Montelukast in early childhood asthma. Predict value of IgG in clinical reply in children 2 to 5 years old?
BACKGROUND
According to current knowledge, asthma is basically an inflammatory process. Its causes and physiopathological mechanisms are various. The final result is a recurrent obstructive bronchial process, with sibilants and/or dypnea, which causes an upset in functional respiratory tests, among which the maximum respiratory peak flow meter diminished for the age, sex, and height of patient.


OBJECTIVE
Our aim is to evaluate if response to treatment with Montelukast has any link with immnuloglobin values (IgG, IgA, IgM, IgE) at start of treatment.


METHODS
Included in the study were 32 children, of whom 2 did not begin and 1 who did not provide personal data. There were 29 patients in total, 11 girls and 18 boys. Each made three visits: first where they were instructed, together with their parents, in how to manage the meter and where they received the peak flow meter, Vitalograph, and personal data sheet, where personal and family medical history were noted. The second visit was after 4 weeks, for a clinical assessment and the third visit after 8 weeks. The value register of the PEF would be made morning and night, noting the highest value of three measurements. IgG, IgA, IgM, IgA values were quantified before treatment began. The statistic package STATA 2001 was used in the treatment of data statistics.


RESULTS
Our between the value reached by the PEF after treatment and the IgG values at the beginning of treatment (0.712). In lesser measurement for IgA values (0.660). For each 100 mg/ml of increase in the value of IgG, an increase of 10 l/min in the PEF measurement before and following treatment with Montelukast was produced.


CONCLUSIONS
IgG values increase with age. Children with a greater IgG value at the beginning of treatment reached higher PEF values after same. It is not known if the results would be similar with another type of treatment and the way in which IgG influences the results. What appears to be confirmed by available studies is that this relation is found in a group of small children, the aim of our study.
Hernando
S V
SV
Unidad de Alergia Pediátrica, Servicio de Pediatría, Clínica Virgen de la Vega, Murcia, Spain. vhernandos@cajamas.es
Rodríguez
M
M
Ayala
S J A
SJ
Costa
G F
GF
Chumilla
V M A
VM
García
C M
CM
Jiménez
F J M
FJ
Lorente
G S
GS
Navarro
G F
GF
Orihuela
C C
CC
Ortuño
M M P
MM
Pelegrín
L B
LB
D000085:Acetates / Q000627:therapeutic use*; D000367:Age Factors; D001249:Asthma / Q000097:blood / Q000188:drug therapy*; D015415:Biomarkers; D002675:Child, Preschool; D003521:Cyclopropanes; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D010366:Peak Expiratory Flow Rate; D011237:Predictive Value of Tests; D011804:Quinolines / Q000627:therapeutic use*; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D015415:Biomarkers; D003521:Cyclopropanes; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D007073:Immunoglobulin E; C093875:montelukast