- Title
- Novel applications of exhaled nitric oxide in children with IgE-mediated food allergy and infants at increased risk of atopy
- Creator
- Percival, Elizabeth Joy
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2023
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- This thesis explores novel applications of exhaled nitric oxide (eNO) as a biomarker for food allergy in children and for exposure to ambient air pollution in infants at increased risk of atopy. The atopic diseases of eczema, food allergy, asthma and allergic rhinitis are among the most commonly reported chronic health conditions affecting Australian children, with infants born to mothers with asthma having an increased risk of developing them. Fraction of exhaled nitric oxide (FeNO) has a clinical role as a biomarker of airway inflammation (particularly in asthma) in children and adults. However, in infants methodological challenges occur with its use and uncertainty exists about the biological roles at this age. Peanut allergy is one of the most common food allergies in childhood and can be a life-threatening event. The limitations of diagnostic tools in predicting who is likely to react after eating the suspected allergen often requires medically supervised food challenges to clarify the existence of food allergy. Furthermore, while the likelihood of reaction can be estimated using current diagnostic tools, they do not predict the severity of the reaction, resulting in uncertainty about the potential consequences of ingesting the suspected food allergen. The first research study in chapter 3 presents a follow-up study of FeNO in children with peanut allergy. FeNO displayed potentially high accuracy and reproducibility in predicting allergic reaction at peanut challenge at least twelve months after the original measurement and peanut challenge were performed. The second research study in chapter 4 describes an observational study measuring change in FeNO in school aged children undergoing peanut challenge to clarify allergy status. Remarkably, FeNO decreased more dramatically in those who subsequently developed anaphylaxis during the challenge and furthermore, this occurred prior to the development of lower respiratory tract symptoms and signs of anaphylaxis. The third research study in chapter 5 depicts an association between postnatal air pollution exposure and eNO in young infants of mothers with asthma during pregnancy. This augments the understanding of the biological roles of eNO in infants with a suspected inflammatory mechanism driving NOS2 expression and eNO production in the postnatal period of young infants at increased risk of atopy. Overall, these studies advance the diverse understanding of eNO in children with peanut allergy and infants at increased risk of atopy, affirming its standing as a biomarker of atopy and alluding to a potential inflammatory process through postnatal exposure to air pollution in infants of mothers with asthma in pregnancy.
- Subject
- air pollution; allergy; exhaled nitric oxide; FeNO; food allergy; fraction exhaled nitric oxide; infant; iNOS; NOS2; peanut; peanut sIgE; predict; anaphylaxis; reproducibility; season; skin prick test; Ara h2; Ara h2 sIgE; asthma; atopy; breathing for life trial; diagnosis; eNO
- Identifier
- http://hdl.handle.net/1959.13/1504881
- Identifier
- uon:55595
- Rights
- Copyright 2023 Elizabeth Joy Percival
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 1 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 221 KB | Adobe Acrobat PDF | View Details Download |