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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pharmacol. | doi: 10.3389/fphar.2019.01094

Montelukast improves symptoms and lung function in asthmatic women compared with men.

Renata Esposito1,  Giuseppe Spaziano1*, Domenico Giannattasio2, Francesco Ferrigno2, Angela Liparulo1,  Antonietta Rossi3,  Fiorentina Roviezzo3,  Maurizio Sessa1, 4, Maddalena Falciani2,  Liberato Berrino1, Mario Polverino2, Francesca Polverino5 and Bruno D'Agostino1
  • 1Section of Pharmacology L. Donatelli, Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Italy
  • 2Mauro Scarlato Hospital, ASL Salerno, Italy
  • 3Department of Pharmacy, University of Naples Federico II, Italy
  • 4Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
  • 5Asthma and Airway Disease Research Center, University of Arizona, United States

Purpose
Gender differences exist in the prevalence of asthma and allergic diseases, partially due to the effects of sex hormones on the development of allergic manifestations. Women, compared to men, are more prone to suffer allergic asthma, experience difficulties in controlling asthma symptoms, and show adverse responses to drugs. However, there are knowledge gaps on the effectiveness of anti-leukotrienes (LT) drugs on lung function, symptoms, and pulmonary and systemic inflammation in adult asthmatic women compared to men. We conducted a prospective cohort study to characterize the effectiveness of an anti-LT drug, montelukast (MS), in asthmatic adult women and men.
Methods
Twenty-one asthmatic subjects (which 11 women and 10 men) were treated with low-dose of inhaled corticosteroids (ICS) in combination with MS. The optimal control of the symptoms was achieved in both groups according to the Global Initiative for Asthma (GINA) guidelines. At enrollment, and after 13 weeks from the beginning of MS, pulmonary function tests and asthma control tests (ACT) were performed, and the fraction of exhaled nitric oxide (FeNO) and blood eosinophils levels were measured.
Results
From baseline until the end of the study, women treated with ICS+MS had better control of the asthmatic symptoms, defined as higher asthma control test (ACT) score, (17.00 ± 1.07 to 23.36 ± 0.45; p<0.0015), and improved pulmonary function (with higher forced expiratory volume in 1 second [from 77.25 ± 6.79 to 103.88 ± 6.24; p<0.0077], and forced vital capacity [from 91.95 ± 6.81 to 113.17 ± 4.79; p<0.0183], compared with men. Interestingly, ICS+MS-treated women had significantly lower levels of blood eosinophils (from 5.27 ± 0.30 to 3.30 ± 0.31; p<0.0449), and FeNO (from 44.70 ± 7.30 to 25.20 ± 3.90; p<0.0294) compared with men.
Conclusion
The treatment with MS, added to ICS, in women leads to better control of symptoms, better management of lung function, and decreased inflammation levels compared with ICS+MS treatment in men.

Keywords: Montelukast, Leukotrienes (LTs), Eosinophils, Asthma, Nitric o×ide, Gender difference

Received: 12 Jun 2019; Accepted: 26 Aug 2019.

Copyright: © 2019 Esposito, Spaziano, Giannattasio, Ferrigno, Liparulo, Rossi, Roviezzo, Sessa, Falciani, Berrino, Polverino, Polverino and D'Agostino. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: PhD. Giuseppe Spaziano, Section of Pharmacology L. Donatelli, Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, 80138, Campania, Italy, giuseppe.spaziano@unicampania.it