Background:Macrolides exert anti-inflammatory and immunomodulatory effects beyond their purely antibacterial action, as demonstrated by several bronchial inflammatory disorders, including asthma.Methods:Fifty-eight children with newly diagnosed mild persistent asthma were selected by using the Global Initiative for Asthma guidelines and were randomly divided into the study (group I) (n = 36) and control (group II) (n = 22) groups. Mycoplasma pneumonia-specific immunoglobulin G and -specific immunoglobulin M antibody levels of each participant were measured by enzyme-linked immunosorbent assay. Clarithromycin 5 mg/kg daily and placebo were given to groups I and II, respectively, for 4 weeks. All of the children had maintenance inhaled corticosteroid (fluticasone propionate, one puff twice [50 μg/puff] daily). Forced expiratory volume in 1 second, forced expiratory flow at 25–75% of the pulmonary volume, exhaled nitric oxide value, total IgE level, absolute eosinophil count, and eosinophilic cation protein value were measured at baseline and at the end of the treatment.Results:There are significantly increased forced expiratory volume in 1 second and forced expiratory flow at 25–75% of the pulmonary volume levels and decreased exhaled nitric oxide values after the 4-week clarithromycin treatment. The study group also had a decreased peripheral blood absolute eosinophil count and eosinophilic cation protein level, but not for the total IgE level, after the treatment.Conclusion:Four weeks of sub-antimicrobial doses of clarithromycin may improve pulmonary function and decrease eosinophilic inflammation in children with asthma.

Hypercholesterolaemia and hypertriglyceridaemia were not found in any of the persistent asthmatic children, and thus they are not high risk factors for asthma. Similarly, there were no differences in apo-A1 and apo-B between any of the BMI groups. No differences were found in LDL levels, however HDL levels were increased in all four groups, indicating that allergic sensitisation may have occurred. Controlling body weight and restricting calorie intake may be as important as appropriate pharmacological management in controlling asthma.

The results showed that cross-reactive non-steroidal anti-inflammatory drug hypersensitivity may exist between ibuprofen and aspirin. This raises the possibility that asthma exacerbation could be mediated by ibuprofen ingestion.

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Although the prevalence with which food causes asthma is not well known, food allergy is implicated in a variety of respiratory symptoms. Eighty-two asthmatic children aged 6-16 years with doctor-diagnosed sensitization to inhalants and presenting with asthma exacerbation participated in this study of food allergies linked to asthma exacerbations. The diagnosis of food allergy was established using a questionnaire, clinical criteria, serum-specific IgE antibody measurements, and an atopy patch test. Asthma exacerbation was determined using fractional exhaled nitric oxide management after the children were admitted to the hospital. On the basis of questionnaire data, suspected food allergy was identified in 59.8% children. The positive and negative rates of serum food-specific IgE tests were 54.9% and 45.1%, respectively. The results of atopy patch tests in radioallergosorbent-positive participants were 88.9% positive and 12.5% negative. Food allergy is a risk factor for asthma exacerbation, and evaluation of food allergy in selected patients with asthma is indicated.