title: Association of symptom control with changes in lung function, bronchial hyperresponsiveness, and exhaled nitric oxide after inhaled corticosteroid treatment in children with asthma.
abstract: BACKGROUND
  A key therapeutic approach to asthma, which is characterized by chronic airway inflammation, is inhaled corticosteroid (ICS). This study evaluated the association of symptom control with changes in lung function, bronchial hyperresponsiveness (BHR), and exhaled nitric oxide (eNO) after ICS treatment in asthmatic children.
  
  
  METHODS
  A total of 33 children aged between 5 and 12 years with mild to moderate persistent asthma were treated with 160 μg ciclesonide per day for 3 months. At days 0 and 90, the following parameters were assessed: asthma symptom scores; lung function, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25-75% of forced vital capacity (FEF25-75%); BHR to methacholine and adenosine 5-monophosphate (AMP); and eNO.
  
  
  RESULTS
  Asthma symptom scores, lung function parameters, BHR to methacholine and AMP, and eNO levels at day 90 were significantly improved versus day 0 (all p < 0.001). Symptom scores at day 90 were not correlated with changes in lung function and BHR to methacholine during the follow-up period, whereas those at day 90 were more closely correlated with changes in BHR to AMP (r = 0.511, p = 0.003) than with eNO (r = -0.373, p = 0.035). Additionally, changes in PC20AMP were correlated with changes in PC20methacholine (r = 0.451, p = 0.011) and eNO (r = -0.474, p = 0.006).
  
  
  CONCLUSIONS
  Changes in the BHR to AMP, and to a lesser extent eNO, correlate with asthma symptom control after ICS treatment. BHR to AMP may better reflect the relationship between improved airway inflammation due to ICS treatment and asthma symptoms.
authors.affiliation: Department of Pharmacy, Asan Medical Center, Seoul, South Korea.
authors.forename: Geun-Mi
authors.initials: GM
authors.lastname: Park
authors.affiliation: Department of Pharmacy, Asan Medical Center, Seoul, South Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Han
authors.affiliation: Department of Pharmacy, Asan Medical Center, Seoul, South Korea.
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jisun
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Soo-Jong
authors.initials: SJ
authors.lastname: Hong
authors.affiliation: Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, South Korea.
authors.forename: Song-I
authors.initials: SI
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Soonchunhyang University School of Medicine, Seoul, South Korea.
authors.forename: Hyeon-Jong
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: jyu3922@gmail.com.
authors.forename: Jinho
authors.initials: J
authors.lastname: Yu
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D045853:Exhalation; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D009569:Nitric Oxide; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D012882:Skin Tests
chemical_list: D000305:Adrenal Cortex Hormones; D009569:Nitric Oxide; D007073:Immunoglobulin E
keywords: Adenosine 5-monophosphate; Asthma; Bronchial hyperresponsiveness; Children; Inhaled corticosteroid