Leukotriene modifiers in the treatment of asthma
- 25 April 1998
- Vol. 316 (7140) , 1257-1258
- https://doi.org/10.1136/bmj.316.7140.1257
Abstract
Leukotriene modifiers are an entirely new class of asthma treatment, which have entered clinical practice in 1996-7 in several countries including Britain, Japan, and the United States. Their development is an example of rational drug design following the elucidation of leukotriene structures in 1979-80 and the subsequent confirmation of their pathophysiological role as inflammatory mediators in asthma.1 There are two types of leukotriene modifier: leukotriene synthesis inhibitors and cysteinyl leukotriene receptor antagonists.2 Both are used to block the bronchoconstrictor and pro-inflammatory activity of cysteinyl leukotrienes within the asthmatic airway. Cysteinyl leukotrienes (LTC4, LTD4, and LTE4) were originally identified as long lasting smooth muscle spasmogens and collectively termed “slow reacting substance of anaphylaxis” (SRS-A). They are now known to be metabolites of arachidonic acid formed by the 5-lipoxygenase pathway1 and are produced almost exclusively by inflammatory leucocytes, especially mast cells, basophils, and eosinophils. The leukotriene receptor antagonists block the activity of cysteinyl leukotrienes at their receptors ( CysLT 1 ) on bronchial smooth muscle and elsewhere, while the leukotriene synthesis inhibitors block the synthesis of all leukotrienes by interrupting the 5-lipoxygenase pathway.2 Cysteinyl leukotrienes are among …Keywords
This publication has 16 references indexed in Scilit:
- Overexpression of leukotriene C4 synthase in bronchial biopsies from patients with aspirin-intolerant asthma.Journal of Clinical Investigation, 1998
- Naturally occurring mutations in the human 5-lipoxygenase gene promoter that modify transcription factor binding and reporter gene transcription.Journal of Clinical Investigation, 1997
- Acute and chronic effects of a 5-lipoxygenase inhibitor in asthma: A 6-month randomized multicenter trialJournal of Allergy and Clinical Immunology, 1996
- Effects of montelukast (MK-0476), a new potent cysteinyl leukotriene (LTD 4) receptor antagonist, in patients with chronic asthmaJournal of Allergy and Clinical Immunology, 1996
- Leukotriene antagonists and synthesis inhibitors: New directions in asthma therapyJournal of Allergy and Clinical Immunology, 1996
- Cysteinyl leukotrienes in asthma: old mediators up to new tricksTrends in Pharmacological Sciences, 1995
- Bronchial biopsy evidence for leukocyte infiltration and upregulation of leukocyte-endothelial cell adhesion molecules 6 hours after local allergen challenge of sensitized asthmatic airways.Journal of Clinical Investigation, 1994
- The Pivotal Role of 5-Lipoxygenase Products in the Reaction of Aspirin-sensitive Asthmatics to AspirinAmerican Review of Respiratory Disease, 1993
- Leukotriene E4 and granulocytic infiltration into asthmatic airwaysThe Lancet, 1993
- URINARY LEUKOTRIENE E4 AFTER ANTIGEN CHALLENGE AND IN ACUTE ASTHMA AND ALLERGIC RHINITISThe Lancet, 1989