Effects of inhaled corticosteroids on exhaled leukotrienes and prostanoids in asthmatic children

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:114

Article

Mondino, C ; Ciabattoni, G ; Koch, P ; Pistelli, R ; Trové, A ; Barnes, PJ ; Montuschi, P

关键词: leukotrienes;    prostaglandins;    exhaled breath condensate;    exhaled nitric oxide;    childhood asthma;    airway inflammation;    noninvasive markers;    corticosteroids;   

DOI  :  10.1016/j.jaci.2004.06.054

来源: Elsevier

【 摘 要 】

Background: Lipid mediators play an important pathophysiologic role in atopic asthmatic children, but their role in the airways or atopic nonasthmatic children is unknown. Objective: We sought (1) to measure leukotriene (LT) E-4, LTB4, 8-isoprostane, prostaglandin E-2, and thromboxane B-2 concentrations in exhaled breath condensate in atopic asthmatic and atopic nonasthmatic children; (2) to measure exhaled nitric oxide (NO) as an independent marker of airway inflammation; and (3) to study the effect of inhaled corticosteroids on exhaled eicosanoids. Methods: Twenty healthy children, 20 atopic nonasthmatic children, 30 steroid-naive atopic asthmatic children, and 25 atopic asthmatic children receiving inhaled corticosteroids were included in a cross-sectional study. An open-label study with inhaled fluticasone (100 mug twice a day for 4 weeks) was undertaken in 14 steroid-naive atopic asthmatic children. Results: Compared with control subjects, exhaled LTE4 (P < .001), LTB4 (P < .001), and 8-isoprostane (P < .001) levels were increased in both steroid-naive and steroid-treated atopic asthmatic children but not in atopic nonasthmatic children (LTE4, P = .14; LTB4, P = .23; and 8-isoprostane, P = .52). Exhaled NO levels were increased in steroid-naive atopic asthmatic children (P < .001) and, to a lesser extent, in atopic nonasthmatic children (P < .01). Inhaled fluticasone reduced exhaled NO (53%, P < .0001) and, to a lesser extent, LTE4 (18%, P < .01) levels but not LTB4, prostaglandin E-2, or 8-isoprostane levels in steroid-naive asthmatic children. Conclusions: Exhaled LTE4, LTB4, and 8-isoprostane levels are increased in atopic asthmatic children but not in atopic nonasthmatic children. In contrast to exhaled NO, these markers seem to be relatively resistant to inhaled corticosteroids.

【 授权许可】

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