The Turkish Journal of Pediatrics
2009 , Vol 51 , Num 5
The Effect of Treatment with Montelukast on Levels of Serum Interleukin-10, Eosinophil Cationic Protein, Blood Eosinophil Counts, and Clinical Parameters in Children with Asthma
Departments of 1Pediatrics, and 2Biochemistry, Karaelmas University Faculty of Medicine, Zonguldak, and 3Department
of Biochemistry, Ufuk University Faculty of Medicine, Ankara, and 4Department of Pediatric Allergy, Başkent University
Faculty of Medicine, Adana, Turkey
Interleukin (IL)-10 is an important immunoregulatory and anti-inflammatory
cytokine. IL-10 levels are reduced in asthmatic airways. A regulatory mechanism
involving IL-4 induced allergen-specific IL-10 production may be defective
in allergic subjects, and this defect potentially contributes to more intense
inflammation. The aim of this study was to define the effect of treatment with
montelukast on serum levels of IL-10, eosinophil cationic protein (ECP), blood
eosinophil counts, and clinical parameters (symptom score and lung function
tests) in children with mild and moderate persistent asthma. Twenty-five
children with mild-to-moderate persistent asthma and 25 nonatopic healthy
children as controls were enrolled in the study. Patients were treated with
montelukast for four weeks. Lung function tests for forced expiratory volume
in 1 second (FEV1), peak expiratory flow (PEF), and forced expiratory flow
between 25% and 75% (FEF25-75) were performed before and after treatment.
Serum IL-10, ECP levels, and blood eosinophil counts were determined in
both the control group and asthmatic children before and after treatment.
The mean serum IL-10 levels were significantly lower before treatment than
after treatment (1.75±0.9 pg/ml and 5.49±3.6 pg/ml; p<0.001) and in control
subjects (5.6±2.8 pg/ml). After four weeks of treatment with montelukast, the
mean blood eosinophil count value (608±73/mm3 and 469±57/mm3; p<0.05)
but not the ECP value (33.98±24.3 μg/L and 29.03±19.2 μg/L; p>0.05) was
significantly decreased. After treatment with montelukast, all clinical parameters
and lung function tests improved. We found no statistical correlations between
the serum level of IL-10 and the serum level of ECP, eosinophil count, lung
function tests, or clinical scores after treatment with montelukast.
Montelukast caused a statistically significant increase in serum IL-10 levels and decrease in peripheral blood eosinophil counts over the four-week treatment period. Our study indicates that montelukast provides clinical benefits for children with chronic asthma and produces an anti-inflammatory response by increasing serum IL-10 levels.
Keywords : childhood asthma, eosinophil, interleukin-10, montelukast