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Author Bisgaard, H. url  openurl
  Title Pathophysiology of the cysteinyl leukotrienes and effects of leukotriene receptor antagonists in asthma Type Journal Article
  Year (down) 2001 Publication Allergy Abbreviated Journal Allergy  
  Volume 56 Suppl 66 Issue Pages 7-11  
  Keywords Anti-Asthmatic Agents/*therapeutic use; Asthma/*drug therapy/*physiopathology; Cysteine/*physiology; Humans; Inflammation Mediators/*physiology; Leukotriene Antagonists/pharmacology/*therapeutic use; Leukotrienes/*physiology  
  Abstract Cysteinyl leukotrienes, synthesized de novo from cell membrane phospholipids, are proinflammatory mediators that play an important role in the pathophysiology of asthma. These mediators are among the most potent of bronchoconstrictors and cause vasodilation, increased microvascular permeability, exudation of macromolecules and edema. The cysteinyl leukotrienes also have potent chemoattractant properties for eosinophils, causing an influx of eosinophils into the airway mucosa, which further fuels the inflammatory process. In addition, the cysteinyl leukotrienes are potent secretagogues and reduce ciliary motility, which may hinder mucociliary clearance. Asthmatic patients demonstrate increased production of cysteinyl leukotrienes during naturally occurring asthma and acute asthma attacks as well as after allergen and exercise challenge. The leukotriene receptor antagonists montelukast, zafirlukast and pranlukast inhibit bronchoconstriction in asthmatic patients undergoing allergen, exercise, cold air or aspirin challenge. They attenuate the hallmarks of asthmatic inflammation, including eosinophilia in the airway mucosa and peripheral blood. Moreover, exhaled nitric oxide concentrations, another correlate of airway inflammation, are decreased during montelukast treatment in children. Cysteinyl leukotriene synthesis is not blocked by corticosteroid therapy. This important observation suggests that the leukotriene receptor antagonists represent a novel therapeutic approach, one that may provide benefits that are additive with corticosteroid therapy. This supposition is supported by clinical observations that treatment with leukotriene receptor antagonists significantly improve asthma control when added to inhaled corticosteroid therapy. Moreover, the bronchodilator properties of the leukotriene receptor antagonists are additive with those of beta agonists. These data provide strong support for the use of leukotriene receptor antagonists for treating asthma.  
  Address Department of Paediatrics, University Hospital of Copenhagen, Cophenhagen, Denmark. bisgaard@rh.dk  
  Corporate Author Thesis  
  Impact Factor 06,028 First Author Bisgaard, H. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Bisgaard, H.  
  ISSN 0105-4538 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:11421935 Approved no  
  Call Number Serial 228  
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