Exhaled nitric oxide and asthma in childhood

Asthma was first described in the medical literature of Greek antiquity. It is difficult to determine whether by referring to “asthma”, Hippocrates and his school (460-360 B.C.) meant an autonomous clinical entity or a symptom. The clinical presentation of asthma nowadays has probably changed little compared to 200 years ago. However, there are now many more people with asthma. According to the Global Initiative for Asthma: ‘Asthma is a disorder defined by its clinical, physiological, and pathological characteristics. The predominant feature of the clinical history is episodic shortness of breath, particularly at night, often accompanied by cough. Wheezing appreciated on auscultation of the chest is the most common physical finding. The main physiological feature of asthma is episodic airway obstruction characterized by expiratory airflow limitation. The dominant pathological feature is airway inflammation, sometimes associated with airway structural changes (www.ginasthma.org).’ In Western countries the prevalence of childhood asthma and atopic diseases has increased dramatically during the end of the last century. There are large differences in asthma prevalence between Western countries, and between the different continents. In Western countries, asthma is one of the most frequent chronic disorders in childhood, with a high burden of morbidity, absenteeism from school, health care costs and reduced quality of life.

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