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

AbstractBackgroundMethodsResultsConclusionEosinophil-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 (<italic>p</italic> = 0.0001; <italic>n</italic> = 20) and Mont Group (<italic>p</italic> < 0.0001; <italic>n</italic> = 20), but there were no significant differences between the two groups. EDN concentration also significantly decreased after treatment in both groups (<italic>p</italic> < 0.0001 and <italic>p</italic> < 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 (<italic>p</italic> < 0.0001 and <italic>p</italic> = 0.0027, respectively) but the High EDN Group had greater reductions. EDN concentrations in the High EDN Group decreased significantly from either treatment (<italic>p</italic> < 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. [ABSTRACT FROM AUTHOR]