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Clinical Efficacy of Vitamin D Combined with Montelukast in Children with Cough Variant Asthma and Its Effect on IL-17 and Treg |
YUE Jingwei, WANG Yan, ZHANG Min |
Xi'an Children's Hospital, Shaanxi Xi'an 710002, China |
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Abstract Objective: To analyze the clinical efficacy of vitamin D (VD) combined with montelukast in children with cough variant asthma (CVA) and its effect on interleukin-17 (IL-17) and regulatory T cells (Treg). Methods: Two hundred and forty-four children with CVA treated in our hospital from September 2019 to May 2021 were prospectively selected as the research objects and divided into control group (n = 61), montelukast group (n = 61), VD group (n = 61) and combined group (n = 61) through simple random method and random number table. Children in the control group were treated with routine treatment, and the other three groups were given montelukast, VD and their combination respectively for 12 weeks on the basis. The clinical efficacy and pulmonary function [including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF)] and the levels of blood IL-17, CD4+CD25+Treg cells were compared among four groups. Results: The remission time and disappearance time of cough in combined group were significantly lower than those in control group, montelukast group and VD group (P<0.05). There were no significant differences in baseline data, FEV1, FVC, PEF, blood IL-17, CD4+CD25+ Treg cell levels and the incidence of adverse reactions among four groups before treatment (P>0.05). The levels of FEV1, FVC, PEF, blood CD4+CD25+Treg cells after treatment in four groups were significantly higher than those before the intervention, and the blood level of IL-17 was significantly lower than those before the intervention (P<0.05), and the application effect of the combined group was better than that of the other three groups (P<0.05). Analysis of factorial variance showed that montelukast and VD intervention were helpful to reduce cough remission time, cough disappearance time and IL-17, and increase FEV1, FVC, PEF and CD4+CD25+ Treg (P<0.05), and there was no interaction between them (P>0.05). Conclusion: VD combined with montelukast could significantly promote the remission of cough and improve lung function in children with CVA, which can be related to correcting Th17/Treg imbalance.
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