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.

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 microg/L and 29.03 +/- 19.2 microg/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,

The effect of montelukast on soluble interleukin-2 receptor and tumor necrosis factor alpha in pediatric asthma.

Proinflammatory cytokines such as tumor necrosis factor (TNF) alpha and soluble interleukin 2 receptor (sIL-2R) are very important mediators in induction of inflammatory response in lung. The aim of this study was to investigate anti-inflammatory response of cysteinyl leukotriene receptor antagonist montelukast on macrophage and T-cell activation by sIL-2R and TNF-alpha in mild atopic asthmatic children. Fifteen children with mild-to-moderate atopic asthma and 15 nonatopic children as control, enrolled in the study. Asthmatic children were treated with montelukast, 5-mg tablets, for 1 month. Lung function test forced expiratory volume in 1 second (FEV1) was performed before and after treatment. Serum TNF-alpha, sIL-2R, and eosinophil cationic protein levels were determined in the control group and in asthmatic children before and after treatment. The mean eosinophil cationic protein value was significantly decreased (33.1 +/- 14.8 and 22.2 +/- 12.1; p < 0.05) and FEV1 was significantly increased (86.9 +/- 20.9 and 102.1 +/- 12.7; p < 0.05) after 1 month treatment with montelukast. The mean serum IL-2R levels were significantly higher in the before treatment group than in the after treatment group (1061.9 +/- 491 and 794 +/- 230.9; p < 0.05) or in control subjects (581.1 +/- 123; p < 0.01). The mean serum TNF-alpha level was higher in the before treatment group than in the after treatment group and control group (7.30 +/- 3.93, 5.20 +/- 1.46, and 4.95 +/- 1.27; p < 0.05). There was a significant correlation between TNF-alpha and sIL-2R in patients before montelukast treatment (r = 0.674; p < 0.01). This study indicates that montelukast improves clinical parameters and shows anti-inflammatory response by decreasing serum sIL-2R and TNF-alpha levels.