Effects of montelukast treatment on clinical and inflammatory variables in patients with cystic fibrosis.
BACKGROUND
In cystic fibrosis (CF), the inflammatory process contributes to progressive lung tissue damage. Cysteinyl leukotrienes have been found in the sputum of patients with CF at high concentrations sufficient to cause potent biological effects.


OBJECTIVE
To evaluate the effect of anti-inflammatory treatment with montelukast sodium in patients with CF.


METHODS
Twenty-six patients aged 6 to 18 years were recruited to this 20-week, randomized, double-blind, placebo-controlled, crossover trial. Patients received montelukast or placebo for 8 weeks in addition to their regular CF treatment. Before and after treatment, findings from spirometry, whole-body plethysmography, and the clinical wheezing and cough scales were evaluated. At the same time, serum and sputum samples were obtained for the measurement of eosinophil cationic protein, interleukin 10 (IL-10), IL-8, and myeloperoxidase levels.


RESULTS
Twenty-three patients completed the study. Compared with placebo use, montelukast treatment significantly improved forced expiratory volume in I second, peak expiratory flow, and forced expiratory flow between 25% and 75% and significantly decreased cough and wheezing scale scores (P < .001 for all). There were no significant changes in vital capacity, thoracic gas volume, airway resistance, and residual volume after treatment. Compared with placebo use, montelukast treatment decreased serum and sputum levels of eosinophil cationic protein and IL-8, decreased sputum levels of myeloperoxidase, and increased serum and sputum levels of IL-10 (P < .001 for all).


CONCLUSIONS
Montelukast may have measurable anti-inflammatory properties in patients with CF.
Stelmach
Iwona
I
Department of Pediatrics and Allergy, M Curie Hospital, Zgierz, Poland. interna@wss.izerz.pl
Korzeniewska
Aleksandra
A
Stelmach
Wlodzimierz
W
Majak
Pawel
P
Grzelewski
Tomasz
T
Jerzynska
Joanna
J
D000085:Acetates / Q000627:therapeutic use*; D000293:Adolescent; D000403:Airway Resistance / Q000187:drug effects; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D002648:Child; D003371:Cough; D018592:Cross-Over Studies; D003521:Cyclopropanes; D003550:Cystic Fibrosis / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D047150:Eosinophil Cationic Protein / Q000032:analysis; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008297:Male; D009195:Peroxidase / Q000032:analysis; D011804:Quinolines / Q000627:therapeutic use*; D012135:Respiratory Sounds; D013183:Sputum / Q000201:enzymology / Q000276:immunology; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D016209:Interleukin-8; D011804:Quinolines; D013440:Sulfides; D016753:Interleukin-10; D009195:Peroxidase; D047150:Eosinophil Cationic Protein; C093875:montelukast