Effect of Montelukast on the Expression and Variation of TGF-β for Children With Mild Persistent Asthma
Condition: Asthma
MeSH terms: Asthma
Study type: Observational

Summary: 
      The Objective of our research is to observe the effect of cysteinyl leukotriene receptor
      antagonist on the expression and variation of TGF-β1 levels and mRNA expression in children
      with mild persistent asthma in their plasma and T lymphocyte, to discuss the role of TGF-β1
      in the pathogenesis of bronchial asthma in children and to evaluate the function of
      regulation of leukotriene receptor antagonist on asthma in children.
    

Detailed description: 
      The majority pediatric asthma patients in Shanghai are mild persistent asthma. These patients
      require controller medications every day to achieve and maintain control. Leukotriene
      receptor antagonist is one of the options which have been recommended to use as a mono
      controller therapy. Patient satisfaction and compliance was better with montelukast,
      attributed to oral intake and convenience. Owing to its easy and simple oral once a day
      administration montelukast was found to be advantageous over ICS. On the other hand, recent
      studies have shown that there is a considerable degree of airway remodeling in peripheral
      airways in patients with mild asthma.The new information points out the need for large, long
      term studies on the treatment of mild persistent asthma, with an emphasis on exacerbations,
      remodeling, and the relationship between these outcomes and markers of asthma control. TGF-β
      participates in the initiation and propagation of inflammatory and immune responses in the
      airways. The leukotrienes exert their biologic actions by binding to and activating specific
      receptors. Montelukast, a cysteinyl leukotriene 1(CysLT1) receptor antagonist, acts on LTC4,
      LTD4 and LTE4, and, therefore, on airway inflammation and bronchoconstriction. Some results
      suggest that low dose of Montelukast may modulate the parameters of inflammation and
      fibrosis.In this study we try to determine the effects of lower dose Montelukast on the
      expression and variation of TGF-β in induced sputum and T lymphocyte for children with mild
      persistent Asthma.

      Drug in the study provide by MSD. We have done induced sputum procedure in our past study.
      Reagent can be bought from company.
    

Intervention name(s): montelukast
Intervention type(s): Drug
Intervention description(s): montelukast 5-mg chewable tablet with matching placebo once daily in the evening at bedtime.The study consisted of a 2-week, single-blind placebo baseline period and a 12-week double-blind, active treatment period
Other intervention name(s): singulair
Intervention MeSH terms: Montelukast
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        After screening 200 patients, we randomized 120 patients aged 6 to 14 years with a history
        of physician-diagnosed asthma .These patients randomized into montelukast group and placebo
        group.
      
Biospecimen description: 
      Subjects inhaled hypertonic saline (3%) via an ultrasonic nebulizer with the output set at
      maximum for 20 minutes. To collect sputum, subjects were asked to expectorate the sputum onto
      a plastic Petri dish after the 20-min period of inhalation. During the inducing procedure,
      macroscopic characteristics of the sputum were recorded and adequate plugs of sputum were
      separated from saliva and processed immediately after expectoration.The complete blood count,
      platelet count, and serum biochemical analyses were done meanwhile.
    
Keywords: asthma; child; transforming growth factor beta(TGF-β); Leukotriene Antagonists(Montelukast)