Tahan Fulya, Celik Serkan, Eke Gungor Hatice
Erciyes University, School of Medicine, Department of Pediatric Allergy, 38039 Kayseri, Turkey.
Erciyes University, School of Medicine, Department of Pediatric Allergy, 38039 Kayseri, Turkey.
Allergol Immunopathol (Madr). 2015 Jul-Aug;43(4):376-82. doi: 10.1016/j.aller.2014.06.008. Epub 2015 Jan 7.
Acute bronchiolitis comprises a major cause for morbidity in infants with viral infection which induces an immune inflammatory response that may produce long lasting harmful effects. Currently, there is no effective therapy for bronchiolitis.
Our aim was to investigate the efficacy of five-day montelukast therapy in acute bronchiolitis management.
The study included 50 infants with acute bronchiolitis. The infants with first episode of acute bronchiolitis were randomly assigned to receive daily montelukast dose of 4mg over five days after admission or no treatment. Plasma eotaxin, IL-4, IL-8 and IFN-gamma levels were evaluated before and after treatment by ELISA method. In the present study, the primary outcome measure was change in clinical severity score, whilst secondary outcome measures were changes in plasma eotaxin, IL-4, IL-8, IFN-gamma levels.
No significant differences was found in clinical severity score with five-day montelukast treatment (p>0.05, Mann-Whitney U test). There were no significant differences in plasma eotaxin, IL-4, IL-8, IFN-gamma levels between the groups (p>0.05 Mann-Whitney U test). There was significant decrease in plasma IFN-gamma levels following five-day montelukast treatment (p=0.027, Wilcoxon). There were no significant differences in plasma IL-4, IL-8, IFN-gamma levels between the groups after five-day montelukast treatment (p>0.05, Wilcoxon). There was significant increase in eotaxin levels after five-day montelukast treatment (p=0.009, Wilcoxon).
Our study showed that montelukast affected plasma IFN-gamma and eotaxin levels after five days of treatment. Further studies are needed to demonstrate effects of montelukast on chemokine levels in bronchiolitis.
急性细支气管炎是婴儿病毒感染导致发病的主要原因，病毒感染会引发免疫炎症反应，可能产生长期有害影响。目前，尚无治疗细支气管炎的有效疗法。
我们的目的是研究为期五天的孟鲁司特治疗在急性细支气管炎管理中的疗效。
该研究纳入了50例急性细支气管炎婴儿。首次发作急性细支气管炎的婴儿在入院后随机分配，一组在五天内每日接受4mg孟鲁司特治疗，另一组不接受治疗。采用酶联免疫吸附测定法（ELISA法）在治疗前后评估血浆嗜酸性粒细胞趋化蛋白、白细胞介素-4、白细胞介素-8和干扰素-γ水平。在本研究中，主要结局指标是临床严重程度评分的变化，次要结局指标是血浆嗜酸性粒细胞趋化蛋白、白细胞介素-4、白细胞介素-8、干扰素-γ水平的变化。
为期五天的孟鲁司特治疗后，临床严重程度评分无显著差异（p>0.05，曼-惠特尼U检验）。两组间血浆嗜酸性粒细胞趋化蛋白、白细胞介素-4、白细胞介素-8、干扰素-γ水平无显著差异（p>0.05，曼-惠特尼U检验）。为期五天的孟鲁司特治疗后，血浆干扰素-γ水平显著降低（p=0.027，威尔科克森检验）。为期五天的孟鲁司特治疗后，两组间血浆白细胞介素-4、白细胞介素-8、干扰素-γ水平无显著差异（p>0.05，威尔科克森检验）。为期五天的孟鲁司特治疗后，嗜酸性粒细胞趋化蛋白水平显著升高（p=0.009，威尔科克森检验）。
我们的研究表明，孟鲁司特治疗五天后会影响血浆干扰素-γ和嗜酸性粒细胞趋化蛋白水平。需要进一步研究来证明孟鲁司特对细支气管炎中趋化因子水平的影响。
