Leukotriene receptor antagonist treatment of asthma: Are we there yet?  

Oleh:

Kercsmar, Carolyn M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 134 no. 3 (Mar. 1999), page 256-259.
Topik: FEV1; Forced expiratory volume in 1 second; LTRA ; Leukotriene receptor antagonist

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

The pharmacologic armamentarium against asthma remained exceedingly limited for decades, while frustrated patients and clinicians waited for safer, more effective, and convenient medications. The broad clinical spectrum of asthma, its complex pathophysiology involving numerous inflammatory cells and mediators, and an incompletely understood natural history complicate formulation of optimal treatments. Identification of cysteinyl leukotrienes as the components of slow-reacting substance of anaphylaxis, a major effector of asthma symptoms, presents an opportunity to develop novel asthma drugs. Leukotrienes play a significant role in the pathophysiology of asthma triggered by a variety of stimuli. In vitro and in vivo, leukotrienes promote vascular leak and edema formation, bronchoconstriction, mucus secretion, and eosinophil chemotaxis and enhance bronchial hyperresponsiveness. Challenge of the asthmatic airway with allergen or by exercise results in marked increase in leukotriene D4 production and subsequent bronchoconstriction. Blocking the binding of leukotrienes to receptors located on target cells in the airways inhibits their biologic action and thereby demonstrates therapeutic promise. Several studies provide evidence that leukotriene receptor antagonists, notably montelukast and zafirlukast, are more effective than placebo in controlling mild to moderate persistent asthma in adults and children as measured by improvement in peak expiratory flow rate, forced expiratory volume in 1 second, and reduction in symptoms. How do these new medications compare with the old to fulfill some important goals of asthma therapy: to control symptoms, normalize pulmonary function and activity, avoid medication adverse events, and satisfy patients and parents?

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