[Measurement of cytokines in patients with exercise-induced asthma treated with anti-leukotrienes].
BACKGROUND
Exercise-induced asthma is defined as the transient broncho-spasm, that occurs after 3 to 8 minutes of continuous exercise; one of two mechanisms are implicated: the first is given by a hyper-osmolar environment interchange with the warm respiratory air and the water loss, the second due to reactive hyperemia or bronchial blood vessels edema.


OBJECTIVE
To determine the effectiveness and safety of Zafirlukast treatment in exercise induce asthma, and in mild and moderated persistent bronchial asthma. Evaluate the security with laboratory test IL-2, IL-4, INFg, and CD69, to determinate TH1 and Th2 cells, laboratory and thorax x-ray determinations before and after zafirlukast treatment in exercise induce asthma, plus the functional respiratory test, and assert the clinical and adverse reaction with Zafirlukast.


METHODS
A open, prospective, longitudinal study. Challenge test on a treadmill for 8 minutes. Twenty patients from the Allergy Service at Lic. Adolfo López Mateos Hospital, ISSSTE, in México City, fifteen female and five males. Aged 15 to 35 years. There was a control group of ten healthy subjects with similar age and sex. The drug Zafirlukast was administered 20 mg twice a day for eight weeks, with patient's informed and signed consent. Laboratory test: Blood Cell count, transaminases, bilirubins A, G, M and E immunoglobulins thorax X-ray, electrocardiogram, functional respiratory test before and after treatment.


RESULTS
Zafirlukast blocked exercise induced asthma in the early and late phases. There was a statistically significant improvement of a VEF-1 after exercise with a p > 0.001; furthermore, there was significant improvement in the mid-spiratory speed before the exercise with a p > 0.05. The mid-spiratory speed after the exercise, improved (p > 0.01). There were no collateral reactions, such as Churg-Strauss, only transitory headache in six and nauseas in two. There were no statistically significant changes in the cytokines assessment.


CONCLUSIONS
There were no statistically significant changes in the cytokines assessments, in four cases the IL-4 decreased after the treatment. The anti-leukotriene improved the bronchospastic answer during the early and late phases, reducing the FEV-1, decreasing the recovering phase.
Flores Sandoval
Graciela
G
Hospital Regional Lic. Adolfo López Mateos, ISSSTE.
Orea Solano
Modesto
M
Cortés Padilla
V
V
Santos Argumedo
L
L
D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D001250:Asthma, Exercise-Induced / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D001986:Bronchial Spasm / Q000188:drug therapy; D016207:Cytokines / Q000097:blood*; D005080:Exercise Test; D005260:Female; D005540:Forced Expiratory Flow Rates / Q000187:drug effects; D005541:Forced Expiratory Volume / Q000187:drug effects; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007211:Indoles; D007371:Interferon-gamma / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D037181:Lectins, C-Type; D020024:Leukotriene Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D009325:Nausea / Q000139:chemically induced; D048448:Phenylcarbamates; D011446:Prospective Studies; D011859:Radiography; D012449:Safety; D013449:Sulfonamides; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D014105:Tosyl Compounds / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D000099192:CD69 Antigens
D015703:Antigens, CD; D000945:Antigens, Differentiation, T-Lymphocyte; D016207:Cytokines; D007211:Indoles; D007371:Interferon-gamma; D007376:Interleukin-2; D015847:Interleukin-4; D037181:Lectins, C-Type; D020024:Leukotriene Antagonists; D048448:Phenylcarbamates; D013449:Sulfonamides; D014105:Tosyl Compounds; D000099192:CD69 Antigens; C062735:zafirlukast