Effects of Supportive Treatment such as Antioxidant or Leukotriene Receptor Antagonist Drugs on Inflammatory and Respiratory Parameters in Asthma Patients

Abstract

In this study, prospectively, we aimed to determine the effects of the different treatment alternatives on the oxidant system and inflammatory and clinic determinants during the stable period of 1 month following an asthmatic attack. Thirty-one patients (22 female, nine male) were randomly divided into three groups following the stabilization of an acute asthma attack. The control group that is an additional group to the three patient groups consisted of 10 healthy volunteers (five female, five male). The following protocols were used for 4 weeks: Group I: short-acting inhaler beta2 mimetic as required (treatment A)+800 mug inhaler budesonide (treatment B)+leukotriene receptor antagonist; Group II: treatment A and B; Group III: treatment A and B+vitamin E. The serum levels before and after treatment of eosinophilic cationic protein (ECP), leukotriene E4 (LTE(4)), and malondialdehyde (MDA) were determined. The values before and after treatment were statistically compared both with each other and control values. Pretreatment ECP, LTE(4), and MDA levels for the three groups were significantly higher compared with post-treatment levels (P<0.05 to P<0.001) and the control levels (P<0.01 to P<0.001). However, when post-treatment levels were compared with those of the control group, no significant differences were found (P>0.05). Lack of significant variation was observed when the pre- and post-treatment differences in the three groups were compared for each one of ECP, LTE(4), and MDA levels (P>0.05). Leukotriene receptor antagonist or antioxidant agents added to standard asthma treatment did not make a significant contribution on ECP, LTE(4), and MDA levels and respiratory parameters such as spirometric function tests. Etiologic factors and/or the possible changes in different pathogenetic ways of the inflammation process may have been responsible for nonsignificant intertreatment difference in the biomarker levels. The result confirms that suppressing the inflammation in asthma enables the entire inflammatory pathologic process to be controlled.

γ-Tocotrienol reduces human airway smooth muscle cell proliferation and migration

“…Clinical trials of vitamin E supplementation have been performed because low levels of vitamin E have been reported in patients with asthma [16,17,51], but these trials have produced ambiguous results [10,17,52]. In these clinical trials, vitamin E supplementation was mostly comprised of a-tocopherol.…”

Malondialdehyde in Exhaled Breath Condensate as a Marker of Oxidative Stress in Different Pulmonary Diseases

“…This issue is controversial in literature: while some studies reported a reduction in MDA levels after corticosteroid treatment [24], other studies found no difference between ICS-treated and untreated subjects [11]. Antioxidant treatment has been generally reported to be ineffective in modifying markers of oxidative stress [28, 29]. In a preliminary study, we observed a mild, significant attenuation in ozone-induced EBC-MDA increase after 4-week treatment with oral N-acetyl-cysteine in asthmatic patients [30].…”

CAM and Respiratory Disease

“…In children 31 and in adults 32 with asthma, low intake of dietary fresh fruit was associated with a higher frequency of reported asthma symptoms, and in the adults, plasma ascorbic acid levels were significantly lower in the symptomatic vs asymptomatic asthmatics. However, prospective interventional trials involving supplementation of fresh fruit to children for a year, 33 supplementation of vitamin E to adults with asthma for 4–6 weeks, 34 , 35 or supplementation of vitamin C to asthmatics in several placebo‐controlled trials 36 have been unable to discern substantial improvement in asthma control associated with the treatments. Ascorbic acid supplements did have a greater protective effect than placebo for exercise‐induced airway obstruction; however, the protective effect was modest in these asthmatic subjects, who were holding all their usual asthma medications at the time of the exercise challenge 37 …”