Evaluation of Effects of Inhaled Corticosteroid (Budesonide) on Cycstatin C, Angiotensin Converting Enzyme, α -1-Antityripsin, Interleukin–8 and Clinical Status in Mild to Moderate Persistant Asthmatic Children

Öz

Aim: Inhaled corticosteroids have a major role in treating childhood asthma. This study evaluated the effects of budesonide on the clinical and laboratory parameters in asthmatic children. Material and Methods: This prospective study was conducted at the Zonguldak Bülent Ecevit School of Medicine Hospital Pediatric Allergy outpatient clinic between May and October 2004 with 27 mild to moderate persistent asthmatic children and 25 healthy children as the control group. For the first four weeks, the patient group was given symptom score charts, inhaled salbutamol 4x100 µgr daily, and between the fifth and eighth weeks inhaled corticosteroid 1x400 µgr daily. At the beginning of the fifth week and the end of the eighth week, the patient group’s physical examinations were performed, lung functions were assessed, and serum parameters (serum total IgE, eosinophil, ECP, cystatin C, angiotensin-converting enzyme, α-1-antitrypsin, and IL-8) were collected. Results: Although the two groups were similar in terms of sex, weight, and height at the beginning of the study, serum total IgE (p=0.001), eosinophil (p=0.001), eosinophil cationic protein (p=0.001), and ACE values (p=0.004) were significantly higher in the patient group. The comparison of the fourth and eighth weeks' lung function parameters revealed significant improvement in FEV1 (p=0.001), PEF (p=0.003), and FEF %25-75 (p=0.002) in the patient group. A significant decrease was detected in total Ig E (p=0.017), serum eosinophil (p=0.014), eosinophil cationic protein (p=0.015), and, cystatin C (p=0.002) values as well. When the daytime and nighttime symptoms of the patient group were compared consecutively, no differences were observed between the weeks. Conclusion: We conclude that total IgE, eosinophil, ECP, and cystatin C levels may be useful for the follow-up of the treatment of asthma in children.

Anahtar Kelimeler

• asthma
• steroids
• cystatin C
• eosinophil cationic protein
• immunoglobin E

Hafif-Orta Persistan Astımlı Çocuklarda İnhale Kortikosteroid (Budesonide)'in Serum α -1-Antitiripsin, Sistatin C, ACE, IL-8 ve Klinik Üzerine Etkisinin Araştırılması

Öz

Amaç: Bu çalışma astımlı çocukların tedavisinde önemli yeri olan inhale kortikosteroidlerin çocukluk çağı astımında klinik ve laboratuvar parametreleri üzerine etkilerinin incelenmesi amacıyla yapılmıştır. Gereç ve Yöntemler: Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Çocuk Alerji polikliniğinde Mayıs-Ekim 2004 tarihlerinde yapılan prospektif bir çalışmadır. Hafif-orta persistan astım tanısı olan 27 çocuk hasta grubu, 25 sağlıklı çocuk kontrol grubu olarak alındı. Çalışmanın başlangıcında hasta grubuna gündüz ve gece belirtilerini puanlamaları için takip kartları verildi. Hasta grubu 0-4. haftalarda 4x100 µgr salbutamol, 5-8. haftalarda 1x400 µgr inhale kortikosteroid verilerek toplam 8 hafta izlendi. Beşinci haftanın başında ve 8. hafta sonunda hastaların fizik incelemeleri yapılarak laboratuvar değerleri (serum total IgE, eozinofil, eozinofilik katyonik protein, serum alfa -1-antitripsin, sistatin c, anjiyotensin dönüştürücü enzim, IL-8 ) ve solunum fonksiyonları değerlendirildi. Bulgular: Çalışmanın başlangıcında hasta grubu ve kontrol grubu arasında cinsiyet, ağırlık ve boy açısından anlamlı bir farklılık yok iken, hasta grubunda serum total IgE (p=0.001), eozinofil (p=0.001), eozinofilik katyonik protein (p=0.001) ve ACE (p=0.004) değerleri anlamlı düzeyde yüksek bulundu. Hasta grubunda dördüncü ve sekizinci haftaların sonundaki laboratuvar değerleri ve solunum fonksiyon testleri karşılaştırıldı. FEVı (p=0.001), PEF (p=0.003) ve FEF %25-75 (p=0.002) de artış, total Ig E (p=0.017), serum eozinofil (p=0.014), eozinofilik katyonik protein (p=0.015) ve sistatin C (p=0.002) düzeylerinde anlamlı azalma gözlendi. Hasta grubunun gündüz ve gece belirtileri ardışık olarak karşılaştırıldığında haftalar arasında farklılık gözlenmedi. Sonuç: Çalışmamızdaki laboratuvar değerlerinden serum total IgE, eozinofil, eozinofilik katyonik protein ve sistatin C, astım tedavisine yanıtın izlenmesinde yol gösterebilir.

Anahtar Kelimeler

• astım
• steroidler
• sistatin C
• eozinofil katyonik protein
• immünglobin E

Destekleyen Kurum

Yoktur

Etik Beyan

Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Hastanesi Etik Kurulu tarafından 27.05.2004 tarihinde 2004/05 toplantı numarası ile onaylanmıştır.

Teşekkür

Yoktur

Kaynakça

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