D3.369 - Childhood exhaled nitric oxide levels predict new-onset allergic rhinitis in adolescence and young adulthood

Allergic rhinitis is a common disease with rising prevalence in Taiwan and several other developed countries. Fraction of exhaled nitric oxide (FeNO) is a well-established noninvasive marker of airway inflammation. However, the relationship between FeNO levels and the development of new-onset allergic rhinitis remains unclear. This study aimed to investigate the association between childhood FeNO levels and the risk of the development of new-onset allergic rhinitis in adolescence and young adulthood.

The study utilized data from the Prediction of Allergies in Taiwanese CHildren (PATCH) study, a prospective cohort study initiated in 2007. FeNO levels were measured at baseline by a chemiluminescence analyzer (CLD 88sp NO analyzer, Eco Medics, Duernten, Switzerland). General health information, allergic symptoms, and physician-diagnosed allergic diseases were collected at baseline and at 6-year follow-up using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Multiple logistic regression models were applied, after adjusting for potential confounders, to assess the association of FeNO levels with new-onset allergic rhinitis.

Among 1,680 children with baseline FeNO measurements, 1,213 children completed the follow-up assessment. Of 585 children without physician-diagnosed rhinitis or chronic rhinitis symptoms at baseline, 102 (17.4%) children developed new-onset allergic rhinitis during the follow-up period. A significant positive association was observed between FeNO levels at baseline and new-onset allergic rhinitis after adjusting for age, sex, body mass index, breastfeeding, preterm birth, secondhand smoke exposure, and parental allergic diseases (adjusted odds ratio = 4.54, 95% confidence interval: 1.81-11.35).

Our findings suggest that elevated FeNO levels predict new-onset allergic rhinitis in adolescence and young adulthood, highlighting the potential role of airway inflammation in the early identification of children at risk for allergic rhinitis.