Usefulness of suplatast tosilate, a Th2 cytokine inhibitor based on the Thl/Th2 ratio for allergic disease in children: a retrospective study

Abstract

Background:

Children with an atopic predisposition are presumed to have persistent Th2 dominance and thus develop allergic diseases.

Methods:

A total of 45 children who fell to atopic dermatitis and/or intermittent asthma or mild persistent asthma between 2002 and 2007 were enrolled and retrospectively analyzed. Twenty-four children were administered oral treatment with the immunopharmacological drug suplatast tosilate (CAS 94055-76-2) at a dose of 3 mg/kg twice daily. Twentyone of the control group were not administered oral suplatast tosilate but treated with other drugs. Blood was collected before and after administering suplatast tosilate or other drugs, and Th1 cells, Th2 cells, the Th1/Th2 ratio, the total IgE levels, and the eosinophil count were measured.

Results:

In the suplatast tosilate group, Th1 cells increased to 7.9 (1.2–19.8)% from 5.5 (1.1–13.5)% (Wilcoxon P < 0.05), while the Th2 cells showed a decrease from 1.3 (0.5–6.5)% to 1.6 (0.4 – 2.9)%, but the differences were not significant. The Th1/Th2 ratio increased significantly from 4.1 (0.9–7.4) to 5.6 (1.3– 15.5) (shifting to Th1 dominance) in the suplatast tosilate group (Wilcoxon P < 0.05), while it shifted to Th2 dominance in the control group (increased from 4.5 (2.2–12.2) to 5.7 (1.6–11.8)) but did not show significant difference.

Conclusions:

The Th1/Th2 ratio increased significantly after administration of suplatast tosilate, shifting to Th1 dominance. Therefore suplatast tosilate improves Th2 dominance and may inhibit subsequent progression of allergy over the long term.

Key words

Allergy and immunology - Asthma - Dermatitis - Pediatric allergy - Suplatast tosilate - Th1/Th2 balance

• References

• 1 Yoshihara S, Ono M, Yamada Y, Abe T, Arisaka O. Early intervention by Th2 type cytokine inhibitor in pediatric asthma. The 6th Asia Pacific Congress of Allergology and Clinical Immunology 2004; 117: 22
• 2 Yoshihara S, Ono M, Yamada Y, Fukuda H, Abe T, Arisaka O. Early intervention with suplatast tosilate for prophylaxis of pediatric atopic asthma: a pilot study. Pediatr Allergy Immunol 2009; 20: 486-92
• 3 Sano Y, Suzuki N, Yamada H, To Y, Ogawa C, Ohta K et al. Effects of suplatast tosilate on allergic eosinophilic airway inflammation in patients with mild asthma. J Allergy Clin Immunol 2003; 111: 958-66
• 4 Tamaoki J, Kondo M, Sakai N, Aoshiba K, Tagaya E, Nakata J et al. Effect of suplatast tosilate, a Th2 cytokine inhibitor, on steroid-dependent asthma: a double-blind randomised study. Lancet 2000; 356: 273-8
• 5 Yamada Y, Yoshihara S, Arisaka O. Successful treatment of pediatric hypereosinophilic syndrome with suplatast tosilate. Ann Allergy Asthma Immunol 2007; 99: 380-1
• 6 Kohsaka T, Miyazaki T, Noma Y, Kobayashi Y, Higuchi N, Kudoh Y et al. Examination for detection of intracellular cytokines by flow cytometry. J Med Pharm Sci 1997; 38: 875-82
• 7 Yanagihara Y, Kiniwa M, Ikizawa K, Shida T, Matsuura N, Koda A. Suppression of IgE production by IPD-1151T (suplatast tosilate), a new dimethylsulfonium agent: (2) regulation of human IgE response. Jpn J Pharmacol 1993; 61: 31-9
• 8 Iijima H, Tamura G, Hsiue TR, Liu Y, Taniguchi H, Shirato K. Suplatast tosilate inhibits late response and airway inflammation in sensitized guinea pigs. Aml Respir Crit Care Med 1999; 160: 331-5
• 9 Zhao CD, Yokoyama A, Kohno N, Sakai K, Hamada H, Hiwada K. Effect of suplatast tosilate (IPD–1151T) on a mouse model of asthma: inhibition of eosinophilic inflammation and bronchial hyperresponsiveness. Int Arch Allergy Immunol 2000; 121: 116-22