Yüksel Birol, Aydemir Cumhur, Ustündag Gonca, Eldeş Nilüfer, Kutsal Ebru, Can Murat, Demirtaş Selda, Tomaç Nazan
Department of Pediatrics, Karaelmas University Faculty of Medicine, Zonguldak, Turkey.
Turk J Pediatr. 2009 Sep-Oct;51(5):460-5.
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,
白细胞介素（IL）-10是一种重要的免疫调节和抗炎细胞因子。哮喘气道中的IL-10水平降低。一种涉及IL-4诱导的变应原特异性IL-10产生的调节机制在变应性受试者中可能存在缺陷，这种缺陷可能导致更强烈的炎症。本研究的目的是确定孟鲁司特治疗对轻度和中度持续性哮喘儿童血清IL-10水平、嗜酸性粒细胞阳离子蛋白（ECP）、血液嗜酸性粒细胞计数以及临床参数（症状评分和肺功能测试）的影响。25名轻度至中度持续性哮喘儿童和25名非特应性健康儿童作为对照纳入本研究。患者接受孟鲁司特治疗四周。在治疗前后进行1秒用力呼气量（FEV1）、呼气峰值流速（PEF）以及25%至75%之间的用力呼气流量（FEF25-75）的肺功能测试。在对照组和哮喘儿童治疗前后测定血清IL-10、ECP水平以及血液嗜酸性粒细胞计数。治疗前平均血清IL-10水平显著低于治疗后（1.75±0.9 pg/ml和5.49±3.6 pg/ml；p<0.001）以及对照组（5.6±2.8 pg/ml）。孟鲁司特治疗四周后，平均血液嗜酸性粒细胞计数值（608±73/mm3和469±57/mm3；p<0.05）显著降低，但ECP值（33.98±24.3μg/L和29.03±19.2μg/L；p>0.05）未显著降低。孟鲁司特治疗后，所有临床参数和肺功能测试均得到改善。我们发现孟鲁司特治疗后血清IL-10水平与血清ECP水平、嗜酸性粒细胞计数、肺功能测试或临床评分之间无统计学相关性。在四周治疗期间，孟鲁司特使血清IL-10水平有统计学意义的升高，外周血嗜酸性粒细胞计数有统计学意义的降低。我们的研究表明，孟鲁司特为慢性哮喘儿童带来临床益处，并通过提高血清IL-10水平产生抗炎反应。
