Influence of Parental Disease Phenotypes and Smoking on Fractional Exhaled Nitric Oxide Values in Offspring

Background: It is well known that parental factors such as allergic diseases and smoking can influence respiratory disease in the offspring. It is however relatively unknown how parental factors influence levels of fractional exhaled nitric oxide (FeNO) in the offspring – a known clinical biomarker of type-2 airway inflammation commonly raised in asthmatics Aim: We aimed to investigate if parental allergic diseases, smoking and higher FeNO levels are associated with FeNO levels in their offspring. Methods: We used offspring (n=617) aged 16-47 years from the Respiratory Health in Northern Europe, Spain and Australia generation (RHINESSA) study with parental information from the Respiratory Health in Northern Europe (RHINE) study and the European Community Respiratory Health Survey (ECRHS). Linear regression models were used to assess percent change in offspring FeNO by presence of parental allergic rhinitis (AR), asthma and smoking. We also assessed percent increase in offspring FeNO (n=364) per 1% increase in parental FeNO. Results: Parental AR was significantly associated with higher FeNO in the offspring after adjusting for offspring age, gender, height, current smoking, AR, allergic sensitisation and parental asthma. Paternal and maternal AR were associated with higher FeNO in the offspring (22.0% [95%CI 6.7-39.4], p=0.004, and 16.1% [3.1-30.7], p=0.015, respectively). Parental asthma and smoking were not associated with offspring FeNO after adjustments. For every 1% increase in parental FeNO, offspring FeNO increased by 0.12% (p=0.04) in adjusted models Conclusions: Parental AR and higher parental FeNO values were associated with higher levels of FeNO in offspring.