Effect of pranlukast on bronchial inflammation in patients with asthma.
BACKGROUND
Pranlukast (8-[p-(4-phenylbutyloxy) benzol] amino-2-[tetrazol-5-yl]-4-oxo-4H-1-benzopyran hemihydrate), a selective cysteinyl leukotriene receptor antagonist, has been reported to exhibit not only antileukotrine activity but also pharmacological activity including antieosinophilic effects.


OBJECTIVE
This study was designed to investigate whether the antiasthmatic activity of pranlukast is associated with a reduction in eosinophilic inflammation.


METHODS
A double-blind, randomized, crossover design was used. Subjects received 225 mg of pranlukast or placebo orally twice daily for 4 weeks and then, after a washout period of at least 4 weeks, crossed over to receive the alternative treatment. We assessed the effects of pretreatment with pranlukast on bronchoconstriction precipitated by inhalation of methacholine in 32 adult patients with mild or moderate bronchial asthma; those who were in stable clinical condition were allocated to this study. Blood and sputum samples were taken the morning of the methacholine provocation test. Eosinophil counts and measurement of eosinophilic cationic protein (ECP) were performed.


RESULTS
After the 4 weeks of treatment with pranlukast, patients' symptoms, blood eosinophils, serum ECP, sputum eosinophils, and sputum ECP were significantly decreased. Furthermore, values of PC20-methacholine significantly improved in the treatment with pranlukast.


CONCLUSIONS
Our results suggest that pranlukast has an anti-inflammatory effect on bronchial eosinophilic infiltration. This study raises further interesting therapeutic possibilities and argues for further trials of new approaches to the treatment of bronchial asthma.
Yoshida
S
S
Institute for Comprehensive Medical Sciences, Fujita Health, University School of Medicine, Toyoake, Japan.
Ishizaki
Y
Y
Shoji
T
T
Onuma
K
K
Nakagawa
H
H
Nakabayashi
M
M
Akahori
K
K
Hasegawa
H
H
Amayasu
H
H
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology; D001798:Blood Proteins / Q000032:analysis; D001985:Bronchial Provocation Tests; D016084:Bronchoconstriction / Q000187:drug effects; D002867:Chromones / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D047091:Eosinophil Granule Proteins; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D012260:Ribonucleases; D013183:Sputum / Q000166:cytology / Q000276:immunology
D018927:Anti-Asthmatic Agents; D001798:Blood Proteins; D002867:Chromones; D047091:Eosinophil Granule Proteins; D016210:Methacholine Chloride; D012260:Ribonucleases; C047681:pranlukast