Effect of suplatast tosilate on goblet cell metaplasia in patients with asthma.
BACKGROUND
Goblet cell metaplasia is a pathologic characteristic of asthma, associated with excess mucus secretion. Interleukin (IL)-4 and IL-13 plays an important role in mucus hypersecretion. Suplatast tosilate (suplatast), an antiallergic agent, is a Th2 cytokine inhibitor that suppresses the synthesis of IL-4, IL-5, IL-13, and eosinophilic airway inflammation.


OBJECTIVE
We examined the effects of suplatast on mucus production in bronchial biopsy specimens taken from asthmatic subjects.


METHODS
Oral suplatast 300 mg daily, or placebo was administered for 3 months in a double-blind, parallel-group study in 25 patients with asthma. Biopsy specimens were evaluated at before and after treatment for alcian blue/period acid-Schiff (AB/PAS), MUC5AC staining in bronchial epithelium and IL-4+, IL-13+ cells as well as inflammatory cells in lamina propria.


RESULTS
There were significant decreases in the percentage of AB/PAS (P < 0.01) and MUC5AC (P < 0.01) stained area in the suplatast group. These changes were accompanied by significant decreases in IL-4+ and IL-13+ cells in suplatast-treated subjects. Additionally, we have observed that the number of infiltrating eosinophils and CD4+ T cells significantly decreased.


CONCLUSIONS
These findings suggest that suplatast prevents goblet cell metaplasia through modulation of Th2 cytokine production and the recruitment of eosinophils and CD4+ T cells in the asthmatic airways.
Hoshino
M
M
Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan.
Fujita
Y
Y
Saji
J
J
Inoue
T
T
Nakagawa
T
T
Miyazawa
T
T
D000284:Administration, Oral; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001190:Arylsulfonates / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000473:pathology; D001706:Biopsy; D001980:Bronchi / Q000276:immunology / Q000473:pathology; D004848:Epithelium / Q000276:immunology; D005260:Female; D020397:Goblet Cells / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D007377:Interleukin-3 / Q000096:biosynthesis; D015847:Interleukin-4 / Q000096:biosynthesis; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D013452:Sulfonium Compounds / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use
D018926:Anti-Allergic Agents; D001190:Arylsulfonates; D007377:Interleukin-3; D013452:Sulfonium Compounds; D015847:Interleukin-4; C073028:suplatast tosilate