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The efficacy of single-high dose inhaled corticosteroid versus oral prednisone treatment on exhaled leukotriene and 8-isoprostane levels in mild to moderate asthmatic children with asthma exacerbation.
Allergol Immunopathol (Madr). 2016 Mar-Apr; 44(2):138-48.AI

Abstract

BACKGROUND

The anti-inflammatory effect of high-dose inhaled corticosteroids (ICS) in children with asthma exacerbation is unknown. We aimed to investigate the efficacy of single-high dose ICS versus oral prednisone treatment followed by a course of six day high-dose ICS or oral prednisone (P) treatment on the concentrations of Cys-LTs and 8-isoprostane levels in the exhaled breath condensate (EBC) of children with asthma exacerbation.

METHODS

Ninety-four children with moderate-severe asthma exacerbation were evaluated with asthma scores, peak expiratory flow rate (PEF), forced expiratory volume in first second (FEV1) and exhaled Cys-LT and 8-isoprostane levels before and after treatment. EBC was collected from 52 patients before and four hours after treatment with inhaled fluticasone propionate (FP) (4000 μg) or P and after six days of treatment with FP-1000 μg/day or P. Cys-LTs and 8-isoprostane concentrations were determined using a specific immunoassay kit.

RESULTS

Both single high-dose FP (n=59) and p (n=35) treatment resulted in a significant improvement in asthma score (p<0.0001), PEF (p<0.0001), and FEV1 (p<0.0001). Cys-LT concentration in the EBC decreased significantly both after the initial treatment (p=0.001), and at the end of the six-day period in the FP group (p<0.0001). 8-Isoprostane concentration was lower only after six days of treatment with FP-1000 μg/day in the FP group (p=0.023). There was a significant decrease in exhaled Cys-LTs after four hours (p=0.012) and six days of P treatment (p=0.018) in children with asthma exacerbation.

CONCLUSIONS

High-dose ICS treatment may be useful in the treatment of children with asthma exacerbation. The effects start as early as after four hours. The suppression of Cys-LTs production contributes to the early effects. Suppression of both Cys-LTs and oxidants may favourably contribute to the effects observed later.

Authors+Show Affiliations

Department of Pediatric Allergy and Immunology, Gaziantep University School of Medicine, Gaziantep, Turkey. Electronic address: okeskin@gantep.edu.tr.Department of Pediatrics, Gaziantep University School of Medicine, Gaziantep, Turkey.Department of Pediatrics, Gaziantep University School of Medicine, Gaziantep, Turkey.Department of Pulmonology, Gaziantep University School of Medicine, Gaziantep, Turkey.Department of Pediatric Allergy and Immunology, Gaziantep University School of Medicine, Gaziantep, Turkey.Department of Pediatric Allergy and Immunology, Gaziantep University School of Medicine, Gaziantep, Turkey.Department of Biostatistics, Gaziantep University School of Medicine, Gaziantep, Turkey.Department of Pulmonology, Gaziantep University School of Medicine, Gaziantep, Turkey.Department of Pediatrics, Gaziantep University School of Medicine, Gaziantep, Turkey.

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26318413

Citation

Keskin, O, et al. "The Efficacy of Single-high Dose Inhaled Corticosteroid Versus Oral Prednisone Treatment On Exhaled Leukotriene and 8-isoprostane Levels in Mild to Moderate Asthmatic Children With Asthma Exacerbation." Allergologia Et Immunopathologia, vol. 44, no. 2, 2016, pp. 138-48.
Keskin O, Uluca U, Keskin M, et al. The efficacy of single-high dose inhaled corticosteroid versus oral prednisone treatment on exhaled leukotriene and 8-isoprostane levels in mild to moderate asthmatic children with asthma exacerbation. Allergol Immunopathol (Madr). 2016;44(2):138-48.
Keskin, O., Uluca, U., Keskin, M., Gogebakan, B., Kucukosmanoglu, E., Ozkars, M. Y., Kul, S., Bayram, H., & Coskun, Y. (2016). The efficacy of single-high dose inhaled corticosteroid versus oral prednisone treatment on exhaled leukotriene and 8-isoprostane levels in mild to moderate asthmatic children with asthma exacerbation. Allergologia Et Immunopathologia, 44(2), 138-48. https://doi.org/10.1016/j.aller.2015.05.006
Keskin O, et al. The Efficacy of Single-high Dose Inhaled Corticosteroid Versus Oral Prednisone Treatment On Exhaled Leukotriene and 8-isoprostane Levels in Mild to Moderate Asthmatic Children With Asthma Exacerbation. Allergol Immunopathol (Madr). 2016 Mar-Apr;44(2):138-48. PubMed PMID: 26318413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The efficacy of single-high dose inhaled corticosteroid versus oral prednisone treatment on exhaled leukotriene and 8-isoprostane levels in mild to moderate asthmatic children with asthma exacerbation. AU - Keskin,O, AU - Uluca,U, AU - Keskin,M, AU - Gogebakan,B, AU - Kucukosmanoglu,E, AU - Ozkars,M Y, AU - Kul,S, AU - Bayram,H, AU - Coskun,Y, Y1 - 2015/08/28/ PY - 2015/02/06/received PY - 2015/04/28/revised PY - 2015/05/07/accepted PY - 2015/8/31/entrez PY - 2015/9/1/pubmed PY - 2016/12/15/medline KW - 8-Isoprostane KW - Asthma exacerbation KW - Children KW - Cysteinyl leukotrienes KW - Exhaled breath condensate KW - Inhaled corticosteroids KW - Oral prednisone KW - Oxidative stress SP - 138 EP - 48 JF - Allergologia et immunopathologia JO - Allergol Immunopathol (Madr) VL - 44 IS - 2 N2 - BACKGROUND: The anti-inflammatory effect of high-dose inhaled corticosteroids (ICS) in children with asthma exacerbation is unknown. We aimed to investigate the efficacy of single-high dose ICS versus oral prednisone treatment followed by a course of six day high-dose ICS or oral prednisone (P) treatment on the concentrations of Cys-LTs and 8-isoprostane levels in the exhaled breath condensate (EBC) of children with asthma exacerbation. METHODS: Ninety-four children with moderate-severe asthma exacerbation were evaluated with asthma scores, peak expiratory flow rate (PEF), forced expiratory volume in first second (FEV1) and exhaled Cys-LT and 8-isoprostane levels before and after treatment. EBC was collected from 52 patients before and four hours after treatment with inhaled fluticasone propionate (FP) (4000 μg) or P and after six days of treatment with FP-1000 μg/day or P. Cys-LTs and 8-isoprostane concentrations were determined using a specific immunoassay kit. RESULTS: Both single high-dose FP (n=59) and p (n=35) treatment resulted in a significant improvement in asthma score (p<0.0001), PEF (p<0.0001), and FEV1 (p<0.0001). Cys-LT concentration in the EBC decreased significantly both after the initial treatment (p=0.001), and at the end of the six-day period in the FP group (p<0.0001). 8-Isoprostane concentration was lower only after six days of treatment with FP-1000 μg/day in the FP group (p=0.023). There was a significant decrease in exhaled Cys-LTs after four hours (p=0.012) and six days of P treatment (p=0.018) in children with asthma exacerbation. CONCLUSIONS: High-dose ICS treatment may be useful in the treatment of children with asthma exacerbation. The effects start as early as after four hours. The suppression of Cys-LTs production contributes to the early effects. Suppression of both Cys-LTs and oxidants may favourably contribute to the effects observed later. SN - 1578-1267 UR - https://www.unboundmedicine.com/medline/citation/26318413/The_efficacy_of_single_high_dose_inhaled_corticosteroid_versus_oral_prednisone_treatment_on_exhaled_leukotriene_and_8_isoprostane_levels_in_mild_to_moderate_asthmatic_children_with_asthma_exacerbation_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0301-0546(15)00102-0 DB - PRIME DP - Unbound Medicine ER -