Can montelukast correct immune dysregulation in preschool children with mild persistent asthma?

Document Type : Original Article

Authors

1 Department of Pediatrics, faculty of medicine, Suez Canal University, Ismailia, Egypt.

2 Clinical pathology department, faculty of medicine, Suez Canal University, Ismailia, Egypt.

3 Clinical pathology, faculty of medicine, Suez Canal University, Ismailia,Egypt.

4 Microbiology and Immunology department, faculty of medicine, Suez Canal University, Ismailia, Egypt.

Abstract

Background: Asthma is the most common inflammatory disorder among
preschool and school-age children. Regulation of immune cells and their
cytokines is essential to control asthma. Montelukast is a leukotriene
receptor antagonist that suppresses inflammatory cell proliferation, and
reduces cytokines and mediator secretion. Objective: The research
team's goal was to study the immunological parameters among mild
asthmatic patients before and after the treatment with Montelukast .
Methods: Forty preschool children with mild persistent asthma and
twenty healthy, non-allergic children were included in the study. Blood
eosinophil count, total IgE, serum IL-4, IL-10, and IL-13 levels were
assessed. T helper (CD3+CD4+) and T regulatory (CD4+CD25+) cell
counts were measured using flow cytometry; for mild asthmatics before
and after six weeks of treatment with Montelukast and for the control
group. Results: Asthmatic children have shown a significant elevation of
serum levels of IgE, IL4 and IL13, and also an increase of eosinophils,
total lymphocyte T cells and T helper cell count. However; serum levels
of IL10 and Treg cell count was lower in asthmatics compared to control.
Following six weeks of Montelukast treatment, all immunological
parameters improved. There was a significant elevation of serum levels
of IL10 and Treg cell count, with a decrease in serum levels of IgE, IL4
and IL13; eosinophil counts, and helper T cells. Conclusion:
Montelukast treatment improves the impaired immunological balance of
mild asthmatic children through the increase of serum IL-10, T
regulatory cell counts that have anti-inflammatory and
immunoregulatory effects. It also decreases T helper cells and their
proinflammatory cytokines.

Keywords