Original Article
 

Effect of Montelukast and Budesonide Aerosol Inhalation in the Treatment of Allergic Rhinitis And asthma in Children and Its Effect on the Inflammatory Response of Children

Abstract

Studies have investigated montelukast and budesonide aerosol inhalation for treating allergic rhinitis (AR) and bronchial asthma (BA) in children. However, there are significant variations in dosage and duration of administration. This research evaluated the efficacy in children with AR and BA and analyzed montelukast's impact on the inflammatory response.
This retrospective cohort study involved 100 children with AR and BA who were admitted to “Baoding Hospital, Beijing Children's Hospital Affiliated with the Capital Medical University” from October 2022 to September 2023. They were divided into a budesonide group (budesonide n=50) and a combination group (montelukast and budesonide, n=50). Comparisons were made between the two groups in terms of clinical efficacy, severity scores of AR and BA before and after treatment, inflammatory indicators (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)), pulmonary function indicators (forced expiratory volume in the first second (FEV1), peak expiratory flow rate (PEF)), and adverse reactions.
After treatment, the severity scores of AR and BA in the combination group were 4.00±0.93 points and 2.64±0.56 points, which were lower than those in the budesonide group (5.14±0.66 points and 3.31±0.65 points, respectively). The total response rate of the combination group (96.00%) was higher than that of the budesonide group (80.00%). The levels of IL-6 and TNF-α in the combination group were lower than those in the budesonide group, and the levels of FEV1 and PEF in the combination group were higher than those in the budesonide group.
Mometasone combined with budesonide shows good treatment effects in children with AR and BA.

1. Siddiqui ZA, Walker A, Pirwani MM, Tahiri M, Syed I. Allergic rhinitis: diagnosis and management. Br J Hosp Med (Lond). 2022;83(2):1-9.
2. Cohen B. Allergic Rhinitis. Pediatr Rev. 2023;44(10):537-50.
3. Chetta A, Calzetta L. Bronchial asthma: an update. Minerva Med. 2022 Feb;113(1):1-3.
4. Nappi E, Paoletti G, Malvezzi L, Ferri S, Racca F, Messina MR, et al. Comorbid allergic rhinitis and asthma: important clinical considerations. Expert Rev Clin Immunol. 2022;18(7):747-58.
5. Hellings PW, Steelant B. Epithelial barriers in allergy and asthma. J Allergy Clin Immunol. 2020;145(6):1499-509.
6. Demkow U, Stelmaszczyk-Emmel A. Extracellular Vesicles in Allergic Rhinitis and Asthma and Laboratory Possibilities for Their Assessment. Int J Mol Sci. 2021;22(5):2273.
7. Zhao L, Yang Y, Zang YR, Zhang QQ, Liang X, Yuan GM, et al. Risk factors for asthma in patients with allergic rhinitis in eastern China. Am J Otolaryngol. 2022 May-Jun;43(3):103426.
8. Jafari M, Sobhani M, Eftekhari K, Malekiantaghi A, Gharagozlou M, Shafiei A. The Effect of Oral Montelukast in Controlling Asthma Attacks in Children: A Randomized Double-blind Placebo Control Study. Iran J Allergy Asthma Immunol. 2023;22(5):413-419.
9. Rahman MA, Chakraborty R, Ferdousi KR, Alam A, Chowdhury MK, Paul BK. New Therapeutic Approach to Treat Allergic Rhinitis & Bronchial Asthma, Considering These Two as One United Airway Disease. Mymensingh Med J. 2017;26(1):216-21.
10. Li HT, Chen ZG, Lin YS, Liu H, Ye J, Zou XL, et al. CpG-ODNs and Budesonide Act Synergistically to Improve Allergic Responses in Combined Allergic Rhinitis and Asthma Syndrome Induced by Chronic Exposure to Ovalbumin by Modulating the TSLP-DC-OX40L Axis. Inflammation. 2018;41(4):1304-20.
11. Guo S, Cao C. Effects of montelukast sodium combined with budesonide on pulmonary function, serum IgE levels, and EOS percentage in children with comorbid allergic rhinitis and asthma. Am J Transl Res. 2023;15(12):6823-31.
12. Zuberi FF, Haroon MA, Haseeb A, Khuhawar SM. Role of Montelukast in Asthma and Allergic rhinitis patients. Pak J Med Sci. 2020 Nov-Dec;36(7):1517-22.
13. Mayoral K, Lizano-Barrantes C, Zamora V, Pont A, Miret C, Barrufet C, et al. Montelukast in paediatric asthma and allergic rhinitis: a systematic review and meta-analysis. Eur Respir Rev. 2023;8;32(170):230124.
14. Comité Nacional de Neumonología; Comité Nacional de Alergia; Comité Nacional de Emergencia y Cuidados Críticos; Comité Nacional de Familia y Salud Mental. Guía de diagnóstico y tratamiento: asma bronquial en niños ≥ 6 años. Actualización 2021 [Guideline on diagnosis and treatment: bronchial asthma in children ≥ 6 years old. Update 2021]. Arch Argent Pediatr. 2021;119(4):S123-58.
15. Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, et al. International consensus statement on allergy and rhinology: Allergic rhinitis - 2023. Int Forum Allergy Rhinol. 2023;13(4):293-859.
16. Ai J, Xie Z, Qing X, Li W, Liu H, Wang T, et al. Clinical Effect of Endoscopic Vidian Neurectomy on Bronchial Asthma Outcomes in Patients with Coexisting Refractory Allergic Rhinitis and Asthma. Am J Rhinol Allergy. 2018;32(3):139-46.
17. Huang HQ, Shen HH. [Annual progress in treatment of bronchial asthma 2022]. Zhonghua Jie He He Hu Xi Za Zhi. 2023;46(1):55-61.
18. Qian K, Xu H, Chen Z, Zheng Y. Advances in pulmonary rehabilitation for children with bronchial asthma. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023;52(4):518-25.
19. Breiteneder H, Peng YQ, Agache I, Diamant Z, Eiwegger T, Fokkens WJ, et al. Biomarkers for diagnosis and prediction of therapy responses in allergic diseases and asthma. Allergy. 2020;75(12):3039-68.
20. Chen X, Guan WJ, Sun SX, Zheng PY, Sun LH, Chen DH, et al. Effects of Intranasal Cellulose Powder on Asthma Control in Children with Mild-to-Moderate Perennial Allergic Rhinitis: A Randomized, Placebo-Controlled Trial. Am J Rhinol Allergy. 2019;33(2):184-93.
21. Benson M, Strannegård IL, Strannegård O, Wennergren G. Topical steroid treatment of allergic rhinitis decreases nasal fluid TH2 cytokines, eosinophils, eosinophil cationic protein, and IgE but has no significant effect on IFN-gamma, IL-1beta, TNF-alpha, or neutrophils. J Allergy Clin Immunol. 2000;106(2):307-12.
22. Niu Y, Cao M, Li S, Mo J, Zhu Z, Wang H. The Effects of Budesonide Inhalation Treatment on the Expression Levels of Serum IL-6, TGF-β1, and IgE and Pulmonary Function in Patients with Cough Variant Asthma and an Evaluation of Treatment Efficacy. Int J Gen Med. 2024;17(2):1253-61.
23. Altaş U, Altaş ZM, Öz F, Özkars MY. Evaluation of Neuropsychiatric Effects of Montelukast-Levocetirizine Combination Therapy in Children with Asthma and Allergic Rhinitis. Children (Basel). 2023;10(8):1301.
24. Keith PK, Koch C, Djandji M, Bouchard J, Psaradellis E, Sampalis JS, et al. Montelukast as add-on therapy with inhaled corticosteroids alone or inhaled corticosteroids and long-acting beta-2-agonists in the management of patients diagnosed with asthma and concurrent allergic rhinitis (the RADAR trial). Can Respir J. 2009;16 Suppl A(Suppl A):17A-31A.
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Keywords
Allergic rhinitis Asthma Budesonide Inflammatory response Montelukast

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How to Cite
1.
Li H, Nie L, Zhang T, Chen Z, Gao S. Effect of Montelukast and Budesonide Aerosol Inhalation in the Treatment of Allergic Rhinitis And asthma in Children and Its Effect on the Inflammatory Response of Children. Iran J Allergy Asthma Immunol. 2025;:1-9.