Background. Some experimental models, which have been developed in recent years, have made possible to investigate the mechanisms of allergic inflammation in respiratory airways. Antigen stimulation in the upper and lower respiratory airways is followed by the release of several mediators, namely peptide-leukotrienes (leukotrienes C4/D4/E4). When insufflated in the respiratory airways, peptide-leukotrienes are potent constrictors of human bronchi and cause nasal obstruction. The demonstration of the role of leukotrienes in bronchial asthma has prompted the search for leukotriene inhibitors. Aim. The aim of this article is to examine the biological activities of leukotrienes in the pathogenesis of asthma and to evaluate the possible therapeutic role of anti-leukotriene drugs. Results. Two types of leukotriene inhibitors have been developed as yet: drugs which can inhibit leukotriene biosynthesis (for example: MK-0591, MK886, BAYx1005, Zileuton, ZD2138, ABT 761) and drugs which antagonize leukotriene effects at receptor level (for example: Zafirlukast, Pranlukast, BAYx7195, Verlukast, RG-12525, MK-571, MK 0476). Preliminary data suggest that leukotriene receptor antagonists may find a place in the treatment of mild-moderate asthma induced by allergen, cold dry air, exercise and aspirin. The proposed minimum dose of Zafirlukast was shown to be comparable in safety and efficacy to the optimal dose of cromolyn sodium in patients with mild-to-moderate asthma. The same results were obtained when the pharmacological activity of leukotriene biosynthesis inhibitors was evaluated. Conclusions. Local and/or systemic steroids have a pivotal role in the treatment of bronchial asthma, since they have potent antinflammatory activities, and bronchial asthma is recognized as an inflammatory disease. Leukotriene antagonists and synthesis inhibitors can have a complementary role in the therapy of allergic and non allergic asthma, especially as steroid-sparing drugs.
|Number of pages||10|
|Publication status||Published - Sep 1997|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine