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Asthma is a chronic disease in which the airways become inflamed, swollen
and airway muscles tighten making it difficult to breathe. The symptoms
may come and go, with or without treatment, but airway inflammation remains.
Often it is very difficult for a health care provider to detect if a child
has airway inflammation, for current diagnostic tools have not been very
predictive of inflammation or asthma diagnosis for those suspected; this
can lead to the under treatment of asthma. A nitric dioxide monitor (NO)
can be used as a non-invasive means for measuring airway inflammation in
elementary school children with diagnosed asthma as well as to screen children
suspected or at risk for the disease. The Center for Asthma & Environmental
Exposure (CAEE) has implemented a school-based intervention which serves
15 public elementary schools in Buffalo and Niagara Falls and one Head Start
Program. The current enrollment is 8289, of which approximately 1650 (20%)
have physician diagnosed asthma, and nearly 1243 (15%) have chronic respiratory
symptoms or are at risk for a breathing problem. The NO monitor will be
used in conjunction with an 18-item asthma questionnaire, lung function
testing (spirometry) and peak flow measurement as tools for assessing children
with asthma, and to screen children with chronic respiratory symptoms without
diagnosed asthma.
Children 4 to 9 years old participating in the CAEE school-based asthma
program will be recruited, 150 children will be randomly selected. The children
will be tested to measure exhaled NO, and a pulmonary function test and
peak flow to measure reversibility of airway obstruction.
The results of this project will aid in the diagnosis, monitoring of asthma
and will provide an objective measure of airway inflammation in children.
We expect the NO use to result in increased use of anti-inflammatory controller
medications for children with asthma. We will screen 150 children; however
the results of the study will be applicable to a much larger group.
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