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[Serum pyridoxal concentration in children during theophylline therapy for bronchial asthma]
Insights
Long-term theophylline therapy for asthma in children may lower vitamin B6 levels. This reduction in vitamin B6 status could potentially contribute to theophylline-induced seizures, even within therapeutic ranges.
Area of Science:
- Pediatric Pulmonology
- Clinical Nutrition
- Pharmacology
Background:
- Bronchial asthma is a common chronic respiratory disease in children.
- Theophylline is a bronchodilator used in asthma management.
- Vitamin B6 (pyridoxal) plays a crucial role in neurotransmitter synthesis.
Purpose of the Study:
- To investigate the impact of sustained-release theophylline therapy on serum pyridoxal levels in pediatric asthma patients.
- To explore the relationship between the duration of theophylline treatment and vitamin B6 status.
- To assess the potential link between theophylline therapy, vitamin B6 levels, and seizure risk.
Main Methods:
- A cohort of 42 children with bronchial asthma was divided into two groups based on the duration of theophylline treatment (less than 4 weeks vs. more than 5 weeks).
- Serum pyridoxal concentrations were measured and compared between the two groups.
- Serum theophylline concentrations were also measured and correlated with serum pyridoxal levels.
Main Results:
- Children treated with theophylline for over 5 weeks (Group B) exhibited significantly lower serum pyridoxal concentrations compared to those treated for less than 4 weeks (Group A) (p < 0.01).
- No significant correlation was found between serum pyridoxal concentration and serum theophylline concentration.
- Long-term theophylline therapy appears to deplete vitamin B6 status in children with asthma.
Conclusions:
- Sustained-release theophylline therapy may lead to a decrease in vitamin B6 status in pediatric asthma patients.
- Reduced vitamin B6 status could potentially lower brain gamma-aminobutyric acid levels, increasing the risk of theophylline-induced seizures, irrespective of serum theophylline levels.
- Monitoring vitamin B6 status in children on long-term theophylline therapy may be warranted.
Abstract:
This study was designed to investigate the effect of sustained-release theophylline therapy on serum pyridoxal concentration in children with bronchial asthma. Forty-two children with bronchial asthma were divided into two groups according to duration of theophylline administration: The 22 children in group A had been treated with theophylline for less than 4 weeks, whereas the 20 children in group B had been treated for more than 5 weeks. The results obtained from this study were as follows: 1) The serum pyridoxal concentration in group B was significantly lower than that those in group A (p < 0.01). 2) The serum pyridoxal concentration was not significantly correlated with the serum theophylline concentration. These findings suggest that long-term theophylline therapy can depress vitamin B6 status in children with bronchial asthma. Theophylline-induced seizure may be caused by the possible decreased in gamma-aminobutyric acid concentration in the brain as a result of decrease in gamma-aminobutyric acid concentration in the brain as a result of decrease in vitamin B6 status, even if the serum theophylline concentrations are within the therapeutic range.