Elevated fractional exhaled nitric oxide (FeNO) is a clinical indicator of uncontrolled asthma in children receiving inhaled corticosteroids

Objective: Our study aims to explore the correlation between fractional exhaled nitric oxide (FeNO) and inhaled corticosteroids (ICS) efficacy in childhood bronchial asthma (BA).247 pediatric BA patients were selected and divided into 3 treatment groups based on drug therapy: treatment group 1 (seretide, n = 86), treatment group 2 (budesonide, n = 79), and treatment group 3 (salbutamol, n = 82). Another 90 healthy children were recruited as control group. FeNO, FEV1%pred, FEV1/FVC, MEF25%, MEF50% and PEF%, total serum IgE, EOS%, induced sputum EOS% and supernatant inflammatory indexes (ECP, IL-8, and TNF-α) of sputum, ECP, IL-8 and TNF-α were detected.Compared with pretreatment, 6 months posttreatment, FeNO, induced sputum EOS%, supernatant inflammatory indexes decreased (all p < 0.05), but pulmonary function indexes and childhood asthma control test (C-ACT) increased in treatment groups (all p < 0.05). FeNO, induced sputum EOS%, and supernatant inflammatory indexes in treatment group 1 were lower than those in treatment group 2 and 3 (all p < 0.05); total serum IgE and peripheral blood EOS% in treatment group 1 and 2 were lower but pulmonary function indexes were higher than those in treatment group 3 (all p < 0.05); according to Pearson correlation analysis, in both ICS and non-ICS groups, FeNO was positively correlated to ECP but negatively to C-ACT.ICS is effective in BA treatment, and FeNO associated with ICS efficacy is an indicator for BA intervention. FeNO combing with pulmonary function indexes had a predictive value in BA response.