Effects of exercise training and montelukast in children with mild asthma

Maria R. Bonsignore, Stefania La Grutta, Fabio Cibella, Nicola Scichilone, Giuseppina Cuttitta, Amelia Interrante, Margherita Marchese, Mario Veca, Marco Virzi', Anna Bonanno, Mirella Profita, Giuseppe Morici

Research output: Contribution to journalArticle

Abstract

PURPOSE: Data from the general population suggest that habitual exercise decreases bronchial responsiveness, but the possible role of exercise in asthmatics is undefined. The leukotriene receptor antagonist montelukast decreases bronchial responsiveness and exercise-induced symptoms in asthmatic children. This randomized study in children with mild asthma evaluated the combined effects of aerobic training for 12 wk and montelukast or placebo on bronchial responsiveness (BHR) to methacholine, exercise-induced bronchoconstriction (EIB), inflammatory markers in exhaled breath condensate (EBC), and asthma exacerbations. METHODS: Fifty children (mean age ± SD: 10.2 ± 2.4 yr) with mild stable asthma were randomly assigned to placebo (N = 25) or montelukast (N = 25). Before and after training, we assessed BHR and EIB and markers of airway inflammation-that is, exhaled nitric oxide (eNO), pH, and cysteinyl-leukotriene concentration-in EBC. RESULTS: Training increased maximal workload and peak minute ventilation. After training, the methacholine dose causing a 20% fall in FEV1 (PD20) increased in both groups. A decreased slope of FEV1 decline at increasing methacholine dose was found only in montelukast-treated children. EIB prevalence halved after training in both groups (EIB + children, placebo group: 10 pretraining, 4 posttraining; EIB + children, montelukast group: 8 pretraining, 5 posttraining; P < 0.05 by χ on all children). Resting eNO was unaffected, whereas the pH of EBC decreased after training in both groups. Cysteinyl-leukotriene concentrations were low in most children at both times. During training, montelukast-treated children showed fewer asthma exacerbations compared with the same period of the previous year. CONCLUSIONS: In children with mild stable asthma, exercise training decreased bronchial responsiveness to methacholine. Montelukast also decreased bronchial reactivity (FEV1 slope) and protected against exacerbations, suggesting a beneficial synergistic action of these two interventions in mild asthma.

Original languageEnglish (US)
Pages (from-to)405-412
Number of pages8
JournalMedicine and Science in Sports and Exercise
Volume40
Issue number3
DOIs
StatePublished - Mar 1 2008

Keywords

  • Aerobic exercise
  • Bronchial responsiveness
  • Deep inspiration
  • Leukotrienes
  • Methacholine

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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  • Cite this

    Bonsignore, M. R., La Grutta, S., Cibella, F., Scichilone, N., Cuttitta, G., Interrante, A., Marchese, M., Veca, M., Virzi', M., Bonanno, A., Profita, M., & Morici, G. (2008). Effects of exercise training and montelukast in children with mild asthma. Medicine and Science in Sports and Exercise, 40(3), 405-412. https://doi.org/10.1249/MSS.0b013e31815d9670