ABSTRACT
The effect of montelukast and cromolyn on allergic inflammation and bronchial hyperresponsiveness was compared in 40 children with mild persistent asthma. Twenty children received oral montelukast [Singulair] while twenty children received inhaled cromolyn [Intal-5 MDI] during the study period of 6 weeks. Asthmatic children were evaluated clinically and with pulmonary function tests [forced expiratory volume in one second [FEV[1]] and peak expiratory flow [PEFR], challenge tests [histamine and exercise] and measurement of inflammatory markers [blood eosinophil count, serum immunoglobulin E [IgE], eosinophil cationic protein [ECP], interleukin 4[IL4] and nitric-oxide products in sputum] both. before and after six weeks therapy with either montelukast or cromolyn. Twenty age and sex matched non atopic children served as controls. Asthmatic children, on admission, had significant decrease in mean FEV[1] and PEFR and increase in mean eosinophil count, serum levels of total serum IgE, ECP, IL4 and sputum nitric-oxide products as compared to controls. Both drugs produced significant and equal improvement in pulmonary functions [FEV[1] and PEFR], decrease in the degree of bronchial hyperresponsiveness to histamine and exercise and a significant decrease in blood eosinophil count, serum IgE, ECP and IL4 and sputum nitric-oxide products. However all these parameters were still significantly different as compared to mean control levels. Better asthma symptoms control was observed with montelukast than with cromolyn sodium and there was a greater significant adherence with montelukast than with cromolyn- sodium with both patients and parents preference for montelukast