).ConclusionsOur study revealed that Current airway inflammation and airway obstruction predicted AHR at this point.FeNO, RR, PTEF/TEF25, and age were effective predictive parameters for the degree of AHR in children aged 0–3 years with suspected asthma; FeNO >14 ppb served as an independent factor suggesting AHR in children at methacholine concentrations of 8 mg/ml, and the combined parameters showed better predictive efficacy.https://www.frontiersin.org/articles/10.3389/fped.2025.1388951/fullinfantspulmonary functionairway inflammationFeNOairway hyperresponsiveness (AHR)
spellingShingle Jiangjiao Qin
Jiangjiao Qin
Fangjun Liu
Fangjun Liu
Ting Wang
Ting Wang
Zhou Fu
Zhou Fu
Ying Lin
Ying Lin
Xia Wang
Xia Wang
Jing Zhao
Jing Zhao
Sha Liu
Sha Liu
Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthma
Frontiers in Pediatrics
infants
pulmonary function
airway inflammation
FeNO
airway hyperresponsiveness (AHR)
title Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthma
title_full Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthma
title_fullStr Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthma
title_full_unstemmed Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthma
title_short Correlation between tidal breathing pulmonary function, exhaled nitric oxide and airway hyperresponsiveness in children aged 0–3 years with suspected asthma
title_sort correlation between tidal breathing pulmonary function exhaled nitric oxide and airway hyperresponsiveness in children aged 0 3 years with suspected asthma
topic infants
pulmonary function
airway inflammation
FeNO
airway hyperresponsiveness (AHR)
url https://www.frontiersin.org/articles/10.3389/fped.2025.1388951/full
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