プランルカストの鼻茸好酸球浸潤抑制効果に関する臨床的検討 The Efficacy of Pranlukast Hydrate for Chronic Sinusitis with Nasal Polyp
Endoscopic sinus surgery (ESS) is performed to treat chronic sinusitis and usually shows a good outcome. However, chronic sinusitis with marked eosinophil infiltration into nasal polyp and the sinus mucosa is sometimes intractable to surgical as well as conventional conservative treatments.<br>This type of sinusitis is frequently complicated with non-atopic asthma and is now termed eosinophilic rhinosinusitis (ERS). Systemic administration of steroids is known to be effective for asthma and to reduce the recurrence of ERS after ESS. Pranlukast hydrate is also effective for asthma, but its effectiveness for ERS has not yet been observed. The present study was designed in order to investigate the suppressive effect of pranlukast hydrate on eosinophil infiltration into nasal polyps in comparison with histamine receptor-1 antagonist olopatadine hydrochloride. Twenty patients of ERS aged from 28 to 86 years old (average: 49.9) who were treated at the out-patient clinic of Kagoshima University Hospital between April 2004 and June 2006 were enrolled in the study. Pranlukast hydrate was administered to 8 patients and olopatadine hydrochloride was administered to 6 patients. The other 6 patients did not receive any medication as a control. Eosinophil infiltration in nasal polyps was examined before and after the administration of pranlukast hydrate or olopatadine hydrochloride, and findings were compared longitudinally in each patient. The diagnosis of ERS was obtained when eosinophils in the histology sections of removed nasal polyps are observed more than 60/field in the average of five fields at 200 × magnification under light microscopy. As a result, administration of pranlukast hydrate significantly decreased eosinophil infiltration into the nasal polyps. However, there were no apparent suppressive effects on eosinophil infiltration in patients treated with olopatadine hydrochloride. Although these findings should be confirmed by double blind control study using a larger number of patients, the present study showed a suppressive efficacy of pranlukast hydrate on eosinophil infiltration into nasal polyps and suggests the usefulness of pranlukast hydrate for the treatment of ERS.
耳鼻咽喉科臨床 101(9), 715-720, 2008-09-01
The Society of Practical Otolaryngology