ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1567548
Application of fractional exhaled nitric oxide and nasal nitric oxide in the evaluation of asthma control
Provisionally accepted
- 1Department of Pediatric Respiratory, Children's Medical Center，The First Hospital of Jilin University, Changchun, China
- 2Department of Pediatrics, Yanbian University Hospital, Yanji, Jilin Province, China
- 3Department of Pediatrics, Tianjin Children's Hospital, Tianjin, China
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Background: Asthma is the most common chronic respiratory disease in childhood, and effective control of airway inflammation is crucial in its management. Fractional exhaled nitric oxide (FeNO) and fractional nasally exhaled nitric oxide (FnNO) are non-invasive biomarkers that reflect airway inflammation. This study aimed to evaluate the role of FeNO and FnNO in assessing asthma control status and to explore their correlation with pulmonary function parameters in pediatric patients.This was a retrospective observational study. A total of 88 children with asthma were classified into three groups based on Childhood Asthma Control Test (C-ACT) scores: the control group, the partial control group, and the poor control group. FeNO, FnNO, and pulmonary function tests were measured and compared across the three groups. The correlation between FeNO/FnNO levels and pulmonary function indices was also analyzed.The levels of FeNO and FnNO were significantly higher in the poor control group compared with those in the partial control and the control groups (p<0.05). As asthma control improved, forced vital capacity (FVC) showed a statistically significant increase. The forced expiratory volume in one second (FEV₁), maximal expiratory flow at 50% of FVC (MEF₅₀%), and mean midexpiratory flow (MMEF) values in the poor control group were significantly lower than those in the other two groups, and PEF was significantly reduced compared with that in the control group. However, no significant correlations were found between FeNO or FnNO levels and any of the pulmonary function parameters.Although FeNO and FnNO levels differed significantly among asthma control groups, no significant correlation was observed between these biomarkers and pulmonary function parameters. These findings suggest that FeNO and FnNO should be used together to assess asthma control status, but they may not directly reflect changes in pulmonary function in children with asthma.
Keywords: Fractional exhaled nitric oxide (FENO), Fractional nasally exhaled nitric oxide (FnNO), Asthma Control Test (ACT), Asthma, Pulmonary Function
Received: 27 Jan 2025; Accepted: 24 Jun 2025.
Copyright: © 2025 Ma, Lin, Zheng, Wang, Cui and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li Liu, Department of Pediatric Respiratory, Children's Medical Center，The First Hospital of Jilin University, Changchun, China
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