Am. J. Respir. Crit. Care Med., Vol 151, No. 4, Apr 1995, 1194-1200.
Bronchial reactivity in asthmatic children at high and low altitude. Effect of budesonide
AL Boner, A Comis, M Schiassi, P Venge and GL Piacentini
Clinica Pediatrica, Universita di Verona, Italy.
Inhaled steroids may control bronchial inflammation in asthmatics exposed
to allergens. In this study we evaluated whether prophylactic budesonide
would prevent relapse of asthma in children re-exposed to offending
allergens at sea level, after a period of antigen avoidance at high
altitude. Thirty children received either budesonide (200 micrograms
b.i.d.) or placebo (double-blind). Following a 4-wk baseline period and 2
wk of treatment at high altitude, children were treated for 3 mo at sea
level. Methacholine challenge and pulmonary function studies were performed
before and after baseline period, after the 2 wk of treatment in the
mountain environment, and at the end of treatment. ECP serum levels were
evaluated after the baseline period and at the end of treatment. PEFR and
symptoms were recorded in a diary card during the study. The increase in
methacholine provocative dosage was greater, although not significant (p =
0.096), in the budesonide than in the placebo group after the treatment at
high altitude and remained higher at the end of the treatment (p = 0.04).
ECP levels increased in both the groups with no significant difference. Our
results confirm that budesonide, in addition to its efficacy in treating
pre-existent airway inflammation, is effective in preventing the increase
of reactivity in asthmatic children re-exposed to allergens.
