Anti-inflammation mechanism and effect of the combination therapy of montelukast and inhaled corticosteroid on the moderate continuous asthma in children

Objective To observe the clinical effect of the combined administration of montelukast and inhaled corticosteroid on children with moderate continuous asthma and investigate the anti-inflammation mechanism of montelukast.Methods 60 children with moderate continious asthma aged 2-5 years old were randomly divided into two groups,group A:4 mg montelukast orally daily plus 200 μg budesonide inhaled daily(30 cases)and group B:200 μg budesonide inhaled daily(30 cases).The duration of treatment was 3 months.20 health children were served as normal control group.Before starting therapy,4 weeks and 3 months later,clinical effects were observed;the concentrations of serum CysteinyLTs(CysLTs)and Interleukin-5(IL-5)were measured.Results Before treatment,the levels of CysLTs and IL-5 in patients with asthma were significantly higher than those in normal control group(P0.01).After treatment,the asthmatic symptoms score,the length of each exacerbation episode,the number of exacerbation and the total amount of systemic corticosteroid used of group A were significantly lower than those of group B(P0.01);CysLTs and IL-5 levels decreased significantly in group A compared with those in group B(P0.05,P0.01,).CysLTs levels in group B had no significantly difference both pre-treatment and post-treatment(P0.05).Conclusion The combination of montelukast and inhaled corticosteroid is more effective than only inhaled corticosteroid in children with moderate continuous asthma,it also can lower the total amount of systematic corticosteroid used.Montelukast can lower the levels of CysLTs and IL-5 in serum of children with moderate continuous asthma,inhibit the release inflammatory mediator.The suppressive effects may be an important mechanisms for montelukast to antagonize airway inflammation of asthma.