Abstract
Inhaled glucocorticoids may suppress the eosinophil markers serum eosinophil cationic protein (ECP) and urine eosinophil protein X (EPX) in children with asthma. The aim of the present study was to see whether age or administration regimen may affect the suppressive effect of inhaled budesonide on serum ECP or serum or urine EPX in children with asthma. Two separate randomized double-blind crossover trials with two treatment periods of 4 weeks duration were conducted. Study 1: Inhaled budesonide 400 μg twice daily versus placebo in 14 13- to 16-year-old adolescents. Study 2: Inhaled budesonide 800 μg once daily versus 400 μg twice daily in 22 prepubertal children aged 5-12 years. Blood and urine samples were collected on the last day of each period for assessment of serum ECP, serum EPX, and urine EPX by radioimmunoassays. In study 1 (the adolescent group), placebo and budesonide serum ECP (mean SEM) were 8.7 (0.9) and 5.5 (0.8) μg/L (p < 0.01), serum EPX 32.2 (2.9) and 24.7 (2.4 μg/L (p = 0.04), and urine EPX/creatinine 41.6 (6.9) and 27.0 (2.8) μg/mmol (p = 0.03), respectively). In study 2 (the prepubertal group), run in serum EPX (31.3 (2.8) μg/L) was reduced during both the budesonide 800 μg once daily [27.6 (2.6) μg/L (p = 0.02)] and the 400 μ g twice daily [25.0 (1.8) μg/L (p = 0.01)] budesonide period, whereas serum ECP and urine EPX did not vary between the periods. Serum ECP and urine EPX may be more sensitive markers of anti-inflammatory effects of inhaled glucocorticoids in adolescents than in prepubertal children with asthma, and the suppressive effect seems not to differ between once- and twice-daily administration.
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