Background and objectives: ASTHMA is a major public health problem affecting over millions people worldwide. INTERMITTENT ASTHMA is the most common pattern in children. ASTHMA exacerbations often occur after viral respiratory infection.Montelukast (a leukotriene receptor antagonist) has a rapid onset of action and may be effective on reduction of ASTHMA exacerbation if that use early onset viral upper respiratory tract infection.Method and materials: A total of 187 children with INTERMITTENT ASTHMA aged between 6-12 years with were participated in this multicenter, randomized, double-blind, placebo-controlled clinical trial over 2-month period. The children were divided into two groups as Montelukast (93) and placebo (94). Treatment with Montelukast or placebo was initiated by parents at the onset of viral upper respiratory tract infection and continued for 7 days.Results:. Montelukast significantly decreased the cough by 6% (p=0.006), night time awakenings by 5.4% (p=0.013), whereas there were a non significant reduction in wheezing, thachypnea and respiratory distress. (p=0.801) Conclusion: A short course of Montelukast, introduced at the first sign of an viral URI, results in a reduction in symptoms such as: cough and nights awakened. Montelukast as an available treatment, has no significant side effect. Further studies are needed with exceeding cases and duration.

Introduction: Mild INTERMITTENT ASTHMA is common in children and viral infections are responsible for the majority of exacerbations. As leukotrienes are potent inflammatory mediators, some studies have shown that Montelukast, a leukotriene receptor antagonist, may be effective on reduction of ASTHMA symptom. To determine whether a short course of Montelukast in ASTHMAtic children with common cold would modify the severity of an ASTHMA episode.Materials and Methods: Children, aged 6-12 years with INTERMITTENT ASTHMA participated in this randomized, double-blind, placebo-controlled clinical trial. Treatment with Montelukast or placebo was initiated at the onset of viral upper respiratory tract infection and continued for 7 days. Primary outcomes included the clinical manifestation: duration of episodes, daily symptom, nights symptoms and activity limitation. Secondary outcomes included the need for beta agonist usage, oral prednisolone, physician visit, hospital admission and school absence.Results: A total of 187 children with INTERMITTENT ASTHMA were randomized, 93 to Montelukast group and 94 to placebo group. Montelukast significantly decreased the cough by 17.3% (P<0.001), nighttime awakenings by 5.4% (P=0.01), interference with normal activity by 6% (P<0.01), time off from school by 6% (P<0.01), b-agonist usage by 17.2% (P<0.001) and doctor visits by 12.2% (P<0.01) compared to placebo. Whereas there was a non significant reduction in wheezing, tachypnea, respiratory distress, ASTHMA exacerbation, oral prednisolone and hospitalization (P=0.8).Conclusion: A short course of Montelukast, introduced at the first sign of a viral infection, results in a reduction in cough, β-agonist use and nights awakened, time off from school and limitation of activity. More studies are needed to evaluate the optimal dose and duration of treatment.

ASTHMA has been linked to family disfunctioning and poor control of the disease.This study was conducted to analyze the interactions between the level of INTERMITTENT ASTHMA control, family functioning and respiratory function and between quality of life of ASTHMAtic patients and their caregivers.7 to 15 years old children with INTERMITTENT ASTHMA were included. ASTHMA Control Test Questionnaire, Pediatric ASTHMA Quality of Life Questionnaire (PAQLQ) test, and flowmetry were applied to children and Pediatric ASTHMA Caregiver’s Quatily of Life Questionnaire (PAQCLQ) and the Family Functioning Perception Test (FF-SIL) were applied to their parents.The most affected areas of family functioning in dysfunctional families were adaptability and permeability. A medium to high strength of association was founded between the emotional function of parents and the emotional function of children, R2=0.552. The most remarkable associations were among parents’ limitation of activities and parents' emotional function (r=0.837), parents’ limitation of activities and child's emotional function (r=0.722), parents' emotional role and limitation of activities (r=0.837), parents’ emotional role and emotional functioning of children with ASTHMA (r=0.743) and the limitation of activities of children with ASTHMA and the emotional function of children with ASTHMA (r=0.870).No direct associations were founded among respiratory function, disease control and family functioning in Mexican children with INTERMITTENT ASTHMA and emotional function of parents and children were associated in both groups.

The aim of this study was to demonstrate that handgrip strength test can discriminate the presence/absence of ASTHMA and between INTERMITTENT and moderate persistent ASTHMA in children.140 children (70 healthy and 70 with ASTHMA) completed the Pediatric ASTHMA Quality of Life Questionnaire (PAQLQ) and performed the handgrip strength test. Forty-eight hours later, subjects performed spirometry.The results showed Handgrip strength was significantly lower (p<0.001) in children with ASTHMA compared with healthy ones. There were also significant differences (p=0.024) according to the severity of the disease; children with moderate persistent ASTHMA performed worse than children with INTERMITTENT ASTHMA. Binary logistic regression analysis and ROC curve analysis revealed that the result in handgrip strength test was a predictive factor for ASTHMA (cut-off at 16.84 kg) and for severity of pathology (cut-off at 15.06 kg).Handgrip strength was reduced in children with ASTHMA. Handgrip strength was positively associated with lung capacity and quality of life. The fact that the handgrip strength test was able to discriminate between presence/absence of ASTHMA and between INTERMITTENT and moderate persistent ASTHMA in children suggested that this test could be used as a complementary tool in the monitoring of ASTHMA in daily clinical practice.

Introduction: Toll-like receptor (TLR) stimulation can lead to the activation of both innate and adaptive immune responses. Recently, some reports have pointed out to the role of membranous form of TLR2 in ASTHMA pathogenesis. In this respect, this study aimed to examine serum and sputum levels of soluble form of TLR2 (sTLR2) in both patients with ASTHMA and healthy individuals.Materials and Methods: Serum and sputum samples were obtained from ASTHMAtic patients (n=33) and normal subjects (n=19). All the subjects were otherwise healthy. The ASTHMAtic patients were classified into four groups according to Global Initiative for ASTHMA (GINA). Eosinophile count and total serum IgE were determined in peripheral blood and sputum. Also, we established a sandwich ELISA to measure the serum and sputum levels of sTLR. Results: The means of sTLR2 optical density levels in serum and sputum samples of the ASTHMAtics were significantly lower than those obtained from the healthy controls (0.44±0.12 VS 0.72±0.15 IU/ml, P=0.003). sTLR2 optical density decreased concomitantly with the increase in the levels of ASTHMA severity, but the differences observed were not statistically significant. Conclusion: The levels of sTLR2 decreased in serum and sputum samples obtained from ASTHMAtic patients, as compared to the healthy individuals.