WESTPORT, CT (Reuters Health) – Treatment with inhaled triamcinolone acetonide reduces levels of serum markers of inflammation and improves lung function in children with atopic asthma, according to Polish researchers.
Dr. Iwona Stelmach of M. Curie Hospital, Zgierz, and colleagues suggest that measurement of peripheral blood markers might be a useful method of monitoring airway inflammation, particularly in young children. Thus, "difficult" objective tests such as sputum induction and bronchial biopsy could be avoided.
To test the efficacy of this approach, the researchers conducted a double-blind study of 48 dust-mite sensitive children (ages 6 to 18 years) with mild to moderate asthma. They were randomized to twice-daily treatment with a total of 400 µg of triamcinolone (Azmacort; Rhone-Poulenc Rorer, Collegeville, PA) or placebo. The findings appeared in the October issue of the Annals of Allergy, Asthma and Immunology.
After 4 weeks of treatment, there was a significant improvement in measures of lung function (FEV1) and in bronchial hyperresponsiveness to histamine challenge (PC20). There was also a significant decrease in serum inflammatory markers including eosinophil blood count, eosinophil cationic protein (ECP) and soluble receptor of interleukin-2 (sIL-2R).
Furthermore, a significant correlation was found between ECP and sIL-2R both before and after triamcinolone treatment. However, no significant correlation was seen between the clinical markers of disease severity, FEV1 and PC20, and any of the serum markers of allergic inflammation.
The researchers, who suggest that "each inflammatory marker may show different degrees of responsiveness to inhaled steroids," call for wider ranging studies to investigate this possibility.
Ann Allergy Asthma Immunol 2001;87:319-326.
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