Magnesium Status & Therapeutic Effect in Asthmatic Children


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Type: Project Material

Department: Allergy and Clinical Immunology

No of Chapters: 5

Reference: Yes

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The study aimed at outlining the possible role of magnesium (Mg) in the pathogenesis and treatment of bronchial asthma. Twenty
seven asthmatic children (mean age 9.07 ± 3.79 years) were studied during wheezy episodes : 8 with mild persistent asthma, 8 with
moderate persistent asthma and 11 with severe persistent asthma. Fifteen age and sex matched healthy children were included as a
control group. Measurement of Mg concentration was carried out in serum (SMg), 24 hours urine sample (UMg) and intracellularly
in mononuclear cells (MMg) and erythrocytes (EMg) by atomic absorption spectrophotometry.
Asthmatic children had significantly lower Mg whether extracellular (SMg: 0.7 ± 0.18 mmol/L, UMg: 2.68 ± 8 mmol/L) or intracel-
lular (MMg: 1.7 ± 1.22 fmol/cell, EMg: 0.09 ± 0.03 fmol/cell)compared to controls (SMg: 0.85 ± 0.12 mmol/L, UMg:3.9 ± 0.73 mmol/L,
MMg:3.75 ± 2.03 fmol/cell and EMg: 0.198 ± 0.026 fmol/cell with p < 0.001 in all except EMg where p < 0.05).
Patients with severe asthma had significant deficiency of SMg as well as intracellular Mg when compared to controls with signifi-
cant decrease in UMg excretion. In moderate asthma, there was a deficiency in intracellular Mg but SMg was comparable to controls
possibly maintained by decreased renal excretion as evident from the decreased UMg concentration. Patients with mild asthma had
significant deficiency only in EMg. The degree of Mg deficiency whether intra or extracellular, closely followed the grade of asthma
severity with significant lower SMg, UMg, MMg and EMg in severe as compared to mild asthma and significantly lower MMg and EMg
in severe as compared to moderate asthma. SMg and MMg also correlated negatively with respiratory rate and positively with peak
expiratory flow rate (PEFR) in severely asthmatic children.
Intravenous infusion of MgSO4
(50 mg/kg), given to severely asthmatic children who did not respond to 3 doses of nebulized B2
– agonist, resulted in clinical improvement and significant increase in PEFR, SMg, MMg and EMg with further increase in MMg and
EMg at follow up (after 2 – 4 wks).
It is concluded that asthmatic children suffer Mg deficiency, the degree of which increase with increasing severity of asthma.
Urinary and intracellular Mg proved to be more reliable than SMg as indices of magnesium status. UMg being less invasive and easily
assayed is recommended for monitoring magnesium status in asthmatics. Lastly, MgSO4
infusion proved efficacious and is recom-
mended as a bronchodilator in acute episodes.


Magnesium (Mg) is a cation that has a modulatory effect on the contractile state of smooth muscle cells in various tissues. Hypomag-
nesemia leads to contraction while hypermagnesemia leads to relaxation [1]. The relationship between hypomagnesemia and increased
contractile state may be explained by the inhibitory effect of Mg on the secretion of acetyl choline from presynaptic neurons and by the antagonism between Mg and calcium (Ca) in the cell [2]. Mg can block the triggering effect of Ca on chemical mediator release from baso-
phils and mast cells [3]. It can also inhibit the synthesis of prostanoids enhanced by Ca ion influx [4].
As asthma is characterised by widely varying degrees of contraction of bronchial smooth muscles, Mg deficiency could perpetuate the
contractile state of bronchial smooth muscles [1]. Furthermore, Mg therapy might be an appropriate approach to the problem. However,
the results of clinical studies of Mg therapy in asthma have been conflicting [5,6].


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