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

Recent meta-analyses 28 of Green et al.'s study 8 and 2 others 29,30 bolster the hypothesis that treatment-based eosinophil indices is more efficacious (i.e., reduces the frequency and severity of exacerbations) than treatment based on clinical symptoms and other traditional objective measures of lung function such as peak expiratory flow and spirometry. Tailoring patient treatment based on the direct and objective measurement of airway inflammation resulted in significantly less frequent and severe asthma exacerbations and, consequently a trend towards fewer asthma-related hospital admissions. 28 Knowing both the inflammatory profile and the clinical categorization of the patient develops a clearer phenotype of the asthma patient and appears to contribute to improved asthma care. 27, 31 Using a more accurate biomarker for eosinophilic inflammation in the management of asthma may produce even better results. 32, 33 It has been suggested by many studies that EDN is a more accurate biomarker than eosinophil numbers or percentages. 11, 12, 22, 32 Future studies of EDN as a biomarker for the diagnosis, treatment and monitoring of conditions associated with airway inflammation -such as recurrent wheeze, multiple-trigger wheeze and asthma -are needed.