Novel therapeutic approach to primary biliary cirrhosis patients: Anti-eosinophil strategy

BACKGROUND/AIMS: Primacy biliary cirrhosis (PBC) is a chronic cholestatic liver disease of unknown cause. Morphologically, PBC is characterized by eosinophil infiltration into the portal tract in recent studies. Pranlukast, a new drug, is a leukotriene antagonist, which suppresses eosinophil infiltration in atopic dermatitis or asthma. METHODOLOGY: In this study, pranlukast monotherapy was used to treat 12 patients with a diagnosis of PBC, classified as stage I or II according to Scheuer'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. Improvement 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 all 12 patients at 2 months and 6 months after the start of treatment. Absolute eosinophil counts improved at 6 months after the start of treatment. CONCLUSIONS: Given its efficacy and the absence of side effects, planlukast appears to be the medical treatment of choice for patients with early-stage PBC. But, a randomised, controlled, double-blind trial is urgently needed.