慢性咳嗽患者患者に対するLT拮抗薬の効果と気道内肥満細胞の動態について

抄録

We examined clinical effects of single administration of montelukast, a leukotriene receptor antagonist (LTRA), for 8 weeks on cough variant asthma (CVA) in 23 patients (19 females and 4 males, mean age 46.2 years). Montelukast improved the cough symptoms in 14 patients, however, not in the other 9 patients, whose symptoms disappeared by inhaled fluticasone propionate (FP) at a dose of 400μg/day. We also obtained biopsy specimens of bronchial mucous membrane from the patients and stained them with both anti-human tryptase antibody and our newly developed anti-human mast cell antibody (5C12). We previously reported 5C12 to be a potential marker of airway mast cell stability, based on the findings that the number of subepithelial tryptase-positive mast cells in CVA patients appeared to be higher than that in control subjects, and that the mast cells were strongly positive for 5C12 in deeper submucosal layer in contrast to the weak expression in mast cells in the subepithelial layer. In the present study, the number of 5C12-positive mast cells was higher in cases where montelukast was effective than where it was ineffective. These results suggest that variability of efficacy of LTRA on CVA may be partly due to heterogeneity of property of airway mast cells in this disease. [Jpn J Physiol 55 Suppl:S232 (2005)]