BRONCHIAL REACTIVITY IN ASTHMATIC-CHILDREN AT HIGH AND LOW-ALTITUDE -EFFECT OF BUDESONIDE

Inhaled steroids may control bronchial inflammation in asthmatics expo sed to allergens. In this study we evaluated whether prophylactic bude sonide would prevent relapse of asthma in children re-exposed to offen ding allergens at sea level, after a period of antigen avoidance at hi gh altitude. Thirty children received either budesonide (200 mu g 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 se a level. Methacholine challenge and pulmonary function studies were pe rformed before and after baseline period, after the 2 wk of treatment in the mountain environment, and at the end of treatment. ECP serum le vels were evaluated after the baseline period and at the end of treatm ent. 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 gr oup after the treatment at high altitude and remained higher at the en d 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 inflammati on, is effective in preventing the increase of reactivity in asthmatic children re-exposed to allergens.