title: Effect of montelukast on markers of airway remodeling in children with asthma.
abstract: BACKGROUND
  Asthma is a pathology characterized by chronic inflammation and remodeling of the airways.
  
  
  OBJECTIVE
  To evaluate the effect of montelukast treatment on markers of airway inflammation and remodeling in children with mild asthma and to evaluate if the administration of montelukast to children with mild asthma could inhibit the release of matrix metallopeptidase 9, matrix metallopeptidase 12, tissue inhibitor of metalloproteinase 1, transforming growth factor beta 1, C-peptide terminal procollagen type (PICP), and eosinophils count, which are markers of inflammation and remodeling in induced sputum.
  
  
  METHODS
  Thirty children with mild asthma were recruited. They were randomized into two groups: group A received montelukast and as needed beta-2-agonist for 8 weeks (T0-T1), whereas group B received placebo and as needed beta-2-agonist for 8 weeks. After 2 weeks of washout (T1-T2), they were reallocated for treatment according a crossover design (T2-T3). Tests for lung function, oral exhaled nitric oxide, and hypertonic saline solution-induced sputum level were performed at T0-T1-T2-T3.
  
  
  RESULTS
  In the placebo group, the PICP mean (standard deviation [SD]) value at baseline was 2279.42 ± 2530.77 pg/mL and 1916.00 ± 2178.75 pg/mL after treatment. Patients treated with montelukast, in contrast, showed a baseline mean (SD) value of 2439.29 ± 2834.51 pg/mL and 1406.72 ± 1508.65 pg/mL after treatment. The difference between the mean pre- and posttreatment decrease of PICP in the two groups was statistically significant (delta -690.21 pg/mL [95% confidence interval, -1220.83 to -159.5844 pg/mL]; p = 0.011). The mean (SD) percentage of the eosinophil count in the placebo group was 3.11 ± 4.03% at baseline and 4.86 ± 5.83% after treatment. Patients treated with montelukast, in contrast, showed a percentage mean (SD) value at baseline of 4.51 ± 5.48% and, after treatment, of 3.06 ± 3.29%. The difference between the mean pre- and posttreatment decrease of the percentage eosinophil count in the two groups was statistically significant (delta -2.76% [95% confidence interval, -4.65 to -0.87%]; p = 0.004).
  
  
  CONCLUSIONS
  This study investigated in vivo effects of montelukast on remodeling markers. The reduction of PICP levels and eosinophil count supported the hypothesis that montelukast can modulate collagen deposition in airways and reduce eosinophilic airway inflammation. Clinical Trials database clinicaltrials.gov (NCT00875082).
authors.affiliation: University of Verona, Verona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Tenero
authors.forename: Michele
authors.initials: M
authors.lastname: Piazza
authors.forename: Marco
authors.initials: M
authors.lastname: Sandri
authors.forename: Annachiara
authors.initials: A
authors.lastname: Azzali
authors.forename: Iolanda
authors.initials: I
authors.lastname: Chinellato
authors.forename: Diego
authors.initials: D
authors.lastname: Peroni
authors.forename: Attilio
authors.initials: A
authors.lastname: Boner
authors.forename: Giorgio
authors.initials: G
authors.lastname: Piacentini
mesh_terms: D000085:Acetates / Q000494:pharmacology / Q000627:therapeutic use*; D000293:Adolescent; D056151:Airway Remodeling; D018927:Anti-Asthmatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D015415:Biomarkers; D002648:Child; D003521:Cyclopropanes; D005260:Female; D006801:Humans; D008297:Male; D011804:Quinolines / Q000494:pharmacology / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D013440:Sulfides; D016896:Treatment Outcome
chemical_list: D000085:Acetates; D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; C093875:montelukast