Montelukast Reduces Serum Levels of Eosinophil-Derived Neurotoxin in Preschool Asthma

Kim, Chang-Keun; Callaway, Zak; Park, Jin-Sung; Nishimori, Hisashi; Ogino, Tikatoshi; Nagao, Mizuho; Fujisawa, Takao

Children aged 1 to 6 years were enrolled in this study. Because asthma is a heterogeneous disease and especially difficult to diagnose in this age group, the definition of asthma used was based on the Global Initiative for Asthma (GINA) 2 and Japanese pediatric guidelines. 14 Major inclusion criteria were as follows: 1) 3 or more recurrent wheezing episodes within a year, with at least one confirmed by a physician, and multiple-trigger wheeze (not just common cold but other triggers such as exercise, crying or laughing); and 2) improvement of wheezing after administration of inhaled or oral short-acting beta2-agonists. Minor inclusion criteria include at least one of the following: 1) parental asthma, 2) physician-diagnosed atopic dermatitis (AD), 3) physician-diagnosed allergic rhinitis (AR) or 4) physiciandiagnosed food allergy. To be included in the study, a patient must have had both major criteria and at least one of the minor inclusion criteria. Criteria for randomization included patient was: 1) symptomatic during the run-in period; and 2) had a sEDN level ≥ 53 ng/ mL, 13 with positive specific IgE to HDM (Immulite 2000 3gAllergy > 0.1 IU A /mL). 14 Exclusion criteria included one or more of the following: 1) patients who received asthma controller medication, such as ICSs or LTRAs, in the previous 6 months; 2) chronic lung disease, heart or kidney disease or any other congenital disease; and 3) a patient whom the physician regarded as inappropriate for the study (e.g., did not attend the clinic when instructed).