Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age

Tamara L. Blake, Anne B. Chang, Mark D. Chatfield, Julie M. Marchant, Helen L. Petsky, Margaret S. McElrea

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Fractional exhaled nitric oxide (FENO) levels can identify eosinophilic asthma phenotypes. We aimed to determine FENO values of healthy Aboriginal and/or Torres Strait Islander (Indigenous) Australians, differences between these Indigenous ethnic groups, and appropriateness of published cutoff values.

    Methods: We measured FENO levels in 1,036 Indigenous Australians (3-16 years of age). Participants were classified into healthy (ie, no asthma or atopy history) or asthmatic and/or atopic groups.

    Results: Median FENO values and distribution did not differ between Indigenous ethnicities. For healthy participants < 12 years of age (n = 390), 7.2% of our cohort fell into the inflammatory zone of the American Thoracic Society (ATS), National Institute for Health and Care Excellence (NICE), and British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) guidelines (cutoff 35 parts per billion [ppb]), but only 3.8% fell into this category when using the Global Initiative for Asthma (GINA) guidelines (50 ppb). Similarly, when using the NICE and BTS/SIGN guidelines (40 ppb) for participants 12 to 16 years of age (n = 213), more healthy participants fell into the inflammatory zone compared with the ATS and GINA guidelines (50 ppb) (9.9% vs 4.7%, respectively).

    Conclusions: FENO values for healthy Indigenous Australians children (3-16 years of age) are likely higher than published white-based values. The GINA recommended cutoff value (> 50 ppb) appears the most appropriate for identifying healthy Indigenous children but requires confirmation from a larger study.

    Original languageEnglish
    Pages (from-to)239-246
    Number of pages8
    JournalChest
    Volume156
    Issue number2
    DOIs
    Publication statusPublished - Aug 2019

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    Cite this

    Blake, T. L., Chang, A. B., Chatfield, M. D., Marchant, J. M., Petsky, H. L., & McElrea, M. S. (2019). Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age. Chest, 156(2), 239-246. https://doi.org/10.1016/j.chest.2019.02.401
    Blake, Tamara L. ; Chang, Anne B. ; Chatfield, Mark D. ; Marchant, Julie M. ; Petsky, Helen L. ; McElrea, Margaret S. / Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age. In: Chest. 2019 ; Vol. 156, No. 2. pp. 239-246.
    @article{0f6c188cf82b4bada2b379fe4dae8314,
    title = "Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age",
    abstract = "Background: Fractional exhaled nitric oxide (FENO) levels can identify eosinophilic asthma phenotypes. We aimed to determine FENO values of healthy Aboriginal and/or Torres Strait Islander (Indigenous) Australians, differences between these Indigenous ethnic groups, and appropriateness of published cutoff values. Methods: We measured FENO levels in 1,036 Indigenous Australians (3-16 years of age). Participants were classified into healthy (ie, no asthma or atopy history) or asthmatic and/or atopic groups. Results: Median FENO values and distribution did not differ between Indigenous ethnicities. For healthy participants < 12 years of age (n = 390), 7.2{\%} of our cohort fell into the inflammatory zone of the American Thoracic Society (ATS), National Institute for Health and Care Excellence (NICE), and British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) guidelines (cutoff 35 parts per billion [ppb]), but only 3.8{\%} fell into this category when using the Global Initiative for Asthma (GINA) guidelines (50 ppb). Similarly, when using the NICE and BTS/SIGN guidelines (40 ppb) for participants 12 to 16 years of age (n = 213), more healthy participants fell into the inflammatory zone compared with the ATS and GINA guidelines (50 ppb) (9.9{\%} vs 4.7{\%}, respectively). Conclusions: FENO values for healthy Indigenous Australians children (3-16 years of age) are likely higher than published white-based values. The GINA recommended cutoff value (> 50 ppb) appears the most appropriate for identifying healthy Indigenous children but requires confirmation from a larger study.",
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    author = "Blake, {Tamara L.} and Chang, {Anne B.} and Chatfield, {Mark D.} and Marchant, {Julie M.} and Petsky, {Helen L.} and McElrea, {Margaret S.}",
    year = "2019",
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    Blake, TL, Chang, AB, Chatfield, MD, Marchant, JM, Petsky, HL & McElrea, MS 2019, 'Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age', Chest, vol. 156, no. 2, pp. 239-246. https://doi.org/10.1016/j.chest.2019.02.401

    Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age. / Blake, Tamara L.; Chang, Anne B.; Chatfield, Mark D.; Marchant, Julie M.; Petsky, Helen L.; McElrea, Margaret S.

    In: Chest, Vol. 156, No. 2, 08.2019, p. 239-246.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Fractional Exhaled Nitric Oxide Values in Indigenous Australians 3 to 16 Years of Age

    AU - Blake, Tamara L.

    AU - Chang, Anne B.

    AU - Chatfield, Mark D.

    AU - Marchant, Julie M.

    AU - Petsky, Helen L.

    AU - McElrea, Margaret S.

    PY - 2019/8

    Y1 - 2019/8

    N2 - Background: Fractional exhaled nitric oxide (FENO) levels can identify eosinophilic asthma phenotypes. We aimed to determine FENO values of healthy Aboriginal and/or Torres Strait Islander (Indigenous) Australians, differences between these Indigenous ethnic groups, and appropriateness of published cutoff values. Methods: We measured FENO levels in 1,036 Indigenous Australians (3-16 years of age). Participants were classified into healthy (ie, no asthma or atopy history) or asthmatic and/or atopic groups. Results: Median FENO values and distribution did not differ between Indigenous ethnicities. For healthy participants < 12 years of age (n = 390), 7.2% of our cohort fell into the inflammatory zone of the American Thoracic Society (ATS), National Institute for Health and Care Excellence (NICE), and British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) guidelines (cutoff 35 parts per billion [ppb]), but only 3.8% fell into this category when using the Global Initiative for Asthma (GINA) guidelines (50 ppb). Similarly, when using the NICE and BTS/SIGN guidelines (40 ppb) for participants 12 to 16 years of age (n = 213), more healthy participants fell into the inflammatory zone compared with the ATS and GINA guidelines (50 ppb) (9.9% vs 4.7%, respectively). Conclusions: FENO values for healthy Indigenous Australians children (3-16 years of age) are likely higher than published white-based values. The GINA recommended cutoff value (> 50 ppb) appears the most appropriate for identifying healthy Indigenous children but requires confirmation from a larger study.

    AB - Background: Fractional exhaled nitric oxide (FENO) levels can identify eosinophilic asthma phenotypes. We aimed to determine FENO values of healthy Aboriginal and/or Torres Strait Islander (Indigenous) Australians, differences between these Indigenous ethnic groups, and appropriateness of published cutoff values. Methods: We measured FENO levels in 1,036 Indigenous Australians (3-16 years of age). Participants were classified into healthy (ie, no asthma or atopy history) or asthmatic and/or atopic groups. Results: Median FENO values and distribution did not differ between Indigenous ethnicities. For healthy participants < 12 years of age (n = 390), 7.2% of our cohort fell into the inflammatory zone of the American Thoracic Society (ATS), National Institute for Health and Care Excellence (NICE), and British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) guidelines (cutoff 35 parts per billion [ppb]), but only 3.8% fell into this category when using the Global Initiative for Asthma (GINA) guidelines (50 ppb). Similarly, when using the NICE and BTS/SIGN guidelines (40 ppb) for participants 12 to 16 years of age (n = 213), more healthy participants fell into the inflammatory zone compared with the ATS and GINA guidelines (50 ppb) (9.9% vs 4.7%, respectively). Conclusions: FENO values for healthy Indigenous Australians children (3-16 years of age) are likely higher than published white-based values. The GINA recommended cutoff value (> 50 ppb) appears the most appropriate for identifying healthy Indigenous children but requires confirmation from a larger study.

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    KW - guidelines

    KW - pediatric asthma

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    U2 - 10.1016/j.chest.2019.02.401

    DO - 10.1016/j.chest.2019.02.401

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