Published by Misasa Medical Center, Okayama University Medical School
Published by Misasa Medical Center, Okayama University Medical School

<Formerly known as>
岡大三朝分院研究報告 (63号-72号) 環境病態研報告 (57号-62号)
岡山大学温泉研究所報告 (5号-56号) 放射能泉研究所報告 (1号-4号)

<Availability>
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A case with persistent asthma symptoms despite fluticasone treatment in which concomitant treatment with montelukast and perilla seed oil-rich supplementation significantly improved asthma control

高田 真吾 岡山大学病院三朝医療センター内科
芦田 耕三 岡山大学病院三朝医療センター内科
保崎 泰弘 岡山大学病院三朝医療センター内科
濱田 全紀 岡山大学病院三朝医療センターリハビリテーション
岩垣 尚史 岡山大学病院三朝医療センター内科
菊池 宏 岡山大学病院三朝医療センター内科
光延 文裕 岡山大学医学部・歯学部附属病院三朝医療センター 内科
抄録
A 25-year-old woman had the chief complaint of recurrent episodes of dyspnea and wheeze. Asthma had been diagnosed at infant years and sometimes experienced asthma attacks. She graduated senior high school and entered technical school in Tokyo. She received fluticasone (400μg daily) but exacerbation continued after she became an office clerk. She returned Kurashiki in October 2001 but had wheeze and asthma exacerbations. She was admitted to our hospital for evaluation and treatment of bronchial asthma on August 2, 2002. After admission, her symptoms subsided within some days. She was treated with montelukast and perilla seed oil-rich supplementation . The number of eosinophils decreased, decrease was observed in leukotriene (LT) B4 generation and in LTC4 generation, and pulmonary function improved following montelukast and perilla seed oil-rich supplementation for 4 weeks. The patient had no exacerbation under treatment and was discharged from the hospital on September 2, 2002. For some patients with persistent asthma, inhaled corticosteroids may fail to achieve adequate control possibly because corticosteroids do not completely inhibit the synthesis and release of cysteinyl leukotrienes (cysLTs) in the lung. Montelukast blocks the interaction of cysLTs with their receptor and resulting downstream events and perilla seed oil-rich diet suppresses LT generation. Combination therapy with montelukast and perilla seed oil-rich diet is more effective than montelukast or perilla seed oil-rich diet alone because of additive effects of montelukast with perilla seed oil-rich diet. We suggest that montelukast and perilla seed oil-rich supplementation are effective options when bronchial asthma patients receive inhaled corticosteroid but exacerbation continues.
キーワード
モンテルカスト (montelukast)
気管支喘息 (bronchial asthma)
ロイコトリエンC4 (leukotriene C4)
エゴマ油食 (perilla seed oil-rich supplementation)
フルチカゾン (fluticasone)
ISSN
1348-1258
NCID
AA11840279