Effect of theophylline on urinary leukotriene B4 and C4 excretion in children with asthma

Chung, Hai Lee; Lee, Jung Jin; Kim, Sang Gyung

Abstract

BACKGROUND
Theophylline has been used in the treatment of asthma for decades as a broncho- dilator, but recent studies suggested that it has anti-inflammatory and immunomodulatory properties.
OBJECTIVE
The aim of this study was to determine the effect of theophylline therapy on urinary excretion of leukotriene B4 (LTB4) and C4 (LTC4), which have been known to play a role in the airway inflammation in asthmatic patients.
METHODS
Fifty-one patients, aged 13 months to 6 years, who were hospitalized with asthma were randomized in to 3 groups according to treatment regimen. Twenty-one patients were administered theophylline with budesonide and salbutamol inhalation (Group 1). Fifteen patients were treated with budesonide and salbutamol inhalation (Group 2) and the other fifteen patients with salbutamol inhalation only (Group 3). Urine samples for the determination of LTB4 and LTC4 were collected on admission and on the fifth hospital day in each patient. The concentrations of urinary leukotrienes were measured by ELISA (Neogen, U.S.A.) and corrected by urinary creatinine levels. Ten controls were also studied.
RESULTS
The initial urinary LTC4 levels in asthmatic children were significantly higher than in controls. Urinary LTC4 was significantly decreased after treatment compared with the initial level in group 1 (p<0.05), but not in groups 2 and 3. Urinary LTB4 did not show significant difference between patients and controls on admission and showed no significant change after treatment compared with the initial levels in all three groups.
CONCLUSION
These results suggest that the suppression of LTC4 synthesis is one of the anti-inflammatory mechanisms of theophylline and support the use of theophylline as a the rapeutic agent in asthmatic patients.