Ribavirin and cysteinyl leukotriene-1 receptor blockade as treatment for severe bronchiolitis

Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, New York, United States
Antiviral Research (Impact Factor: 3.94). 03/2006; 69(2):53-9. DOI: 10.1016/j.antiviral.2005.10.004
Source: PubMed


In this work we have evaluated the clinical responses of pneumovirus-infected mice to combination therapy with the antiviral agent, ribavirin, and the CysLT1 cysteinyl leukotriene receptor antagonist, montelukast. We observed substantial virus replication in our mouse model of pneumovirus infection and significant accumulation of cysteinyl leukotrienes in lung tissue, the latter detected at levels that correlate directly with granulocyte recruitment to the airways. While administration of the nucleoside analog, ribavirin, reduced virus replication approximately 2,000-fold, the clinical outcomes as measured by morbidity and mortality, in response to ribavirin monotherapy were indistinguishable from those of the no-treatment controls. Similarly, montelukast therapy alone did not reduce granulocyte recruitment nor did it improve the clinical outcome. However, combined therapy with ribavirin and montelukast resulted in a significant reduction in morbidity and a substantial reduction in mortality (50% survival at t = 14 days and onward, compared to 10-20% survival in response to montelukast alone or to ribavirin alone, respectively, p < 0.01). These findings define further the independent contributions made by virus replication and by the ensuing inflammatory response to the detrimental sequelae of pneumovirus infection in vivo.

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Available from: Cynthia Bonville, Jul 16, 2014
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    • "The dose of Montelukast (5 mg/kg) was chosen on the basis of published data, where dosages ranging from 5–10 mg/kg have been reported in a wide range of mice experimental models [30], [31], [32]. The dosages of 2 mg/kg and 10 mg/kg were also investigated and the results reveal similar tendencies in xenograft tumor growth inhibition (Data not shown). "
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    • "Further support comes from a model of pneumonia virus of mice (PVM), a paramyxovirus that is a close phylogenetic relative of RSV. PVM infection increased levels of cysLTs in the lung [129]. In this model, administration of either the cysLT1 antagonist montelukast or the nucleoside analog ribavirin did not affect disease severity. "
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