Can montelukast correct immune dysregulation in preschool children with mild persistent asthma?

Background: Asthma is the most common inflammatory disorder amongpreschool and school-age children. Regulation of immune cells and theircytokines is essential to control asthma. Montelukast is a leukotrienereceptor antagonist that suppresses inflammatory cell proliferation, andreduces cytokines and mediator secretion. Objective: The researchteam's goal was to study the immunological parameters among mildasthmatic patients before and after the treatment with Montelukast .Methods: Forty preschool children with mild persistent asthma andtwenty healthy, non-allergic children were included in the study. Bloodeosinophil count, total IgE, serum IL-4, IL-10, and IL-13 levels wereassessed. T helper (CD3+CD4+) and T regulatory (CD4+CD25+) cellcounts were measured using flow cytometry; for mild asthmatics beforeand after six weeks of treatment with Montelukast and for the controlgroup. Results: Asthmatic children have shown a significant elevation ofserum levels of IgE, IL4 and IL13, and also an increase of eosinophils,total lymphocyte T cells and T helper cell count. However; serum levelsof IL10 and Treg cell count was lower in asthmatics compared to control.Following six weeks of Montelukast treatment, all immunologicalparameters improved. There was a significant elevation of serum levelsof IL10 and Treg cell count, with a decrease in serum levels of IgE, IL4and IL13; eosinophil counts, and helper T cells. Conclusion:Montelukast treatment improves the impaired immunological balance ofmild asthmatic children through the increase of serum IL-10, Tregulatory cell counts that have anti-inflammatory andimmunoregulatory effects. It also decreases T helper cells and theirproinflammatory cytokines.