Effects of Leukotriene Receptor Antagonists on Peripheral Eosinophil Counts and Serum IgE Levels in Children with Food Allergy

Abstract

Background: Although the efficacy of leukotriene receptor antagonists (LTRAs) for bronchial asthma is already established, their effect on food allergy remains unclear. Objective: To investigate the efficacy of LTRAs in children with food allergy. Methods: This retrospective study examined 65 children with food allergy who were aged between 3 and 36 months (mean 14 -9.6 months) from 2005 to 2008. Thirty-two children were treated as a dietary control group by avoiding any antigenic foods to which they had previously experienced adverse reactions. The remaining 33 children, designated the LTRA group, were treated with pranlukast (7 mg/kg bodyweight/day) in addition to maintaining dietary control. Clinical symptoms and laboratory data before and after 1 year of treatment were compared between the groups. Results: Allergic symptoms improved in both the dietary controlled and LTRA groups, and there was no significant difference observed in the clinical parameters examined between the groups after the 1-year trial. Peripheral eosinophil count, serum IgE, interleukin (IL)-4, IL-5, IL-6, and eosinophil cationic protein (ECP) levels in children with food allergy were above standardized values in both groups. Although both the dietary controlled and LTRA groups showed a decreased eosinophil count (-273 -232 vs -595 -295/mL; p < 0.05 and p < 0.001, respectively), only children treated with LTRA showed a significant decrease in serum IgE (-73.5 -115 IU/mL; p < 0.01); conversely, the control group exhibited a significant increase in serum IgE (+159 -138 IU/mL; p < 0.01). Furthermore, the LTRA group also showed a significant decrease in serum IL-4 (54.5 -31.0 to 27.3 -10.1 pg/mL), IL-5 (6.7 -5.2 to 5.0 -0.4 pg/mL), and ECP (45.4 -15.0 to 15.0 -9.8 mg/L) levels (p < 0.05 for each).

PM2.5-rich dust collected from the air in Fukuoka, Kyushu, Japan, can exacerbate murine lung eosinophilia

“…IL-4 can stimulate IgE synthesis (Yamakawa et al, 2010) and IgG1 can contribute to antigen-specific eosinophil degradation via FcgRII on the surface of eosinophils (Kaneko et al, 1995). Therefore, increased levels OVA-specific IgE and IgG1 might be related to the enhanced levels of cytokines and lung eosinophilia.…”

Parallel reductions of IgE and exhaled nitric oxide after optimized anti‐inflammatory asthma treatment

“…The reason for this increase can only be speculated upon, but may be related to a rapid decrease in IgE‐binding sites, resulting in increased levels of free measurable IgE antibodies. More recent studies on treatment‐naïve patients with atopic asthma or food allergy indicate that the introduction of anti‐inflammatory treatment with at least medium doses of ICS, as well as treatment with LTRA, reduces IgE concentrations . In contrast, low dose ICS has repeatedly been shown not to reduce IgE , or even to cause a transient increase in IgE concentrations .…”