D2.144 - Bronchial Inflammation and Lung Function in Children with Asthma and Allergic Rhinitis: The Contribution of FeNO and Spirometry

Asthma commonly coexists with allergic rhinitis in pediatric patients, reflecting shared inflammation across the upper and lower airways. A combined assessment of airway inflammation and lung function is therefore important for optimal management. Fractional exhaled nitric oxide (FeNO) provides a non-invasive estimate of eosinophilic airway inflammation, while spirometry remains the reference method for evaluating pulmonary function.This pilot study aimed to examine the relationship between FeNO levels and spirometric parameters in children with asthma and allergic rhinitis.

We carried out a prospective pilot study including 26 children aged >6 years with asthma and allergic rhinitis. Allergic rhinitis was diagnosed based on clinical features and positive skin prick testing.All participants underwent FeNO measurement (ppb) and standard spirometry, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and the FEV1/FVC ratio. Analyses were exploratory and focused on associations between inflammatory and functional outcomes.

Among the 26 included children, 38.5% had FeNO levels >35 ppb, suggesting persistent bronchial eosinophilic inflammation. Spirometry showed moderate functional impairment, with a median FEV1 of approximately 60% of predicted.Higher FeNO values tended to be associated with lower spirometric indices, suggesting that ongoing airway inflammation may be linked to reduced lung function in this population.

These results highlight the complementary value of FeNO and spirometry in the comprehensive assessment of pediatric asthma associated with allergic rhinitis. FeNO measurement appears to be a relevant, non-invasive tool to refine the evaluation of airway inflammatory activity, alongside standard pulmonary function testing.