Montelukast Reduces Serum Levels of Eosinophil-Derived Neurotoxin in Preschool Asthma.
10.4168/aair.2018.10.6.686
- Author:
Chang Keun KIM
1
;
Zak CALLAWAY
;
Jin Sung PARK
;
Hisashi NISHIMORI
;
Tikatoshi OGINO
;
Mizuho NAGAO
;
Takao FUJISAWA
Author Information
1. Asthma & Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Biomarkers;
children;
eosinophil-derived neurotoxin;
asthma
- MeSH:
Asthma*;
Biomarkers;
Budesonide;
Child;
Child, Preschool;
Eosinophil-Derived Neurotoxin*;
Eosinophils;
Humans;
Immunoglobulin E;
Immunoglobulins;
Inflammation;
Inhalation;
Pyroglyphidae
- From:Allergy, Asthma & Immunology Research
2018;10(6):686-697
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Several markers for eosinophilic inflammation have been proposed to predict response to asthma treatment. However, definitive criteria for treatment decisions have not yet been established. We investigate a potentially useful relatively non-invasive biomarker, eosinophil-derived neurotoxin (EDN), to predict favorable responses to budesonide or montelukast, common treatment for children with asthma. METHODS: Young children (1 to 6 years old) were enrolled in this randomized, parallel, 2-group, open-label trial. Criteria for eligibility included: 1) being symptomatic during the run-in period; and 2) having a serum EDN (sEDN) level ≥ 53 ng/mL, with positive specific immunoglobulin E to house dust mite. Eligible patients were randomly placed into 2 groups: the BIS group received budesonide inhalation suspension (BIS) 0.5 mg once daily; the MONT group received montelukast 4 mg once daily. Ineligible patients were invited to receive montelukast 4 mg once daily (OBS group). Treatment period was 12 weeks. RESULTS: Asthma control days increased significantly in the BIS and MONT groups (P < 0.000) over the 12-week study period. There was no significant change in sEDN in the BIS group but there was a significant decrease in the MONT group (P < 0.000). Patients in the OBS group with high EDN levels (< 53 ng/mL) showed a significant decrease due to MONT treatment (P = 0.023). Rescue medication usage significantly decreased in the BIS and MONT groups (P < 0.000). CONCLUSIONS: EDN is a useful relatively non-invasive biomarker for predicting responses to montelukast and budesonide treatment of preschool children with beta2-agonist responsive recurrent wheeze and multiple-trigger wheeze (Trial registry at UMIN Clinical Trials Registry, UMIN000008335).
