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levels between the asthmatics with allergic rhinitis at 252ppb (SD 20) compared to those
wirhout rhinitis at 256ppb (SD 26) (Lundberg, Nordvall et al. 1gg6). In sixteen children with
acute maxillary sinusitis the mean nasal concentration was 70 ppb (+l S.7ppb) increased to
220ppb (+/- 15ppb) after oral antibiotic therapy. In comparison nine children with upper
respiratory tract infections but not thought to have sinusitis had mean nasal NO levels of
249ppb (+t- 32ppb), which did not change after oral antibiotic treatment (Baraldi, Azzolin et
al. t997).
In studies comparing children with asthma and children with CF, Lundberg et al also
compared the plateau oral exhaled NO levels demonstrating no difference between 19 control
children and eight children with cF at a mean of 4.8ppb (sD 1.2) and 5'8ppb (SD 0'8)
respectively. However there was a significant increase in the 36 children with asthma to
l3.gppb (SD 2.5). These higher levels were seen in the asthmatic children despite their taking
a range of medication with twelve on low dose IHCS (defined as 0-100pgs budesonide or
equivalent per day), 16 on moderate doses of IHCS (defined as 200-400pgs budesonide or
equivalent per day) and eight on high doses of IHCS (defined as 600-800pgs budesonide or
equivalent per day). I note there appear to be gaps in these ranges i.e. 100-200pgs and 400-
600pgs which are not discussed but it is likely that there was no child on treatment in these
ranges which would have required odd dosing regimes. With nasal exhalation sampling, there
was no difference between the control group or this asthmatic group (recalling that all were on
IHCS therapy) at 21ppb (SD 9.1) versus 27ppb (SD 2.6), although a possible trend was noted
of a decreasing NO when on the higher steroid doses. There was also no difference in these
two groups when having direct nasal sampling (via a nasal olive) with the controls measured
at 239ppb (SD 20) and the collective asthmatic group measured at 254ppb (SD 17)' However
in both the nasal measurements those that were able to perform the technique from the group
of children with cF showed significantly lower levels with their nasal breathing giving levels
between 9-l5ppb and their nasal direct sampling giving levels between 40-105ppb (Lundberg'
Nordvall et al. 1996). In 68 controls, 90 asthmatics and 67 subjects with CF with a collective
age range from four to 34 years, Dotsch et al used a slowly responding analyser measuring a
series of single exhalations and showed a correlation between exhaled NO levels and the
ambient NO concentration. They then reported results between the three groups studied only
in the subjects that were measured during days of zero ambient No concentration (Dotsch,
Demirakca et al. 1996). The mean level of exhaled NO in 30 asthmatics aged four to fourteen
years was 8.0ppb (+/- 6.lppb), significantly higher than in 37 controls aged four to 34 years at
3.0ppb (+l 2.5ppb). Twenty three patients with CF aged five to 32 years tended to have a
t99