Published ahead of print on March 17, 2004, doi:10.1164/rccm.200311-1544OC Am. J. Respir. Crit. Care Med., Volume 169, Number 10, May 2004, 1131-1134 A more recent version of this article appeared on May 15, 2004
Submitted on November 13, 2003 Effect of Montelukast and Fluticasone Propionate on Airway Mucosal Blood Flow in AsthmaEliana S Mendes1,1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Miami School of Medicine, Miami, FL, USA * To whom correspondence should be addressed. E-mail: awanner{at}miami.edu.
Asthma is associated with an increase in airway blood flow (Qaw), presumably as a manifestation of airway inflammation. We therefore determined the effect of the anti-inflammatory agents montelukast (ML) and fluticasone propionate (FP) on Qaw in twelve patients with mild intermittent asthma. Using a double-blind approach, Qaw along with FEV1 and were determined before and after a two-week treatment period with either ML (10 mg/day), FP (440 µg/day) or 10 mg ML plus 440 mg FP daily, separated by 2 week washout periods. Mean (± SEM) Qaw ranged from 68 ±4.2 to 71.8 ± 5.9 ml.min-1.ml-1 anatomical dead space before the treatment periods. ML, FP, and ML+FP decreased mean Qaw by 21.5%, 20.8% and 26.9 %, respectively (p<0.05 for all). No significant difference was observed among the three regimens. FEV1 and Vmax50 were not changed by any of the treatments. We conclude that at the dosages used, ML and FP are equipotent in reducing Qaw in patients with mild asthma, and that the magnitude of the response is not greater if the two drugs are combined. The results also suggest that the vascular effects of these agents can be assessed independent of their effects on airway function. Key words: bronchial circulation, airway inflammation, glucocorticosteroids, leukotriene modifiers, asthma
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