Chest
Clinical Investigations: AsthmaThe Effect of Montelukast on Exhaled Nitric Oxide and Lung Function in Asthmatic Children 2 to 5 Years Old
Section snippets
Study Design
Children who were referred to our outpatient clinic due to recurrent wheeze over a period of 6 months, and who were symptomatic at the time of referral and had a positive parental history of asthma, were allocated to a run-in period if their eNO level was ≥ 15 parts per billion (ppb) and underwent a blood test (ie, the radioallergosorbent test [RAST]) to detect either food or inhaled allergens as well as a lung function measure (ie, Rint) before the run-in period began (visit 1). Therapy with
Results
From 55 preschool children with recurrent wheeze and a parental history of atopy, 9 had to be excluded due to their inability to perform valid Rint measurements. Forty-six children were allocated to the run-in period, but only 30 fulfilled the inclusion criteria, including positive RAST test result, and were included in the study.
The mean eNO levels at visits 1, 2, and 3 were 31.4 ppb (SD, 13.9 ppb), 33.1 ppb (SD, 12.0 ppb), and 11.6 ppb (SD, 9.5 ppb), respectively. The mean Rint values at
Discussion
In the present study, we investigated the effect of montelukast on levels of eNO and pulmonary function in preschool children with allergic asthma. We included children with chronic wheeze, raised eNO levels, and parental atopy to ensure a degree of homogeneity with regard to phenotype and to maximize the likelihood of persistent airway inflammation being present. Levels of eNO and airway resistance were significantly lower after 4 weeks of treatment with montelukast.
Current guidelines
References (38)
- et al.
Response of preschool children with asthma symptoms to fluticasone propionate
J Allergy Clin Immunol
(2001) - et al.
Effectiveness and safety of inhaled corticosteroids in controlling acute asthma attacks in children who were treated in the emergency department: a controlled comparative study with oral prednisolone
J Allergy Clin Immunol
(1998) - et al.
Exhaled nitric oxide is increased in asthma
Chest
(1995) - et al.
Cysteinyl leukotrienes in asthma: old mediators up to new tricks
Trends Pharmacol Sci
(1995) - et al.
Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year-old children with asthma
J Pediatr
(1998) - et al.
Reduction of eosinophilic inflammation in the airways of patients with asthma using montelukast
Chest
(2002) - et al.
A randomized, double-blind trial of the effect of treatment with montelukast on bronchial hyperresponsiveness and serum eosinophilic cationic protein (ECP), soluble interleukin 2 receptor (sIL-2R), IL-4, and soluble intercellular adhesion molecule 1 (sICAM-1) in children with asthma
J Allergy Clin Immunol
(2002) - et al.
A comparison of exhaled nitric oxide and induced sputum as markers of airway inflammation
J Allergy Clin Immunol
(2000) - et al.
Exhaled nitric oxide in asthma: from bench to bedside
J Allergy Clin Immunol
(2003) - et al.
Significant variability in response to inhaled corticosteroids for persistent asthma
J Allergy Clin Immunol
(2002)
Leukotriene C4 synthase promoter polymorphism and risk of aspirin-induced asthma
Lancet
Inhaled steroids for episodic viral wheeze of childhood
Cochrane Database Syst Rev (database online) 2
Asthma and wheezing in the first six years of life: the Group Health Medical Associates
N Engl J Med
Present and future treatment of asthma in infants and young children
J Allergy Clin Immunol
Exhaled nitric oxide measurements in normal and asthmatic children
Pediatr Pulmonol
Measurements of exhaled nitric oxide with the single-breath technique and positive expiratory pressure in infants
Am J Respir Crit Care Med
Exhaled nitric oxide concentrations during treatment of wheezing exacerbation in infants and young children
Am J Respir Crit Care Med
NO in exhaled air of asthmatic children is reduced by the leukotriene receptor antagonist montelukast
Am J Respir Crit Care Med
Levels of exhaled nitric oxide in recurrently wheezy infants are decreased following inhaled steroid therapy
Schweiz Med Wochenschr
Cited by (0)
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (e-mail: [email protected]).
This study was funded by a Medical School Grant (MSD).