Effect of regular inhaled beclomethasone on exercise and methacholine airway responses in school children with recurrent wheeze

The role of airway inflammation in the pathogenesis of asthma in childhood is uncertain. In the present study, 27 atopic and nonatopic children aged 7-9 yrs who had > or = 5 episodes of wheeze and symptoms of exercise-induced asthma (EIA) in the previous 12 months, performed a methacholine challenge and exercise test on separate days at monthly intervals. The subjects had not received oral or inhaled corticosteroids for 12 months prior to the study. The dose-response relationship to inhaled methacholine was expressed as the cumulative dose provoking a 20% decrease in forced expiratory volume in one second (PD20). Forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) were measured prior to the exercise test and at 0, 3, 5, 10, 15 and 20 min following maximal exercise. Following the first methacholine challenge and exercise test, the children were randomized in a double-blind manner to receive inhaled beclomethasone dipropionate (BDP) 200 micrograms b.i.d. or a placebo b.i.d. from a Diskhaler for 3 months. All children were asymptomatic at the time of testing, and there was no significant change in the baseline FEV1 of any subject prior to either challenge throughout the study period. When compared to placebo, the bronchial responsiveness to exercise and methacholine was significantly attenuated in the children who had received inhaled BDP for at least 1 month. There was no relationship between the bronchial responsiveness to methacholine and exercise. There was no significant difference in the bronchial responsiveness to either stimulus in the atopic and nonatopic children. The results of this study suggest that immunoglobulin E (IgE)- and non-IgE-mediated airway inflammation are important in exercise- and methacholine-induced bronchoconstriction in children with recurrent wheeze, although it is probable that different mechanisms are responsible.

This article has been cited by other articles:

				F. M. de Benedictis, M. M. del Giudice, N. Forenza, F. Decimo, D. de Benedictis, and A. Capristo Lack of tolerance to the protective effect of montelukast in exercise-induced bronchoconstriction in children Eur. Respir. J., August 1, 2006; 28(2): 291 - 295. [Abstract] [Full Text] [PDF]

				M L Burr, D Wat, C Evans, F D J Dunstan, I J M Doull, and on behalf of the British Thoracic Society Research Asthma prevalence in 1973, 1988 and 2003 Thorax, April 1, 2006; 61(4): 296 - 299. [Abstract] [Full Text] [PDF]

				R. Petersen, L. Agertoft, and S. Pedersen Treatment of exercise-induced asthma with beclomethasone dipropionate in children with asthma Eur. Respir. J., December 1, 2004; 24(6): 932 - 937. [Abstract] [Full Text] [PDF]

				S T Remes, J Pekkanen, K Remes, R O Salonen, and M Korppi In search of childhood asthma: questionnaire, tests of bronchial hyperresponsiveness, and clinical evaluation Thorax, February 1, 2002; 57(2): 120 - 126. [Abstract] [Full Text] [PDF]

				M. SCOLLO, S. ZANCONATO, R. ONGARO, C. ZARAMELLA, F. ZACCHELLO, and E. BARALDI Exhaled Nitric Oxide and Exercise-Induced Bronchoconstriction in Asthmatic Children Am. J. Respir. Crit. Care Med., March 1, 2000; 161(3): 1047 - 1050. [Abstract] [Full Text] [PDF]

				J. M. Edelman, J. A. Turpin, E. A. Bronsky, J. Grossman, J. P. Kemp, A. F. Ghannam, P. T. DeLucca, G. J. Gormley, D. S. Pearlman, and for the Exercise Study Group* Oral Montelukast Compared with Inhaled Salmeterol To Prevent Exercise-Induced Bronchoconstriction: A Randomized, Double-Blind Trial Ann Intern Med, January 18, 2000; 132(2): 97 - 104. [Abstract] [Full Text] [PDF]

				R. Crapo Guidelines for Methacholine and Exercise Challenge Testing---1999 . THIS OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY WAS ADOPTED BY THE ATS BOARD OF DIRECTORS, JULY 1999 Am. J. Respir. Crit. Care Med., January 1, 2000; 161(1): 309 - 329. [Full Text]

				A. L. B. CABRAL, G. M. CONCEIÇÃO, C. H. F. FONSECA-GUEDES, and M. A. MARTINS Exercise-induced Bronchospasm in Children . Effects of Asthma Severity Am. J. Respir. Crit. Care Med., June 1, 1999; 159(6): 1819 - 1823. [Abstract] [Full Text]

				J. A. Leff, W. W. Busse, D. Pearlman, E. A. Bronsky, J. Kemp, L. Hendeles, R. Dockhorn, S. Kundu, J. Zhang, B. C. Seidenberg, et al. Montelukast, a Leukotriene-Receptor Antagonist, for the Treatment of Mild Asthma and Exercise-Induced Bronchoconstriction N. Engl. J. Med., July 16, 1998; 339(3): 147 - 152. [Abstract] [Full Text] [PDF]

				J. Hansen-Flaschen and H. Schotland New Treatments for Exercise-Induced Asthma N. Engl. J. Med., July 16, 1998; 339(3): 192 - 193. [Full Text]

				F. E. R. Simons, T. V. Gerstner, and M. S. Cheang Tolerance to the Bronchoprotective Effect of Salmeterol in Adolescents With Exercise-induced Asthma Using Concurrent Inhaled Glucocorticoid Treatment Pediatrics, May 1, 1997; 99(5): 655 - 659. [Abstract] [Full Text] [PDF]

				P. A. Eggleston Are beta -Adrenergic Bronchodilators Safe? Pediatrics, May 1, 1997; 99(5): 729 - 729. [Full Text]