A study of cytokine profile and serum IgE level and their association with montelukast therapy in childhood asthma
Kerbala Journal of Medicine,
Volume 6, Issue 1, Pages 1573-1583
Abstractasthma is the most common allergic disease giving rise to the morbidity or school
absence in children and has an increasing incidence worldwide. Montelukast is a well
known leukotriene receptor antagonist used to treat children with asthma. Several
cytokines in addition to IgE are known to affect the course of the disease and response to
treatment in this regard.
This is a prospective placebo-controlled cohort study done in Kerbala Pediatric Teaching
Hospital during April, 2011 through February, 2013. It aims to test the effect of cytokine
profile and serum IgE level (measured by ELISA) on asthma development and their influence
on 1-month course of montelukast therapy compared to a placebo group (30 patients each).
Of the 60 patients, 30 were given montelukast as add-on therapy and the other 30 were
regarded as placebo group. Serum level of IL2, 4, 10, 17 and IFN-gamma were determined
pre- and post- treatment course in all patients and compared with 30 healthy controls.
Response was assessed according to answer to a pre- formed questionnaire formula answered
by the parents regarding frequency and severity of wheezy attacks.
Results showed a significantly higher level of serum IL4 in asthmatic children than in healthy
control. More importantly, its level was shown to be directly related with poorer clinical
response to montelukast, p value < 0.05. In addition, montelukast was shown to significantly
decrease serum IL4 level in the treatment group (30 asthmatics) compared to the placebo
group, p value <0.05.
Furthermore, our data revealed that the serum level of IL10 was significantly lower in
asthmatics compared to the control healthy children and that the higher the level of IL10, the
better the clinical response to montelukast (r=0.73). While the role of the other cytokines
tested in this study, IL 2, IL 17 and IFN-gamma was non-significant regarding association
with disease or influence on response to montelukast.
Data regarding serum IgE level in the recruited 60 asthmatic children revealed that there is a
significantly increased level compared to the healthy control group, p value < 0.05.
Additionally its serum level negatively correlates with clinical response to montelukast, r=
In conclusion, serum level of IgE, IL4 and IL10 are important markers associated with
childhood asthma development and influencing response to montelukast. Secondly, it was
shown that montelukast add-on therapy has significantly better biochemical and clinical
response in childhood asthma than conventional asthma controllers alone.
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