I. Stelmach et al., Markers of allergic inflammation in peripheral blood of children with asthma after treatment with inhaled triamcinolone acetonide, ANN ALLER A, 87(4), 2001, pp. 319-326
Background: It is important to monitor inflammation regularly in asthma in
addition to clinical symptoms, and there is a great need for noninvasive te
sts that could routinely be used in clinical practice.
Objective: Our hypothesis was that the improvement of clinical parameters,
together with decreased airway responsiveness, could be correlated with cha
nges in the levels of serum markers of inflammation after a 4-week treatmen
t with triamcinolone.
Methods: In this double-blind, randomized, placebo-controlled trial, 48 chi
ldren, aged 6 to 18 years, with mild to moderate atopic asthma, were random
ly allocated to receive triamcinolone or matching placebo for 4 weeks. The
following parameters were measured: the symptom score, forced expiratory vo
lume in I second (FEV1), provocative concentration of histamine causing a 2
0% fall in FEV1 (PC20) for histamine and peripheral blood eosinophil count,
serum levels of the inflammatory markers eosinophil cationic protein (ECP)
, soluble receptor of interleukin-2 (sIL-2R), interleukin-4, soluble interc
ellular adhesion molecule-1 before and after treatment.
Results: The clinical parameters significantly improved after treatment wit
h triamcinolone, the mean value of FEV1 changed from 74% of predicted value
before, to 90% of predicted after treatment (P < 0.0001). PC20 for histami
ne after treatment with triamcinolone increased significantly from the mean
value 2.5 mg/mL to 4.7 mg/mL (P < 0.001). Treatment with triamcinolone sig
nificantly (P < 0.05) decreased serum levels of all the measured inflammato
ry markers. The mean concentration of eosinophil blood count was 380 and 26
1 cells/mm(3); ECP, 83 and 58 ng/mL; serum sIL-2R, 734 and 487 pg/mL; solub
le intercellular adhesion molecule-1, 266 and 210 ng/mL, before and after t
reatment, respectively. The values of interleukin-4 were low and close to t
he sensitivity of the assay. A significant correlation was found between EC
P and sIL-2R levels before and after treatment with triamcinolone.
Conclusions: A significant decrease of all the measured serum parameters wa
s observed after treatment with triamcinolone; however, no significant corr
elation was found among any of those parameters and clinical markers of dis
ease severity (such as FEV1 or PC20H).