Mevsimsel Astım Ve Allerjik Riniti Olan Çocuklarda Tek Doz Setirizin Uygulamasının Adenozin Monofosfat İle Bronşiyal Hiperreaktivite Üzerine Etkisi
Abstract
Bu çalışmanın amacı, allerjik rinitin eşlik ettiği astımlı çocuklarda, rinit tedavisinde kullanılan tekdoz setirizinin, adenozin monofostat (AMP) ile gelişen bronşial hiperreaktivite (BHR) üzerine etkisinin incelenmesidir.Çalışmaya bölümümüzde takip edilen, astımla beraber mevsimsel allerjik riniti olan 7-16 yaş arası 26 hasta alınmıştır. Bu çalışma randomize çift kör ve plasebo kontrollü ve çapraz bir çalışma olarak planlanmıştır. Hastalar kliniğimizde 3 kez görülmüşlerdir. İlk vizitte hastalara Adenozin monofostatla (AMP) ile bronş provokasyon testi yapılıp, PC20 değeri £ 200 mg/ml olanlar 3 gün içerisinde 2. vizite çağrılmışlardır. 2. vizitte solunum fonksiyon testini takiben hastalara randomize olarak ya 10 mg setirizin tablet ya da plasebo verilmiş ve 120 dakika sonra AMP ile bronş provakasyon testine bakılmıştır. 2. vizitten en az 2 gün sonra 3. vizit yapılmış ve benzer prosedürler uygulanmıştır. Çalışmayı tamamlayan 18 hastada Setirizin alan grupta 2. saatte ölçülen PC20AMP değerinin geometrik ortalaması plasebo grubuyla karşılaştırıldığında daha yüksek bulunmuştur (sırasıyla 55.5 ± 5.90 mg/ml ve 17.89 ± 6.38 mg/ml, p<0.05 ). Başka bir deyişle setirizin ortalama geometrik PC20AMP’ yi plaseboya göre 1.58 kat, bazal değere göre 1.65 ikiye katlayan dilusyonda düzeltmiştir. Bu çalışma, astım ve alerjik rinitli çocuklarda setirizinin AMP ile olan bronşprovakasyonunu düzelterek önemli bir antiinflamatuvar etkinliğinin olduğunu göstermiştir. Bu nedenle setirizin sadece alerjik rinitin semptomatik tedavisinde değil aynı zamanda astımı da olan çocuklarda da ek tedavi olarak kullanılabilir. Setirizinin alerjik hastalık spektrumundaki kullanımı için uzun dönem çalışmalar, serum eozinofili, balgam eozinofili, soluk havasında nitrik oksit düzeyi gibi diğer inflamatuvar parametreler üzerine olan etkinliğinin araştırılması gerekmektedir.
References
- Bousquet J, Cauwenberge VP, Khaltaer N. Allergic Rhinitis and its International consensus Report on Diagnosis and Management of Rhinitis. International Rhinitis Management Working Group. Allergy 1994; 49: 1-34.
- Baroody FM, Naclerio RM. Antiallergic effects of H1-receptor an tagonists.Allergy 2000 ; 55 (Suppl 64):17-27.
- Ciprandi G, Ricca V, Tosca M, Landi M, Passalacqua G, Canonica GW.
- Carlsen KH, Carlsen KC. Pharmaceutical treatment strategies for childhood asthma. Curr Opin Allergy Clin Immunol 2008 ;8:168-176.
EFFECT OF SINGLE DOSE CETIRIZINE USE ON BRONCHIAL HYPERREACTIVITY TO ADENOSINE MONOPHOSPHAT IN CHILDREN WITH SEASONAL AND ASTHMA ALLERGIC RHINITIS
Abstract
We investigated the effect of single dose cetrizine which is used in rinitis, on brochial hyperreactivity
due to adenosine monophosphat ( AMP ) in children with asthma and associated allergic rhinitis.
Twentysix children aged 7 to 16 years, with a history of both seasonal allergic rhinitis and asthma
were enrolled in this study which was conducted as a randomized, double-blind, placebocontrolled and cross-over fashion. The patients were seen 3 times in our clinic. At the first visit they
were given bronchial provocative test with AMP. The ones having a PC value of £ 200mg/ml to 20
AMP were called for the second vizit within 3 days. In this visit , he/she was given randomly either
cetrizine 10 mg tablet or placebo after a baseline spirometry. Bronchial challenge with AMP was
started at the 120. minute. The same procedure was repeated at vizit 3, at least 2 days after the vizit
2.
All of the eighteen patients who were able to complete the study protocol demonstrated
significantly better geometric mean of AMP PC values with cetrizine (55.5 ± 5.90 mg/ml) com- 20
pared to those with placebo (17.89 ± 6.38 mg/ml) (P<0.05). In other words, cetrizine improved
geometric mean of AMP PC values 1.58 times as compared to placebo and 1.65 times when 20
compared to basal levels.
In conclusion, this study demonstrates that cetrizine has an important anti-inflammatory effect by
improving AMP PC in children with both asthma and associated allergic rhinitis. Therefore 20
cetrizine may be considered not only for symptomatic treatment of allergic rhinitis but also as an
add-on treatment in children who have asthma allergic rhinitis. Further studies are needed to
determine the long-term effects of cetrizine on, allergic diseases as well as on other inflammatory
markers as exhaled nitric oxide, serum and sputum eosinophilia
References
- Bousquet J, Cauwenberge VP, Khaltaer N. Allergic Rhinitis and its International consensus Report on Diagnosis and Management of Rhinitis. International Rhinitis Management Working Group. Allergy 1994; 49: 1-34.
- Baroody FM, Naclerio RM. Antiallergic effects of H1-receptor an tagonists.Allergy 2000 ; 55 (Suppl 64):17-27.
- Ciprandi G, Ricca V, Tosca M, Landi M, Passalacqua G, Canonica GW.
- Carlsen KH, Carlsen KC. Pharmaceutical treatment strategies for childhood asthma. Curr Opin Allergy Clin Immunol 2008 ;8:168-176.
Details
| Other ID | JA57DH38RD |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | August 1, 2008 |
| Submission Date | August 1, 2008 |
| Published in Issue | Year 2008 Volume: 2 Issue: 1 |
The publication language of Turkish Journal of Pediatric Disease is English.
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