Montelukast treatment response according to eosinophil-derived neurotoxin level in children with allergic rhinitis

Abstract

Eosinophil-derived neurotoxin (EDN) is an important biomarker of eosinophilic inflammation. This study evaluated Montelukast treatment response according to EDN concentration in children with perennial allergic rhinitis (PAR). Fifty-two children with PAR were recruited and took a combination of Montelukast (5mg) and Levocetirizine (5mg) “Mont/Levo Group” or only Montelukast (5mg) “Mont Group” for 4 weeks. All caregivers were instructed to record rhinitis symptoms for 4 weeks. EDN was measured before and after treatment. Daytime nasal symptom scores (DNSS) significantly decreased in both the Mont/Levo (P = 0.0001; n = 20) and Mont Group (P < 0.0001; n = 20), but there were no significant differences between the two groups. EDN concentration also significantly decreased after treatment in both groups (P < 0.0001 and P < 0.001, respectively). For secondary analysis, children with a high initial EDN concentration (EDN ≥ 53 ng/mL) were placed in the “High EDN Group”, while those with a lower initial EDN concentration (EDN < 53 ng/mL) were put in the “Low EDN Group”. Both groups experienced significant reductions in DNSS after either treatment regimen (P < 0.0001 and P = 0.0027, respectively) but the High EDN Group had greater reductions. EDN concentrations in the High EDN Group decreased significantly from either treatment (P < 0.0001). We found that children with AR and a high serum EDN concentration may respond well to Montelukast treatment. A therapeutic strategy using EDN concentrations in patients with AR to evaluate therapeutic response may help improve quality of care.

Key words:

• allergy
• asthma
• biomarker
• eosinophil-derived neurotoxin
• eosinophilic inflammation
• Levocetirizine
• perennial allergic rhinitis

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Funding

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