Leukotriene modifiers for asthma treatment

被引:89
|
作者
Montuschi, P. [1 ]
Peters-Golden, M. L. [2 ]
机构
[1] Univ Cattolica Sacro Cuore, Fac Med, Dept Pharmacol, I-00168 Rome, Italy
[2] Univ Michigan, Sch Med, Dept Internal Med, Div Pulm & Crit Care Med, Ann Arbor, MI USA
来源
CLINICAL AND EXPERIMENTAL ALLERGY | 2010年 / 40卷 / 12期
关键词
EXHALED BREATH CONDENSATE; EXERCISE-INDUCED BRONCHOCONSTRICTION; RANDOMIZED CONTROLLED-TRIAL; CD8(+) T-CELLS; INHALED CORTICOSTEROIDS; RECEPTOR ANTAGONIST; CYSTEINYL-LEUKOTRIENES; AIRWAY INFLAMMATION; 5-LIPOXYGENASE INHIBITION; INTRAVENOUS MONTELUKAST;
D O I
10.1111/j.1365-2222.2010.03630.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
P>Leukotrienes (LTs), including cysteinyl LTs (CysLTs) and LTB4, are potent lipid mediators that have a role in the pathophysiology of asthma. At least two receptor subtypes for CysLTs, CysLT(1) and CysLT(2), have been identified. The activation of the CysLT(1) receptor is responsible for most of the pathophysiological effects of CysLTs in asthma, including increased airway smooth muscle activity, microvascular permeability, and airway mucus secretion. LTB4 might have a role in severe asthma, asthma exacerbations, and the development of airway hyperresponsiveness. CysLT(1) receptor antagonists can be given orally as monotherapy in patients with mild persistent asthma, but these drugs are generally less effective than inhaled glucocorticoids. Combination of CysLT(1) receptor antagonists and inhaled glucocorticoids in patients with more severe asthma may improve asthma control and enable the dose of inhaled glucocorticoids to be reduced while maintaining similar efficacy. The identification of subgroups of asthmatic patients who respond to CysLT(1) receptor antagonists is relevant for asthma management as the response to these drugs is variable. CysLT(1) receptor antagonists have a potential anti-remodelling effect that might be important for preventing or reversing airway structural changes in patients with asthma. This review discusses the role of LTs in asthma and the role of LT modifiers in asthma treatment. Cite this as: P. Montuschi and M. L. Peters-Golden, Clinical & Experimental Allergy, 2010 (40) 1732-1741.
引用
收藏
页码:1732 / 1741
页数:10
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