Can exhaled inflammatory markers predict a steroid response in wheezing preschool children?
Clin Exp Allergy
; 41(8): 1076-83, 2011 Aug.
Article
em En
| MEDLINE
| ID: mdl-21623968
ABSTRACT
BACKGROUND:
The efficacy of inhaled corticosteroids (ICS) varies among wheezing preschool children. Currently, it is not possible to predict which fraction of wheezing children will benefit from an ICS treatment.OBJECTIVE:
We explored whether fractional exhaled nitric oxide (FeNO) and inflammatory markers in exhaled breath condensate (EBC) can predict an ICS response in preschool wheezers.METHODS:
An 8-week ICS study (registered at Clinicaltrial.gov NCT 00422747; 200 µg; beclomethasone extra-fine daily) was performed in 93 wheezing children (age range 2.0-4.4 years). At baseline, FeNO was determined off-line. EBC was collected using a closed glass-condenser. The acidity of EBC was determined and other EBC markers [interleukin (IL)-1α, IL-2, IL-4, IL-5, IL-10, soluble intercellular adhesion molecule, interferon-γ, eotaxin] were measured using a multiplex immunoassay. The change in airway resistance (Rint) and symptom score following ICS treatment was related to atopy (positive Phadiatop Infant test), FeNO and EBC markers.RESULTS:
Airway resistance and symptoms mildly improved after ICS treatment [median (IQR) 1.4 (1.2-1.7) to 1.3 (1.1-1.5) kPa s/L, symptom score 26 (23-28) to 28 (24-29), P < 0.01, respectively]. Only IL-10 and atopy had limited predictive value regarding a change in symptoms [ß (SE) =-0.13 (0.07), P = 0.08, ß (SE) = 2.05 (1.17), P = 0.08, respectively]. CONCLUSIONS AND CLINICAL RELEVANCE We did not find convincing evidence that FeNO and EBC markers could predict an ICS response in preschool wheezers. Recommendations for future studies on this topic are given.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Sons Respiratórios
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Corticosteroides
Tipo de estudo:
Guideline
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Prognostic_studies
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Risk_factors_studies
Limite:
Child, preschool
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article