Document Detail

Protection against exercise-induced bronchoconstriction by montelukast in aspirin-sensitive and aspirin-tolerant patients with asthma.
MedLine Citation:
PMID:  12220476     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Montelukast, a cysteinyl-leukotriene receptor antagonist, was reported to have a protective effect against exercise-induced bronchoconstriction (EIB). Aspirin-induced asthma (AIA) is characterized by overproduction of cysteinyl-leukotrienes. OBJECTIVE: The aim of the study was to compare the response to exercise and the effect of montelukast on EIB in AIA as compared to aspirin-tolerant asthma (ATA). METHODS: A placebo-controlled, double blind, cross-over randomized study was performed in 19 AIA and 21 ATA patients with stable asthma. A single dose of montelukast (10 mg) or placebo (PL), was given orally one hour prior to exercise challenge. FEV1 was measured before and 5, 10, 15 min after exercise and then at 15-minute intervals for 4 h. Urinary LTE4 excretion and blood eosinophil count were measured at baseline, 2 h and 4 h following exercise challenge. RESULTS: Positive bronchial response to exercise was observed in 47.5% of all patients studied. Exercise led to almost identical maximal fall in FEV1 in AIA and ATA patients (23.5% +/- 6.8% vs. 21.8% +/- 12.0%, respectively; P = 0.7). Montelukast, as compared to PL, significantly attenuated EIB in 63.2% of 19 patients with positive exercise test preceded by PL. The mean of maximum fall in FEV1 from the pre-exercise value was 10.2% +/- 13.8 after montelukast as compared to 22.5% +/- 10.2 after placebo (P < 0.001). No significant differences between protective effect of montelukast was observed in AIA as compared to ATA patients (P = 0.63, anova). Urinary LTE4 excretion showed no change following exercise, irrespective of the result of the test in all subjects. CONCLUSION: Patients with AIA and ATA react similarly to exercise challenge and obtain similar protection against EIB by montelukast.
L Mastalerz; A Gawlewicz-Mroczka; E Nizankowska; A Cmiel; A Szczeklik
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  32     ISSN:  0954-7894     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-10     Completed Date:  2003-03-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  1360-5     Citation Subset:  IM    
Department of Medicine, Jagiellonian University School of Medicine, Cracow, Poland.
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MeSH Terms
Acetates / therapeutic use*
Analysis of Variance
Anti-Inflammatory Agents, Non-Steroidal / immunology*
Aspirin / immunology*
Asthma, Exercise-Induced / immunology,  physiopathology,  prevention & control*
Cross-Over Studies
Double-Blind Method
Drug Hypersensitivity / immunology*
Exercise Test
Forced Expiratory Volume
Leukotriene Antagonists / therapeutic use*
Leukotriene E4 / urine
Lung / physiopathology
Middle Aged
Quinolines / therapeutic use*
Reg. No./Substance:
0/Acetates; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Leukotriene Antagonists; 0/Quinolines; 158966-92-8/montelukast; 50-78-2/Aspirin; 75715-89-8/Leukotriene E4

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