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The evaluation of nasal nitric oxide (nNO) has been proposed as a screening tool in children with clinically suspectable primary ciliary dyskinesia. Nevertheless, normal values have been reported for school-aged children. This study was designed to identify normal nNO levels in pre-school children. nNO was assessed in 300 healthy children aged between 1.5 and 7.2. Two hundred and fifty of them were unable to fulfill the guideline requirements for nNO measurement and were assessed by sampling the nasal air continuously with a constant trans-nasal aspiration flow for 30 s during tidal breathing. For those children who were able to cooperate, the average nNO concentration was calculated according to guidelines. A statistically significant relationship between nNO level and age was demonstrated in this study group of pre-school children (p0.001). An increase in nNO of about 100 ppb was observed in children older than 6 yr vs. those aged3. This study presents a description of normal nNO values in pre-school children. The effect of the age and the eventual presence of rhinitis and snoring need to be considered whenever nNO is evaluated in the clinical practice, in particular in non-cooperative children.

Unpasteurized milk consumption was associated with less atopy prevalence. Not only microbial load but also fatty acids and cytokines such as transforming growth factor-beta(1) (TGF-beta(1)) may play a role on the effect of unpasteurized milk. Levels of TGF-beta(1) in different cow's milk samples were evaluated: we consider raw unpasteurized milk before and after boiling, commercial pasteurized and micro-filtrated cow's milk and different commercially available cow's milk formulas. TGF-beta(1) concentration in raw unpasteurized cow's milk was 642.0 +/- 52.9 pg/ml before boiling and decreased significantly after boiling (302.7 +/- 50.59 pg/ml) (p0.05). TGF-beta(1) concentrations were also significantly lower in commercial pasteurized milk (246.2 +/- 43.15 pg/ml) and in commercial micro-filtrated milk (213.0 +/- 31.6 pg/ml) in comparison to unpasteurized unboiled milk (p = 0.002). The levels of TGF-beta(1) in all formula samples were below the threshold of detectability for the assays. As TGF-beta(1) in the milk may contribute to the development of the immature gastrointestinal tract by influencing IgA production and oral tolerance induction, we suggest to consider not only the microbial compounds but also the cytokine patterns to explain the protective effect of unpasteurized cow's milk on allergic disorders.

Chemokines and their receptors may play an important role for leukocyte trafficking in allergic inflammation. Aim was to evaluate whether expression of chemokine receptors CCR4 and CCR8 on cells obtained by sputum induction from asthmatic allergic children may be influenced by house dust mite (HDM) allergen natural exposure. Twenty-one children (7-13 yr) with moderate asthma and sensitized to HDM were evaluated during a prolonged period of allergen avoidance (T0) and after a period of natural allergen exposure (T1). At each time point of sputum induction, lung function evaluation, exhaled nitric oxide (eNO) measurements were performed. At T1, CCR4 and CCR8 expression on sputum-induced cells increased from 28.4% +/- 2.9% and 25.8% +/- 1.9%, to 41.1% +/- 4.2% and 37.5% +/- 2.0%, respectively (p < 0.05 and p = 0.01). After allergen exposure, both sputum eosinophils (from 5.2% +/- 2.0% to 12.1% +/- 4.1%, p < 0.01) and eNO (from 15.1 +/- 2.2 ppb to 24.2 +/- 5.8 ppb, p < 0.05) showed significant increase. Lung function tests presented significant deterioration of Forced Expiratory Flow at 25-75% of Vital Capacity (FEF(25--75)) (p < 0.05) and increase of residual volume (p = 0.002). Significant changes in CC chemokine receptor expression in sputum-induced cells in asthmatic children in response to HDM exposure have been observed leading to consider the relevance of CCR4 and CCR8 in allergic asthmatic inflammation.