title: The combined effects of zafirlukast, prednisone, and inhaled budesonide on IL-13 and IFN-gamma secretion.
abstract: Therapy for asthma often includes the combined use of glucocorticoids and leukotriene receptor antagonists. The short-term, combined effects of these drugs on cytokine secretion and lymphocyte proliferation are ill-defined. The aim of this study was to analyze allergen and mitogen-induced cytokine secretion and lymphocyte proliferation in asthmatics and to determine the effect of combined therapy on these immune responses. Peripheral blood mononuclear cells were isolated from mild, persistent adult asthmatics (n = 28) and analyzed for cat allergen (Fel d 1) and mitogen (phytohemagglutinin) induced IL-13 and IFN-gamma secretion and lymphocyte proliferation. Samples were analyzed before and after 10 days of therapy with oral zafirlukast, prednisone (0.5 mg/kg/day), and inhaled budesonide (1600 mcg/day). Both Fel d 1 and mitogen stimulation resulted in IL-13 and IFN-gamma secretion. Combination drug therapy resulted in a significant decrease in allergen-induced IFN-gamma secretion (p = 0.018) and allergen-specific lymphocyte proliferation (p = 0.02), while IL-13 secretion was unchanged (p = 0.109). This study indicates a role for Th1 cytokines as well as Th2 cytokines in the allergic response.
authors.affiliation: Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, 02114, USA. fgibbons@partners.org
authors.forename: Fiona K
authors.initials: FK
authors.lastname: Gibbons
authors.forename: Elliot
authors.initials: E
authors.lastname: Israel
authors.forename: Aaron
authors.initials: A
authors.lastname: Deykin
authors.forename: Bianca
authors.initials: B
authors.lastname: Schaub
authors.forename: Hong Z
authors.initials: HZ
authors.lastname: He
authors.forename: David L
authors.initials: DL
authors.lastname: Perkins
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Finn
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006023:Glycoproteins; D006801:Humans; D007211:Indoles; D007371:Interferon-gamma / Q000097:blood*; D018793:Interleukin-13 / Q000097:blood*; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000378:metabolism; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D048448:Phenylcarbamates; D010835:Phytohemagglutinins; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D013449:Sulfonamides; D014105:Tosyl Compounds / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D005938:Glucocorticoids; D006023:Glycoproteins; D007211:Indoles; D018793:Interleukin-13; D020024:Leukotriene Antagonists; D048448:Phenylcarbamates; D010835:Phytohemagglutinins; D013449:Sulfonamides; D014105:Tosyl Compounds; D019819:Budesonide; D007371:Interferon-gamma; C059296:Fel d 1 protein, Felis domesticus; D011241:Prednisone; C062735:zafirlukast