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A study of cytokine profile and serum IgE level and their association with montelukast therapy in childhood asthma

Authors: Munther Hussain Al-Kadhimy --- Jaafar Kadhim Naama --- Ali Mansoor Al-Ameri
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 1 Pages: 1573-1583
Publisher: Kerbala University جامعة كربلاء

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Abstract

asthma is the most common allergic disease giving rise to the morbidity or schoolabsence in children and has an increasing incidence worldwide. Montelukast is a wellknown leukotriene receptor antagonist used to treat children with asthma. Severalcytokines in addition to IgE are known to affect the course of the disease and response totreatment in this regard.This is a prospective placebo-controlled cohort study done in Kerbala Pediatric TeachingHospital during April, 2011 through February, 2013. It aims to test the effect of cytokineprofile and serum IgE level (measured by ELISA) on asthma development and their influenceon 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 wereregarded as placebo group. Serum level of IL2, 4, 10, 17 and IFN-gamma were determinedpre- 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 answeredby the parents regarding frequency and severity of wheezy attacks.Results showed a significantly higher level of serum IL4 in asthmatic children than in healthycontrol. More importantly, its level was shown to be directly related with poorer clinicalresponse to montelukast, p value < 0.05. In addition, montelukast was shown to significantlydecrease serum IL4 level in the treatment group (30 asthmatics) compared to the placebogroup, p value <0.05.Furthermore, our data revealed that the serum level of IL10 was significantly lower inasthmatics compared to the control healthy children and that the higher the level of IL10, thebetter the clinical response to montelukast (r=0.73). While the role of the other cytokinestested in this study, IL 2, IL 17 and IFN-gamma was non-significant regarding associationwith disease or influence on response to montelukast.Data regarding serum IgE level in the recruited 60 asthmatic children revealed that there is asignificantly increased level compared to the healthy control group, p value < 0.05.Additionally its serum level negatively correlates with clinical response to montelukast, r=0.58.In conclusion, serum level of IgE, IL4 and IL10 are important markers associated withchildhood asthma development and influencing response to montelukast. Secondly, it wasshown that montelukast add-on therapy has significantly better biochemical and clinicalresponse in childhood asthma than conventional asthma controllers alone.

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