title: Effect of different monotherapies on serum nitric oxide and pulmonary functions in children with mild persistent asthma.
abstract: BACKGROUND
  Common medications used to treat mild persistent asthma are glucocorticoids, leukotriene receptor antagonists and theophylline. The aim of the study was to evaluate monotherapy with either inhaled steroids, oral leukotriene receptor antagonist or theophylline in Egyptian children with mild persistent asthma by determining their clinical, laboratory and spirometric responses to treatment.
  
  
  METHODS
  Thirty-nine mild asthmatic children between 8 and 13 years of age were included in the study. Patients were classified according to therapy received into four groups: oral leukotriene receptor antagonist (montelukast), inhaled corticosteroid (fluticasone propionate), sustained-release (SR) theophylline, and no treatment. Pulmonary function testing was performed at the start of therapy and 8 weeks later using spirometry. Eosinophil count and serum nitric oxide were estimated in the blood. Minitab statistical package was used for analysis of data.
  
  
  RESULTS
  Follow-up after 8 weeks revealed significant improvement in FEV1% in groups 1 (p < 0.01) and 3 (p < 0.05), significant improvement in PEFR in groups 1 (p < 0.05) and 2 (p < 0.01), significant decline in serum NO levels in groups 1 (p < 0.05) and 2 (p < 0.05), as well as significant improvement in eosinophil count in groups 1, 2 and 3 (p < 0.01, < 0.001, < 0.01 respectively). There was a statistically significant positive correlation between the decline in serum NO and the decline in blood eosinophil % in group 2 (p < 0.05).
  
  
  CONCLUSIONS
  Inhaled corticosteroids and montelukast have a significant role in controlling the pulmonary functions and the inflammatory process in children with mild persistent asthma, although inhaled corticosteroids seem to yield a better response. Children with mild persistent asthma should receive a controller medication, and SR theophylline may be a good cost-benefit alternative for low socio-economic groups of patients.
authors.affiliation: Paediatrics Department, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Zeinab Mohamed
authors.initials: ZM
authors.lastname: Radwan
authors.forename: Gamal Abdel
authors.initials: GA
authors.lastname: Nasser Yamamah
authors.forename: Hala Hamdy
authors.initials: HH
authors.lastname: Shaaban
authors.forename: Azza Mohamed
authors.initials: AM
authors.lastname: Omar Abdel-Rahman
authors.forename: Amany
authors.initials: A
authors.lastname: Abdel-Ghany Ismaeil
authors.forename: Elham
authors.initials: E
authors.lastname: Mohamed Mostafa