Novel therapeutic approach to primary biliary cirrhosis patients: anti-eosinophil strategy.
OBJECTIVE
Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease of unknown cause. Morphologically, PBC is characterized by eosinophil infiltration into the portal tract in recent studies. Pranlukast, a new drug, is a leukotriene antagonist, which suppresses eosinophil infiltration in atopic dermatitis or asthma.


METHODS
In this study, pranlukast monotherapy was used to treat 12 patients with a diagnosis of PBC, classified as stage I or II according to Scheuer's classification on the basis of liver biopsy findings.


RESULTS
An improvement in alkaline phosphatase (ALP) was observed beginning one month after the start of pranlukast therapy in all 12 patients. Improvement in ALP and gamma-GTP values was statistically observed at 1, 2, and 6 months after the start of treatment. IgG and IgM values improved in all 12 patients at 2 months and 6 months after the start of treatment. Absolute eosinophil counts improved at 6 months after the start of treatment.


CONCLUSIONS
Given its efficacy and the absence of side effects, planlukast appears to be the medical treatment of choice for patients with early-stage PBC. But, a randomised, controlled, double-blind trial is urgently needed.
Miyaguchi
S
S
Department of Internal Medicine, Tokyo Metropolitan Otsuka Hospital, Japan. skoshiba@gol.com
Oda
M
M
Saito
H
H
Ishii
H
H
D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D002867:Chromones / Q000627:therapeutic use*; D004796:Clinical Enzyme Tests; D004804:Eosinophils / Q000187:drug effects*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007958:Leukocyte Count; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D005723:gamma-Glutamyltransferase / Q000097:blood
D002867:Chromones; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D020024:Leukotriene Antagonists; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; C047681:pranlukast