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

BACKGROUND/AIMS: Primary 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 gamma-GTP values was statistically 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.