Is the Exhaled Nitric Oxide in Infants a Predictive Marker of Asthma ?

Study Overview
=================
Brief Summary
-----------------
Background: It seems that in the infants and the young children, the increase of the Exhaled Nitric Oxide (eNO) is in connection with: (1) the risk of developing respiratory symptoms; (2) the risk of family and personal atopy; (3) the intensity of the respiratory symptoms; (4) the risk of passage of recurrent wheezing to asthma; (5) and contrary to the fact that the investigators noticed at the child's a positive relation with the environmental tobacco smoke Objective: the investigators objective is to bring to light that the rise of the eNO, a non invasive biomarker of the bronchial inflammation, would be a risk factor expected from passage of recurrent wheezing of the infant and the young child (of less than 36 months old) towards the asthma of the child.Methods: Once the diagnosis of recurrent wheezing established, the investigators estimate by questionnaire the severity of the asthma, the personal and familial atopy, the collection of the environmental data. After allergic exploration (skin tests and assay of serum total and specific IgE, complete blood count), the eNO is measured by an off-line tidal breathing method using a chemiluminescence NO analyzer. Annually, a questionnaire will be send to families to appreciate the persistence or the remission of the asthma. After a simple descriptive analysis of the population and a multifactorial descriptive analysis, the investigators shall look for the connections between the rise of the eNO and the various clinical, biological and environmental parameters known to influence the variations of this marker. Then the investigators shall select a set of explanatory variables for a multivariate analysis by a logistic regression step by step.

Detailed Description
-----------------
This study is a epidemiological observation study

Official Title
-----------------
Is the Exhaled Nitric Oxide in Infants a Predictive Marker of Asthma?

Conditions
-----------------
Asthma

Intervention / Treatment
-----------------
* Other: Measure of the exhaled NO


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Infant between 6 and 36 months More than 3 wheezing episodes Questionary and biological assessment for recurrent wheeze Signature of the consent by 2 parents or by the only one of 2 parents (if this last one is the only present in the inclusion of the child) Exclusion Criteria: Infant with respiratory disease in neonatal period Infant with other obstructive pathology (cystic fibrosis, Primary Ciliary Dyskinesia,…) Infant who have a respiratory infection less than 4 weeks Infant with asthma exacerbation or who still have corticosteroid treatment Infant without social security from their parents

Ages Eligible for Study
-----------------
Minimum Age: 6 Months
Maximum Age: 36 Months

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exhaled NO<br> | Other: Measure of the exhaled NO<br>* The exhaled NO will be measure by chemiluminescence in current ventilation by an indirect method (off-line)<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measure of exhaled nitric oxide at the beginning of the study and incidence of asthma symptoms after 3 years of follow up |  | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Atopic status with total and specific IgE levels and skin test, complete blood count |  | 1 day | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Infants, Exhaled Nitric Oxide, Asthma, Tobacco smoke exposure, environment