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奈多罗米钠对尘螨过敏儿童哮喘临床和炎症参数影响的双盲、随机、安慰剂对照试验

Double-blind, randomized, placebo-controlled trial of effect of nedocromil sodium on clinical and inflammatory parameters of asthma in children allergic to dust mite.

作者信息

Stelmach I, Jerzynska J, Brzozowska A, Kuna P

机构信息

M. Curie Hospital, Department of Pediatrics and Allergy, Zgierz, Poland.

出版信息

Allergy. 2001 Jun;56(6):518-24. doi: 10.1034/j.1398-9995.2001.056006518.x.

Abstract

BACKGROUND

The purpose of this study was to determine the clinical effect of nedocromil sodium and its relationship with serum levels of inflammatory mediators by monitoring lung function and noninvasive markers of airway inflammation, such as eosinophil blood counts; serum ECP, sIL-2R, IL-4 and sICAM; and total IgE. Anti-inflammatory medications cause a reduction in the markers of airway inflammation, decrease the intensity of airway hyperresponsiveness, and improve clinical symptoms of asthma. Among the available choices is nedocromil sodium, which is favored in the treatment of asthmatic children due to its very mild side-effects. It has been previously shown to improve the clinical parameters of asthma, but there are limited data on its effect on inflammatory mediators in the serum of asthmatic children.

METHODS

In this double-blind, randomized, placebo-controlled 8-week trial, 39 children, aged 9-16 years, with moderate atopic asthma were randomly allocated to receive either nedocromil sodium, two puffs twice daily, 0.002 g/puff, or placebo, two puffs twice daily. The primary end points were the clinical parameters of asthma measured by asthma symptom score, FEV1, and PC20H. Other end points included the serum levels of various inflammatory markers - ECP, sIL-2R, IL-4, sICAM, and IgE.

RESULTS

Clinical and inflammatory parameters improved with the use of nedocromil sodium, compared with placebo. Nedocromil significantly decreased serum levels of inflammatory markers, as shown in the following table. No correlation was found between any of the measured parameters.

CONCLUSION

Nedocromil sodium provided effective anti-inflammatory treatment for children with moderate atopic asthma.

摘要

背景

本研究的目的是通过监测肺功能以及气道炎症的非侵入性标志物,如嗜酸性粒细胞计数;血清嗜酸性粒细胞阳离子蛋白(ECP)、可溶性白细胞介素-2受体(sIL-2R)、白细胞介素-4(IL-4)和可溶性细胞间黏附分子(sICAM);以及总免疫球蛋白E(IgE),来确定奈多罗米钠的临床疗效及其与血清炎症介质水平的关系。抗炎药物可降低气道炎症标志物水平,减轻气道高反应性强度,并改善哮喘的临床症状。现有药物中,奈多罗米钠因其副作用非常轻微而在儿童哮喘治疗中受到青睐。此前已有研究表明它可改善哮喘的临床参数,但关于其对哮喘儿童血清中炎症介质影响的数据有限。

方法

在这项为期8周的双盲、随机、安慰剂对照试验中,39名9至16岁的中度特应性哮喘儿童被随机分配,分别接受每日两次、每次两喷、每喷0.002 g的奈多罗米钠治疗或每日两次、每次两喷的安慰剂治疗。主要终点是通过哮喘症状评分、第1秒用力呼气容积(FEV1)和组胺激发试验浓度为20mg/ml时的呼气容积(PC20H)来衡量的哮喘临床参数。其他终点包括各种炎症标志物的血清水平——ECP、sIL-2R、IL-4、sICAM和IgE。

结果

与安慰剂相比,使用奈多罗米钠后临床和炎症参数得到改善。奈多罗米钠显著降低了炎症标志物的血清水平,如下表所示。所测参数之间未发现相关性。

结论

奈多罗米钠为中度特应性哮喘儿童提供了有效的抗炎治疗。

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