Clinical Significance of Fractional Exhaled Nitric Oxide (FeNO) Measurements in Juvenile Idiopathic Inflammatory Myopathy‐Associated Interstitial Lung Disease
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Interstitial lung disease (ILD) has a significant impact on morbidity and mortality in juvenile idiopathic inflammatory myopathies (JIIM). Early and noninvasive detection methods are crucial to improve outcomes through timely diagnosis and intervention. Fractional exhaled nitric oxide (FeNO) is commonly used to assess airway inflammation; however, its utility for the diagnosis of ILD in JIIM remains uncertain. This study investigates the role of FeNO as a potential noninvasive biomarker for ILD in pediatric JIIM patients. METHODS: We enrolled 34 pediatric JIIM patients and classified them into ILD (n = 13) and non-ILD (n = 21) groups based on clinical and high-resolution computed tomography (HRCT) findings. Pulmonary function tests (PFTs), diffusing capacity for carbon monoxide (DLCO) and FeNO measurements were analyzed. Statistical analyses included correlations and receiver operating characteristic (ROC) analyses. RESULTS: The prevalence of ILD in our cohort was 38.2%. ILD patients had significantly reduced lung function parameters including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), total lung capacity (TLC), and diffusing capacity for carbon monoxide corrected for alveolar volume (DLCOcSB/VA) compared to the non-ILD group (p < 0.05). FeNO levels were significantly higher in patients with ILD (median 17 ppb vs. 10 ppb; p = 0.011). Furthermore, FeNO was negatively correlated with TLC, and ROC analysis showed discriminatory power in identifying ILD (AUC = 0.797; p = 0.011). Therefore, FeNO could be considered a valuable marker for detecting ILD. CONCLUSION: FeNO correlates with impaired lung function in JIIM-associated ILD and thus shows considerable potential as a noninvasive biomarker to differentiate ILD in pediatric JIIM patients. Our results suggest that integrating FeNO measurements into clinical practice could improve early detection, facilitate timely intervention, and enhance clinical management. Importantly, this study is the first to specifically investigate the clinical utility of FeNO in JIIM patients with ILD. Further large-scale, prospective studies are warranted to validate the role of FeNO in predicting disease progression and therapeutic decisions.
Source: Pediatric Pulmonology
DOI: 10.1002/ppul.71409
Authors: Azer Kilic Baskan, Berrak Oztosun, Aybüke Gunalp, Elif Kilic Konte, Ayse Kalyoncu Ucar, Sebuh Kurugoglu, Ozgur Kasapcopur, Ayse Ayzit Kilinc Sakalli
Institutions: Istanbul University-Cerrahpaşa, Istanbul University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4416733461