Bronchial asthma is a chronic lung disease characterized by reversible airway obstruction, inflammation, and bronchial hyperresponsiveness. The leukotrienes and, in particular, the cysteinyl leukotrienes (Cys LTs) mediate central components of asthmatic airway inflammation such as bronchospasm, mucus production, eosinophil recruitment, and vascular reactions leading to tissue edema. Preliminary data with leukotriene antagonists suggested that they show some beneficial effects in asthmatic children.
This study aimed to evaluate the efficacy of leukotriene antagonist compared to inhaled corticosteroid in the treatment of children with mild persistent asthma
Methods:
This study included 70 children with mild persistent bronchial asthma(48 males and 22 females) with age ranging from 5 to 14 years attending to the outpatient clinic and emergency unit of pediatric department, Assiut University Hospitals, during the period from January (2012) to January (2013). Besides meticulous history and thorough clinical examination, all cases were subjected to the following investigations: CBC including absolute eosinophilic count, Urinary leukotriene E4,serum IL-5 and Pulmonary function tests: included PEFR and FEV.
As regard therapy, patients were divided into two subgroups (35 patients each), one of them received leukotriene antagonist (montelukast) and the other one received inhaled corticosteroid (fluticasone) for 1 month duration. The clinical and laboratory assessment were done on admission and after one month of treatment.
Results:
: No significant differences were found between both groups of patients regarding all parameters( AEC, LE4 ,IL-5, PEFR and FEV1) before and after treatments . After one month of treatment patients in both groups showed significantly lower values of the following parameters :
( AEC, LE4 and IL-5) and significantly higher values of FEV1than before starting treatments ,whereas ,no significant difference were found in both groups regarding PEFR before and after treatment
Conclusions: : Leukotriene antagonists can be used as a monotherapy in patients with mild persistent asthma as alternative to ICS with similar efficacy, better compliance and less side effects