Effect of inhaled corticosteroid treatment on exhaled breath condensate leukotriene E(4) in children with mild asthma.
Chronic airway inflammation in children with asthma might be present even in the absence of pathological lung function tests and is known to increase the risk of permanent pulmonary damage. Thus, we aimed at investigating to what extent inflammatory markers such as leukotrienes (LTs) in exhaled breath condensate (EBC) or fractional exhaled nitric oxide (FE(NO)) reflect therapeutic effects in these patients. Fifty steroid-naive patients (aged 8.8 +/- 2.7 years) were included in the study. EBC was collected before and 6 months after therapy with inhaled corticosteroids. LTs were determined by using commercially available ELISA. In addition, FE(NO) was measured by means of a chemiluminescence analyzer. Conventional lung function testing was performed revealing vital capacity, forced expiratory volume, maximum expiratory flow, and specific resistance. In EBC, LTE(4) but not LTB(4) levels significantly decreased after steroid therapy from 45.3 +/- 36.0 pg/mL to 17.2 +/- 11.4 pg/mL (p < 0.0001) concomitant with a slight, but significant improvement of lung function parameters. Mean FE(NO) also indicated therapeutic success; however, in 20 of 50 patients, exhaled NO concentrations were higher after therapy. These findings suggest that LTE(4) in breath condensate may be helpful in latent inflammatory activity in the bronchial mucosa in children with asthma.
Steiss
Jens-Oliver
JO
University Children's Hospital, Giessen, Germany. jens-oliver.steiss@paediat.med.uni-giessen.de
Rudloff
Silvia
S
Landmann
Eva
E
Rückes-Nilges
Claudia
C
Zimmer
Klaus-Peter
KP
Lindemann
Herrmann
H
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D002648:Child; D015536:Down-Regulation; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D017999:Leukotriene E4 / Q000378:metabolism*; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D018836:Inflammation Mediators; D009569:Nitric Oxide; D017999:Leukotriene E4