Abstract
Cysteinyl-containing leukotrienes (CysLTs) are lipid mediators known to possess potent proinflammatory action. We have recently shown the presence of CysLT1 receptors in primary cultures of human detrusor muscle cells. In this pilot study we investigated whether the CysLT1 receptor antagonist montelukast (Singulair ), currently used to treat asthma, had any effect as a new therapy in the treatment of interstitial cystitis (IC). Ten women with diagnosed IC according to National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) criteria and detrusor mastocytosis (with a minimum of 28 mast cells/mm2 muscle tissue) were included in the study. The patients were treated with 10 mg montelukast daily for 2 months. The efficacy of the treatment was determined by the following parameters: 24-hour urinary frequency, pain using visual analog scales (VAS), and use of analgesics. After 2 months of treatment, 24-hour urinary frequency decreased significantly from 17.38 to 12.58 times (P = 0.005) and pain from 46.8 mm to 23.36 mm (P = 0.01) according to VAS. We observed no side effects of montelukast during the study. Only 3 patients used analgesics and there was no change in their use during the study. We conclude that treatment of IC patients with montelukast resulted in a significant improvement of urinary frequency and pain. Additional placebo controlled clinical studies will eventually lead to a better understanding of the pathological and physiological role of CysLTs and the role of CysLT1 receptor antagonists in the treatment of IC.
Published Version
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