Nasal cytokine modulation by montelukast in allergic children: a pilot study

Allergic rhinitis and asthma are characterized by chronic inflammation due to a Th2 cytokine polarization. Leukotrienes receptor antagonists have been shown to be effective in both diseases.Aim of the study was to evaluate the modulation by the antileukotriene montelukast on Th2 and Th1 cytokines in allergic rhinitis.Fourteen school children affected by persistent allergic rhinitis (PAR) and exercise-induced asthma (EIA) underwent a nasal lavage before and after a two-week treatment with montelukast. A panel of cytokines, including IL4, IL13, and IFN gamma, was measured by immunoassay on nasal lavage samples.Montelukast treatment induced a significant decrease of IL4 and IL13 levels (p0.001, for both comparisons), and a significant increase of IFN gamma (p0.001).Montelukast treatment reversed a typical Th2 cytokine pattern (IL4 and IL13) toward a Th1 (IFN gamma) predominance in children with PAR and EIA. This effect could be considered relevant for long term allergic inflammation control and of interest when treating EIA with concomitant PAR.