Exhaled NO and eosinophil markers in blood, nasal lavage and sputum in children with asthma after withdrawal of budesonide

Pediatr Allergy Immunol. 2004 Aug;15(4):351-8. doi: 10.1111/j.1399-3038.2004.00165.x.

Abstract

Background: There is a need for controlled trials among children with asthma to evaluate and compare different markers of inflammation.

Objective: Our goal was to investigate the effect of withdrawal of inhaled budesonide on repeated measurements of exhaled NO (ENO), peripheral blood eosinophils (PBE), sputum/NAL/serum-eosinophil cationic protein (ECP), bronchial hyperresponsiveness (BHR) and forced expiratory volume in 1 s (FEV(1)) in children with allergic asthma.

Methods: Eighteen asthmatic children were randomly allocated to continue or discontinue use of inhaled budesonide. They were followed up, at six visits for 4 months with regular blood, serum, sputum, and NAL samples. Sixteen age-matched healthy children served as controls.

Results: ENO, PBE, and S-ECP increased significantly in the withdrawal group (p < 0.05) but not in the continuous treatment group. No trend could be observed during the study for markers in sputum or in NAL in either group.

Conclusion: The present data provide evidence for the clinical usefulness of measuring ENO, PBE, and S-ECP and when combined they could help to avoid over- and undertreatment with corticosteroids in the growing child.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / metabolism
  • Asthma / physiopathology
  • Biomarkers / analysis*
  • Bronchial Hyperreactivity / drug therapy
  • Bronchial Hyperreactivity / metabolism
  • Bronchial Hyperreactivity / physiopathology
  • Bronchial Provocation Tests
  • Budesonide / therapeutic use*
  • Child
  • Eosinophil Cationic Protein / analysis
  • Eosinophils / metabolism*
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Inflammation / physiopathology
  • Male
  • Nasal Lavage Fluid / chemistry
  • Nasal Lavage Fluid / immunology
  • Nitric Oxide / analysis*
  • Nitric Oxide / metabolism
  • Sputum / chemistry
  • Sputum / immunology

Substances

  • Anti-Inflammatory Agents
  • Biomarkers
  • Nitric Oxide
  • Budesonide
  • Eosinophil Cationic Protein