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A study of cytokine profile and serum IgE level and their association with montelukast therapy in childhood asthma | ||
| Kerbala Journal of Medicine | ||
| Article 1, Volume 6, Issue 1, 2013, Pages 1573-1583 PDF (0 K) | ||
| Authors | ||
| Munther Hussain Al-Kadhimy; Jaafar Kadhim Naama; Ali Mansoor Al-Ameri | ||
| Abstract | ||
| asthma is the most common allergic disease giving rise to the morbidity or school absence in children and has an increasing incidence worldwide. Montelukast is a well known leukotriene receptor antagonist used to treat children with asthma. Several cytokines in addition to IgE are known to affect the course of the disease and response to treatment in this regard. This is a prospective placebo-controlled cohort study done in Kerbala Pediatric Teaching Hospital during April, 2011 through February, 2013. It aims to test the effect of cytokine profile and serum IgE level (measured by ELISA) on asthma development and their influence on 1-month course of montelukast therapy compared to a placebo group (30 patients each). Of the 60 patients, 30 were given montelukast as add-on therapy and the other 30 were regarded as placebo group. Serum level of IL2, 4, 10, 17 and IFN-gamma were determined pre- and post- treatment course in all patients and compared with 30 healthy controls. Response was assessed according to answer to a pre- formed questionnaire formula answered by the parents regarding frequency and severity of wheezy attacks. Results showed a significantly higher level of serum IL4 in asthmatic children than in healthy control. More importantly, its level was shown to be directly related with poorer clinical response to montelukast, p value < 0.05. In addition, montelukast was shown to significantly decrease serum IL4 level in the treatment group (30 asthmatics) compared to the placebo group, p value <0.05. Furthermore, our data revealed that the serum level of IL10 was significantly lower in asthmatics compared to the control healthy children and that the higher the level of IL10, the better the clinical response to montelukast (r=0.73). While the role of the other cytokines tested in this study, IL 2, IL 17 and IFN-gamma was non-significant regarding association with disease or influence on response to montelukast. Data regarding serum IgE level in the recruited 60 asthmatic children revealed that there is a significantly increased level compared to the healthy control group, p value < 0.05. Additionally its serum level negatively correlates with clinical response to montelukast, r= 0.58. In conclusion, serum level of IgE, IL4 and IL10 are important markers associated with childhood asthma development and influencing response to montelukast. Secondly, it was shown that montelukast add-on therapy has significantly better biochemical and clinical response in childhood asthma than conventional asthma controllers alone. | ||
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