title: [Effect of two doses of budesonide on exhaled nitric oxide and urinary EPX excretion in asthmatic children].
abstract: The use of objective outcome measures that assess airway inflammation in pediatric asthma can provide a good evaluation of asthma severity and treatment response. In this double-blind and randomized study the effects of 200 micro g of budesonide and 800 micro g of budesonide on markers of inflammation (exhaled nitric oxide (eNO), eosinophil protein X (EPX) excretion in urine) and on lung function (FEV (1)) were prospectively investigated in 24 ICS-naive children with mild persistent to moderate persistent asthma over a period of eight weeks. After eight weeks of treatment 200 micro g and 800 micro g of budesonide led to a significant decrease (p < 0.025) in eNO [median (90 % interval): 200 micro g: - 17.2 ppb (- 54.6 to 0.9); 800 micro g: - 13.2 ppb (- 44.6 to - 1.7)]. A significant change in urinary EPX excretion was only observed in the high dose group [200 micro g: - 10.3 micro g/mmol creatinine (- 116.2 to 50.5), p = 0.9; 800 micro g: - 49.2 micro g/mmol creatinine (- 231.0 to 48.7), p = 0.02]. However, a significant difference between the change from baseline after 8 weeks of either group was found neither for eNO (p = 0.66) nor for EPX excretion (p = 0.04). In conclusion, our data demonstrate that 800 micro g budesonide per day did not show any advantage in reduction of airway inflammation, measured by eNO and urinary EPX excretion, in children with mild persistent to moderate persistent asthma.
authors.affiliation: Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Freiburg. karin.storm@gmx.de
authors.forename: K
authors.initials: K
authors.lastname: Storm Van's Gravesande
authors.forename: J
authors.initials: J
authors.lastname: Mattes
authors.forename: A
authors.initials: A
authors.lastname: Endlicher
authors.forename: K
authors.initials: K
authors.lastname: Alving
authors.forename: G
authors.initials: G
authors.lastname: Ihorst
authors.forename: J
authors.initials: J
authors.lastname: Kühr
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000503:physiopathology* / Q000652:urine; D001944:Breath Tests; D001993:Bronchodilator Agents / Q000494:pharmacology*; D019819:Budesonide / Q000494:pharmacology*; D002648:Child; D004305:Dose-Response Relationship, Drug; D047208:Eosinophil-Derived Neurotoxin; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis*; D012129:Respiratory Function Tests; D012260:Ribonucleases / Q000652:urine*
chemical_list: D001993:Bronchodilator Agents; D009569:Nitric Oxide; D019819:Budesonide; D047208:Eosinophil-Derived Neurotoxin; D012260:Ribonucleases