A comparison of topical budesonide and oral montelukast in seasonal allergic rhinitis and asthma

Wilson, Andrew M.; Dempsey, Owen; Sims, Erika J.; Lipworth, Brian J.

doi:10.1046/j.1365-2222.2001.01088.x

Cited by 115 publications

(85 citation statements)

References 33 publications

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“…15 The efficacy of speech therapy for clinical and functional control of allergic rhinitis was demonstrated here, supporting…”

Section: Discussionsupporting

confidence: 69%

“…5,12 Compliance was monitored by systematically weighing the metered-dose inhalers on an analytic balance. 13 The BDT group attended 16 speech therapy sessions covering three stages of treatment: awareness and proprioception of breathing mode and type -using an atlas on respiratory physiology and anatomy, nose-blowing technique Pulmonary function test guidelines 15 were followed when measuring FEV 1 with a spirometer (B100 Puritan BennettRenaissance).…”

Section: Methodsmentioning

confidence: 99%

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O impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais

Campanha¹,

Fontes²,

Camargos³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To determine the impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents.Methods: This was a quasi-experimental randomized study of 24 mouth breathing patients with asthma and allergic rhinitis, aged from 6 to 15 years. All patients were taking beclomethasone diproprionate through oral inhalation at the start of the study. At enrollment on the study, oral inhalation was substituted with exclusively nasal inhalation and 1 month later half of the patients began speech therapy. They attended 16 speech therapy sessions in 8 weeks and continued taking beclomethasone dipropionate through exclusively nasal inhalation (BDT group). The comparison group received only beclomethasone diproprionate through exclusively nasal inhalation (BDI group). Both groups were assessed five times. Clinical scores were calculated for allergic rhinitis and asthma, an adapted version of the Marchesan orofacial myofunctional assessment protocol was applied, and parents/guardians' observations were recorded, in addition to spirometry measurements of peak inspiratory and peak expiratory flow.Results: There were significant improvements in the BDT group: clinical asthma score at T5 (p = 0.046); peak inspiratory flow at T4 (p = 0.030); peak expiratory flow at T3 (p = 0.008); breathing mode and lip position (p = 0.000) from T3 onwards; and parents/guardians' observations at T2, T4, and T5 (p = 0.010; p = 0.027; p = 0.030).Conclusions: Speech therapy in combination with beclomethasone diproprionate through exclusively nasal inhalation resulted in earlier and longer-lasting clinical and functional control of asthma, allergic rhinitis, and mouth breathing than was achieved in the group that only took beclomethasone diproprionate. The efficacy of treating allergic rhinitis when it is associated with asthma has been widely documented. 5 Recovery of upper airway function contributes to asthma control. 5 For allergic patients and mouth breathers, the objective of speech therapy is to reestablish breathing through the No conflicts of interest declared concerning the publication of this article.Suggested citation: Campanha SM, Fontes MJ, Camargos PA, Freire LM. The impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents.

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“…15 The efficacy of speech therapy for clinical and functional control of allergic rhinitis was demonstrated here, supporting…”

Section: Discussionsupporting

confidence: 69%

Section: Methodsmentioning

confidence: 99%

O impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais

Campanha¹,

Fontes²,

Camargos³

et al. 2010

J. Pediatr. (Rio J.)

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“…Taken together these assays clearly gave no evidence of any direct inhibitory effect of montelukast on NOS isoenzymes within the concentration range from 10 -7 to 10 -4 M, far exceeding that achieved during drug therapy (39). Therefore, alternative explanantions for the decreased NO levels measured in expired air from asthmatic subjects after treatment with montelukast should be considered (18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Discussionmentioning

confidence: 95%

“…Since no acute inhibitory effect on NO synthesis, neither directly on the three NOS isoenzymes, nor a suppression of the expression of iNOS was found, alternative explanantions for the decreased NO levels measured in expired air from asthmatic subjects after treatment with montelukast must be considered (18)(19)(20)(21)(22)(23)(24)(25)(26)(27). They may be explained by changes in quantities or sites of NO generation, binding or more distal processes.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies in asthmatic subjects treated with montelukast have shown that such LTD 4 receptor blockade is associated with lower levels of exhaled NO (18)(19)(20)(21)(22)(23)(24)(25)(26)(27). In a murine allergic asthma model in which inflammation was induced by injection of ovalbumin, no evidence for a change in inducible NOS (iNOS) mRNA levels following montelukast treatment was observed (28).…”

Section: Introductionmentioning

confidence: 99%

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Montelukast exerts no acute direct effect on NO synthases

Hamacher¹,

Eichert²,

Braun³

et al. 2007

Pulmonary Pharmacology & Therapeutics

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The cysteinyl leukotrienes (CysLTs) LTC 4 , LTD 4 and LTE 4 are potent proinflammatory lipid mediators that play a central role in inflammation, contraction and remodelling of airways observed in asthmatics. Montelukast, a competitive inhibitor of the cysteinyl leukotriene-1 (CysLT 1 ) receptor attenuates asthmatic airway inflammation, contraction and remodelling. As a number of studies have shown that montelukast reduced exhaled nitric oxide (NO) levels, a marker of inflammation that correlates with the severity of asthma, we investigated whether or not a direct inhibition of NO synthase (NOS) by montelukast takes place.In an ex-vivo rat lung perfusion and ventilation model the NOS-dependent vasodilation effect after lipopolysaccharide (LPS) infusion was assessed with and without montelukast. Functional organ bath studies using isolated aortic rings from the same species aimed to assess effects of montelukast on the inducible and endothelial NOS isoenzymes (i-and eNOS) as well as on iNOS expression.Neuronal NOS (nNOS) was assessed by field stimulated rabbit corpus cavernosum, and isolated human iNOS enzyme activity was assessed for potential inhibition.Montelukast failed to cause vasoconstriction in LPS challenged rat lung, or to inhibit i-and eNOS activity as well as iNOS expression in aortic rings from the same species. Also the assays for nNOS in rabbit corpus cavernosum and on isolated human iNOS enzyme gave no evidence for a direct inhibition by montelukast in physiological and supraphysiological concentrations up to 10 -4 M.We therefore conclude that montelukast has no acute NOS inhibitor action. Its effect on exhaled NO is therefore probably indirectly mediated by a modulation of the asthmatic airway inflammation.

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Fluticasone Nasal Spray and the Combination of Loratadine and Montelukast in Seasonal Allergic Rhinitis

Saengpanich¹,

deTineo²,

Naclerio³

et al. 2003

Arch Otolaryngol Head Neck Surg

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A comparison of topical budesonide and oral montelukast in seasonal allergic rhinitis and asthma

Abstract: Once-daily inhaled plus intranasal budesonide and once daily montelukast showed comparable efficacy on lower airway, but only the budesonide had significant efficacy on upper airway inflammatory markers. Both treatments significantly reduced allergic rhinitis symptoms.

Cited by 115 publications

References 33 publications

O impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais

O impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais

Montelukast exerts no acute direct effect on NO synthases

Fluticasone Nasal Spray and the Combination of Loratadine and Montelukast in Seasonal Allergic Rhinitis

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