Genetic polymorphism of GSTM1 and antioxidant supplementation influence lung function in relation to ozone exposure in asthmatic children in Mexico City.

BACKGROUND: We recently reported that antioxidant supplementation with vitamins C and E mitigated ozone related decline in forced expiratory flow (FEF(25-75)) in 158 asthmatic children in an area with high ozone exposure in Mexico City. METHODS: A study was undertaken to determine whether deletion of glutathione S-transferase M1 (GSTM1 null genotype), a gene involved in response to oxidative stress, influences ozone related decline in FEF(25-75) and the benefit of antioxidant supplementation. RESULTS: GSTM1 null children receiving placebo had significant ozone related decrements in FEF(25-75) (percentage change per 50 ppb of ozone 2.9 (95% CI -5.2 to -0.6), p=0.01); GSTM1 positive children did not. Conversely, the effect of antioxidants was stronger in children with the GSTM1 null genotype. CONCLUSIONS: Asthmatic children with a genetic deficiency of GSTM1 may be more susceptible to the deleterious effects of ozone on the small airways and might derive greater benefit from antioxidant supplementation.

[Exhaled nitric oxide as marker of inflammation in children with asthma]. / Oxido nítrico exhalado como marcador de inflamación en niños con asma.

The nitric oxide is a reactive gas that is produced of endogenous way by enzymes nitric oxide sintetase. Exist a great nitric oxide production induced by the isoforms of the enzyme nitric oxide sintetase, that gives as a result the products training citotoxic, they are important mediating of the defence mechanisms and of normal inflammatory response. The nitric oxide can be detected in the air exhaled in human, their concentrations are increased in patient with asthma, and after the exposition to allergens. The measurement of the exhaled nitric oxide is effected by simple methods, not invasive, to value the degree of inflammation of the air route and response to the treatment with steroids in pediatric patients.

[Wheezing in infants]. / Sibilancias en el lactante.

The wheeze are a common symptom in nursing, especially when suffer infections of the respiratory tract. They are common in 75 to 85% of the children, who have wheezes during some stage of their development between 2 to 5 years old. They can be related to smoking motherly during the pregnancy, exposition to the smoke of the tobacco to the subsequent stage to the birth, exposition to environmental and certain factor infections veers them. The wheezes in patient with atopy maybe they are related to a IgE two standard deviations up above of what is normal and persist as asthma in late stages. The wheeze is an affection syndromatic therefore it is obligatory to seek the factor unfetter you to arrive to a definitive diagnosis.

[Evaluation of the efficacy and safety of mepifylline in oral solution in children with mild and moderate asthmatic crises]. / Valoración de la eficacia y seguridad de la mepifilina en solución oral en niños con crisis de asma leve a moderada.

Efficacy and safety of mepiphylline, a derivative of theophylline, was evaluated in a group of children, aged 6 to 10 years, with mild or moderate acute asthma. A parallel, randomized, double-blind, placebo controlled, prospective study was performed in 40 children. Twenty one of them received mepiphylline in dose of 8 mg/kg/día divided in 3 during 10 days, and 19 (control group) received placebo. Salbutamol aerosols were available in both groups. Clinical and spirometric data were collected before the beginning of the treatment (pre-and-post-nebulized salbutamol), and at the 3rd, 7th and 10th days. Children and parents cooperated with a diary of symptoms, peak-flow measurements and account of salbutamol used. A total relief of symptoms was found in 14 patients in the mepiphylline group and just 8 of the control group, with no significant differences. Neither spirometry nor diary data showed significant differences. Salbutamol was less than 3 days of unnecessary in 13 patients (61.9%) in the mepiphylline group and 8 patients (42.1%) in the control group (p < 0.05; Kolmogorov-Smirnov two samples Test). We conclude that mepiphylline could be a complementary treatment of mild and moderate acute asthma with a good safety in children.