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http://dx.doi.org/10.4168/aair.2018.10.6.686

Montelukast Reduces Serum Levels of Eosinophil-Derived Neurotoxin in Preschool Asthma  

Kim, Chang-Keun (Asthma & Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital)
Callaway, Zak (Asthma & Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital)
Park, Jin-Sung (Asthma & Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital)
Nishimori, Hisashi (Department of Pediatrics, Mie Prefectural General Medical Center)
Ogino, Tikatoshi (Niko Niko Child Clinic)
Nagao, Mizuho (Institute for Clinical Research, Mie National Hospital)
Fujisawa, Takao (Institute for Clinical Research, Mie National Hospital)
Publication Information
Allergy, Asthma & Immunology Research / v.10, no.6, 2018 , pp. 686-697 More about this Journal
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 ${\geq}53ng/mL$, 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).
Keywords
Biomarkers; children; eosinophil-derived neurotoxin; asthma;
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