Introduction: Children with food allergy are at increased risk for asthma and asthma morbidity. Since leukotrienes are implicated in the pathogenesis of both asthma and probably in food allergies, we hypothesized that asthmatic children with concomitant food allergy may have a favorable response to antileukotriene treatment. Methods: Asthmatic children aged 6–18 years with and without food allergy were treated with montelukast and placebo in a double-blind, placebo-controlled cross-over parallel-group study. The primary outcome of the study was improvement in FEV1%. Asthma control tests, spirometry and methacholine challenges were performed as well as Fractional Exhaled Nitric Oxide (FeNO) levels. PGD2, CystLT, and lipoxin levels were measured in exhaled breath condensate (EBC). Results: A total of 113 children were enrolled and 87 completed the study in accordance with the protocol. At baseline, children with food allergy and asthma (FAA) had higher levels of PGD2 and CysLT levels in the EBC than children with asthma alone (AA) (p #x3c; 0.001 for each). In the montelukast arm, although FEV1% was significantly higher in the FAA group compared to AA (p = 0.005), this effect was linked to the baseline difference of FEV1% between both arms. Montelukast treatment failed to improve FEV1% in both groups compared to the placebo. No effect of montelukast was observed in the remaining study parameters. Conclusion: Although children with FAA do not show a more favorable response to montelukast treatment compared to AA, a significant difference between baseline PGD2 and CystLT levels between FAA and AA groups may point to a different endotype of childhood asthma.
Int Arch Allergy Immunol

中文翻译：

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有和没有食物过敏的哮喘儿童的孟鲁司特疗法：它有什么不同吗？

简介：患有食物过敏的儿童患哮喘和哮喘发病率的风险增加。由于白三烯与哮喘的发病机制有关，而且可能与食物过敏有关，我们假设伴有食物过敏的哮喘儿童可能对抗白三烯治疗有良好的反应。方法：在一项双盲、安慰剂对照、交叉平行组研究中，患有或不患有食物过敏的 6-18 岁哮喘儿童接受孟鲁司特和安慰剂治疗。该研究的主要结果是 FEV1% 的改善。进行了哮喘控制测试、肺活量测定和乙酰甲胆碱激发试验以及呼出气一氧化氮 (FeNO) 水平。在呼出气冷凝物 (EBC) 中测量 PGD2、CystLT 和脂氧素水平。结果：共招募了 113 名儿童，87 名儿童按照方案完成了研究。在基线时，食物过敏和哮喘 (FAA) 儿童的 EBC 中 PGD2 和 CysLT 水平高于单纯哮喘儿童 (AA)（ p #x3c；每个为 0.001）。在孟鲁司特组中，尽管 FAA 组的 FEV1% 显着高于 AA ( p = 0.005)，但这种影响与两组之间 FEV1% 的基线差异有关。与安慰剂相比，孟鲁司特治疗未能提高两组的 FEV1%。在其余研究参数中未观察到孟鲁司特的影响。结论：尽管与 AA 相比，FAA 儿童对孟鲁司特治疗没有表现出更好的反应，但 FAA 和 AA 组之间基线 PGD2 和 CystLT 水平之间的显着差异可能表明儿童哮喘的不同内型。
Int Arch 过敏免疫