Yoshihara Shigemi, Ono Mika, Yamada Yumi, Fukuda Hironobu, Abe Toshio, Arisaka Osamu
Department of Pediatrics, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan.
Pediatr Allergy Immunol. 2009 Aug;20(5):486-92. doi: 10.1111/j.1399-3038.2008.00807.x. Epub 2009 Feb 2.
The onset of asthma may be related to Th2 cytokine dominance at the time when food allergies occur several months after birth. This study investigated the effectiveness of early intervention with a Th2 cytokine inhibitor (suplatast tosilate) for prevention of asthma in infants with food allergies and atopic dermatitis. Suplatast tosilate dry syrup (6 mg/kg daily) or a histamine H(1)-blocker (ketotifen fumarate dry syrup: 0.06 mg/kg daily) was administered randomly to 53 infants with atopic dermatitis caused by food allergies. The primary endpoints were the incidence of asthma and the time to the onset of wheezing. The peripheral blood Th1/Th2 ratio, total IgE level, and eosinophil count were measured before and after treatment. After 24 months of treatment, the prevalence of asthma was significantly lower in the suplatast group (20.8%) than in the ketotifen group (65.6%, p < 0.01). Additionally, the time from the start of treatment to the initial episode of wheezing for infants who developed asthma was significantly longer in the suplatast group than the ketotifen group (p < 0.01). Furthermore, the eosinophil count was significantly decreased by suplatast treatment (p < 0.05), and there was a significant difference between the suplatast and ketotifen groups with respect to both the eosinophil count (p < 0.01) and the Th1/Th2 ratio (p < 0.05). The results of the present pilot study suggest that suplatast tosilate is useful for the primary prevention of wheezing and asthma in children.
哮喘的发病可能与出生后数月出现食物过敏时Th2细胞因子占优势有关。本研究调查了使用Th2细胞因子抑制剂（甲苯磺酸舒普拉泰）进行早期干预对预防食物过敏和特应性皮炎婴儿哮喘的有效性。将甲苯磺酸舒普拉泰干糖浆（每日6 mg/kg）或组胺H(1)受体阻滞剂（富马酸酮替芬干糖浆：每日0.06 mg/kg）随机给予53例由食物过敏引起特应性皮炎的婴儿。主要终点是哮喘发病率和喘息发作时间。在治疗前后测量外周血Th1/Th2比值、总IgE水平和嗜酸性粒细胞计数。治疗24个月后，舒普拉泰组哮喘患病率（20.8%）显著低于酮替芬组（65.6%，p<0.01）。此外，舒普拉泰组哮喘婴儿从治疗开始到首次喘息发作的时间显著长于酮替芬组（p<0.01）。此外，舒普拉泰治疗使嗜酸性粒细胞计数显著降低（p<0.05），舒普拉泰组和酮替芬组在嗜酸性粒细胞计数（p<0.01）和Th1/Th2比值（p<0.05）方面均存在显著差异。本初步研究结果表明，甲苯磺酸舒普拉泰对儿童喘息和哮喘的一级预防有用。
