Fluctuation phenotyping based on daily fraction of exhaled nitric oxide values in asthmatic children Georgette Stern, MSc, Johan de Jongste, MD, Ralf.

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Presentation transcript:

Fluctuation phenotyping based on daily fraction of exhaled nitric oxide values in asthmatic children Georgette Stern, MSc, Johan de Jongste, MD, Ralf van der Valk, Eugenio Baraldi, MD, Silvia Carraro, MD, Cindy Thamrin, PhD, Urs Frey, MD, PhD Journal of Allergy and Clinical Immunology Volume 128, Issue 2, Pages 293-300 (August 2011) DOI: 10.1016/j.jaci.2011.03.010 Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Exhaled nitric oxide values over 192 days from 2 subjects with no changes in ICS dose during the study period. A, Subject with a relatively small range of Feno values (5-30 ppb), a constant ICS dose of 1000 μg/d throughout the study, and weak long-range correlations in Feno values reflected by an α value of 0.850. B, Subject with a relatively large range of Feno values (6-40 ppb), a constant ICS dose of 400 μg/d throughout the study, and stronger long-range correlations reflected by an α value of 1.171. Journal of Allergy and Clinical Immunology 2011 128, 293-300DOI: (10.1016/j.jaci.2011.03.010) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Cross-correlation of daily Feno values and symptom scores. Day-by-day Feno values and symptom scores in a subject with a strong concordance between the Feno values and symptom scores are shown. Here the maximum correlation occurred when increases in Feno values preceded increases in symptom scores by 2 days (lag 2). Cross-correlation: lag 0, 0.558; lag 1, 0.607; and lag 2, 0.620. Journal of Allergy and Clinical Immunology 2011 128, 293-300DOI: (10.1016/j.jaci.2011.03.010) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Cross-correlation of daily Feno values and symptom scores in exacerbation groups. Box plots of cross-correlation between symptom scores and Feno values stratified by severe, moderate, or no exacerbation during the study period. Boxes represent 25th and 75th percentiles, with the median line and error bars representing the 10th and 90th percentiles. Journal of Allergy and Clinical Immunology 2011 128, 293-300DOI: (10.1016/j.jaci.2011.03.010) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Receiver operating curves for mean Feno values, mean sum symptom scores, the cross-correlation between Feno values and symptom scores, and the long-range correlation coefficient α to predict exacerbations. The cross-correlation coefficient of Feno values and symptom scores was the best predictor for exacerbations compared with mean Feno values (P = .033), mean symptom scores (P = .80), and α values (P = .16). Journal of Allergy and Clinical Immunology 2011 128, 293-300DOI: (10.1016/j.jaci.2011.03.010) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions