Montelukast Decreases Plasma Endothelin-1 and Serum Eosinophil Cationic Protein Levels in Paediatric Atopic Asthma
Background and objective: Endothelin-1 (ET-1) is produced by vascular endothelial cells and epithelial cells, T-lymphocytes and phagocytes. Increased ET-1 levels have been demonstrated in the bronchial epithelium of asthma patients. In vitro, ET-1 stimulates mucus secretion, activates proinflammatory cells — macrophages and mast cells — and serves as a mitogenic stimulus for fibroblasts and smooth muscle. In addition, ET-1 activates phospholipase 2. Compared with healthy individuals, asthma patients have increased ET-1 levels during an attack and following stabilisation. Our study was designed to examine plasma ET-1 (P-ET) levels in paediatric atopic patients newly diagnosed with persistent mild bronchial asthma and 1 month after initiation of montelukast therapy.
Methods: Patients’ histories were examined, and their blood eosinophil leucocyte count and levels of total serum immunoglobulin E (S-IgE), serum eosinophil cationic protein (S-ECP) and P-ET were determined. Thirty-six patients with persistent mild bronchial asthma were treated with the leukotriene receptor antagonist montelukast, administered once a day for 4 weeks. Second P-ET and S-ECP level determinations were made 4 weeks later with all the children included in the study. P-ET levels were also determined in a group of 27 healthy children who had no atopy in their medical histories and were taking no drugs (including montelukast), and who served as controls.
Results: The mean ± SD pretreatment P-ET level in the 36 study children was 11.542 ± 6.408 pg/L, and this decreased to 5.636 ± 4.419 pg/L after 1 month’s therapy with montelukast (statistically significant difference; p < 0.0001). Both of these values were significantly higher (p < 0.0001 and p < 0.031, respectively) than the mean level in the control group of 27 children (3.543 ± 2.497 pg/L). The mean pretreatment S-ECP level was 35.78 ± 19.58 μg/L, and this decreased to 19.54 ± 13.86 μg/L after 1 month’s therapy (p < 0.001).
Conclusions: This study demonstrated a decrease in P-ET levels in children with mild asthma receiving montelukast. This indicates a reduction in the severity of the inflammatory response and, hence, provides evidence for the anti-inflammatory effect of montelukast. Monitoring both ET-1 and ECP levels at regular follow-up may be useful in assessing these two facets of activity of chronic inflammation in bronchial asthma.
KeywordsMontelukast Eosinophil Cationic Protein Mild Persistent Bronchial Asthma Eosinophil Cationic Protein Level Serum Eosinophil Cationic Protein
This work was supported by MSM grant 6198959216 and MSD, s.r.o Czech Republic. The authors have no potential conflicts of interest that are directly relevant to the contents of this study.
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