Preventable impact of suplatast tosilate dosage on asthma onset in infants

Background: Recent epidemiology suggests the increasing prevalence of allergic diseases including asthma in the industrialized countries, which necessitates the analysis of the mechanisms of allergic diseases and development of the effective treatment. Suplatast tosilate (IPD) has been shown to be clinically effective for the treatment of hypersensitivity and childhood asthma, and it is a novel antiallergic agent that suppresses several processes, including the synthesis of IL-4 and IL-5 in both human and murine Th2 cells. However, The effect of IPD to restrain the bronchial asthma onset of an infant having an established allergic factor has not been examined. Hence influence on asthma onset by the IPD dosage in patients who repeated 1-3 times wheeze after the life that a shift to the childhood asthma was observed.

Objective and Methods: The object is 39 patients who accepted 1-3 times wheeze after birth ranging from 6 months to 3 years in age. After an observation period of two weeks, they were divided into 3 groups; Theophyline treated group (group A), Theophyline + IPD group (group B), and IPD alone (group C). The clinical evaluation was performed concerning frequency of coughing and wheeze, and that of the β2-receptor agonist inhalation consumption in every four months with an asthma diary. In addition, allergic tests; peripheral blood eosinophile count and serum IgE value were determined in every four months.

Results and Discussion: As for the coughing, the frequency fell not significantly 12 months later (the last four months) as compared to the first four months in all groups. Concerning the wheeze, the significant decrease in particular was examined in group B, C. As for the frequency of the β2-receptor agonist inhalation consumption, the significant decrease was observed in group B and C, but not in group A. The meaningful change of the peripheral blood eosinophile count was not observed in group A and C. However it increased  8 and 12 months later significantly in group B. The serum IgE value increased 12 months later in group A and B, whereas such a meaningful increase was never recognized in group C. IPD likely restrains an increase of serum IgE value. Conclusion: IPD regulates IgE production and eosinophile count in patients who show 1-3 times wheeze after life, and has likely action to improve wheeze expression clinically.