NOVEL THERAPEUTIC APPROACH TO PRIMARY BILIARY-CIRRHOSIS PATIENTS - ANTI-EOSINOPHIL STRATEGY

BACKGROUND/AIMS: Primary biliary cirrhosis (PBC) is a chronic cholesta tic liver disease of unknown cause. Morphologically, PBC is characteri zed by eosinophil infiltration into the portal tract in recent studies . Pranlukast, a new drug, is a leukotriene antagonist, which suppresse s eosinophil infiltration in atopic dermatitis or asthma. METHODOLOGY: In this study, pranlukast monotherapy was used to treat 12 patients w ith a diagnosis of PBC, classified as stage I or II according to Scheu er's classification on the basis of liver biopsy findings. RESULTS: An improvement in alkaline phosphatase (ALP) was observed beginning one month after the start of pranlukast therapy in all 12 patients. Improv ement in ALP and y-GTP values was stastically observed at 1, 2, and 6 months after the start of treatment. IgG and IgM values improved in al l 12 patients at 2 months and 6 months after the start of treatment. A bsolute eosinophil counts improved at 6 months after the start of trea tment. CONCLUSIONS: Given its efficacy and the absence of side effects , planlukast appears to be the medical treatment of choice for patient s with early-stage PBC. But, a randomised, controlled, double-blind tr ial is urgently needed.