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Asthma pharmacotherapy: an update on leukotriene treatments

Authors
Trinh, HKT; Lee, SH; Cao, TBT; Park, HS
Citation
Expert review of respiratory medicine, 13(12). : 1169-1178, 2019
Journal Title
Expert review of respiratory medicine
ISSN
1747-63481747-6356
Abstract
INTRODUCTION: Asthma is a chronic inflammatory disease of the airways with a large heterogeneity of clinical phenotypes. There has been increasing interest regarding the role of cysteinyl leukotriene (LT) and leukotriene receptor antagonists (LTRA) in asthma treatment.
AREAS COVERED: This review summarized the data (published in PubMed during 1984-2019) regarding LTRA treatment in asthma and LTs-related airway inflammation mechanisms. Involvement of LTs C4/D4/E4 has been demonstrated in the several aspects of airway inflammation and remodeling. Novel pathways related to LTE4, the most potent mediator, and its respective receptors have recently been studied. Antagonists against cysteinyl leukotriene receptor (CysLTR) type 1, including montelukast, pranlukast and zafirlukast, have been widely prescribed in clinical practices: however, some clinical trials have shown insignificant responses to LTRAs in adult asthmatics, while some phenotypes of adult asthma showed more favorable responses to LTRAs including aspirin-exacerbated respiratory disease, elderly asthma, asthma associated with smoking, obesity and allergic rhinitis.
EXPERT OPINION: Further investigations are needed to understand the role of LTs in airway inflammation and remodeling of the asthmatic airways. There is a lack of biomarkers to predict responsiveness to LTRA, especially in adult asthmatics. Besides CysLTR1 antagonists, targets aiming other LT pathways should be considered.
Keywords
Asthmacysteinyl leukotrienesleukotriene receptor antagonist
MeSH terms
Acetates / therapeutic useAsthma / drug therapy*Asthma, Aspirin-Induced / drug therapyChromones / therapeutic useCysteine / therapeutic use*HumansLeukotriene Antagonists / therapeutic use*Leukotrienes / therapeutic use*Quinolines / therapeutic useTosyl Compounds / therapeutic useTreatment Outcome
DOI
10.1080/17476348.2019.1670640
PMID
31544544
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
AJOU Authors
이, 소희박, 해심
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