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Clinical Investigations: PULMONARY FUNCTION |

Anti-inflammatory and Lung Function Effects of Montelukast in Asthmatic Volunteers Exposed to Sulfur Dioxide*

Henry Gong, Jr., MD, FCCP; William S. Linn, MA; Sheryl L. Terrell, BA; Karen R. Anderson, BS; Kenneth W. Clark, MA
Author and Funding Information

*From the Environmental Health Service (Mss. Terrell and Anderson, and Mr. Clark), Rancho Los Amigos, National Rehabilitation Center, Downey, CA; and the Departments of Medicine (Dr. Gong) and Preventive Medicine (Mr. Linn), Keck School of Medicine, University of Southern California, Los Angeles, CA.

Correspondence to: Henry Gong, Jr., MD, FCCP, 51 Medical Science Building, Rancho Los Amigos National Rehabilitation Center, 7601 East Imperial Hwy, Downey, CA 90242; e-mail: hgong@dhs.co.la.ca.us



Chest. 2001;119(2):402-408. doi:10.1378/chest.119.2.402
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Background: Sulfur dioxide (SO2) gas may induce acute asthmatic responses when inhaled by individuals in the setting of community or occupational air pollution during exercise. Some asthma medications mitigate the SO2 response, which is not fully understood but appears to involve multiple mechanisms.

Objective: We tested the hypothesis that pretreatment with the cysteinyl-leukotriene inhibitor montelukast sodium protects against the inflammatory and bronchoconstrictive effects of SO2 in the airways of asthmatic subjects.

Methods: Asthmatic volunteers (enrolled, 12 subjects; completed study, 11 subjects) were exposed to 0.75 ppm SO2 for 10-min periods during exercise (mean ventilation, 35 L/min) and were exposed similarly to filtered air (control condition) after double-blinded pretreatments with montelukast (10 mg/d for 3 days) and placebo.

Results: After montelukast pretreatment, specific airways resistance, FEV1, symptoms, and eosinophil counts in induced sputum showed statistically and clinically significant improvements in preexposure measurements and/or decreased responses to SO2 exposure or exercise. The mean FEV1 immediately after exposure was 95% of baseline FEV1 with montelukast pretreatment vs 82% with placebo.

Conclusion: Montelukast significantly protects against airways eosinophilic inflammation and bronchoconstriction from SO2 exposure during exercise. This implies a role for leukotrienes in SO2-induced lung effects.

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