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Recent advances in antileukotriene therapy.
Curr Opin Allergy Clin Immunol. 2010 Aug; 10(4):370-6.CO

Abstract

PURPOSE OF REVIEW

Despite profound effects of leukotrienes in experimental models, clinical responses to antileukotriene drugs are highly heterogeneous. This review discusses recent advances concerning the molecular mechanisms of antileukotrienes as well as their efficacy in various clinical scenarios and patient groups.

RECENT FINDINGS

Appreciation of the role of leukotriene E4 and the existence of its distinct receptors may explain the limited efficacy of current leukotriene receptor antagonists. Pharmacogenetic studies highlight the influence of several leukotriene pathway genes on clinical responsiveness. Benefits of addition of antileukotrienes to inhaled corticosteroids in chronic adult asthmatics have been shown, but their role in acute asthma is unclear. Evidence suggests they are not a first-line treatment for allergic rhinitis or urticaria, but may provide useful additional therapy. In children antileukotrienes provide symptomatic benefit in preschool wheezers, but have no clear role in bronchiolitis or acute asthma. Adherence to montelukast appears superior to inhaled corticosteroids. Use in sleep-disordered breathing and eosinophilic gastroenteropathies warrants further investigation. Despite recent concerns thorough analysis of existing data suggests antileukotrienes are well tolerated drugs. The possible link with Churg-Strauss syndrome requires further investigation.

SUMMARY

The leukotriene pathway remains an attractive target in asthma and allergic disease, particularly in light of renewed appreciation of the role of leukotriene E4. Clarification of the clinical role of antileukotrienes is needed.

Authors+Show Affiliations

Department of Allergy and Clinical Immunology, Imperial College, London, UK. g.scadding@imperial.ac.ukNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20585242

Citation

Scadding, Guy W., and Glenis K. Scadding. "Recent Advances in Antileukotriene Therapy." Current Opinion in Allergy and Clinical Immunology, vol. 10, no. 4, 2010, pp. 370-6.
Scadding GW, Scadding GK. Recent advances in antileukotriene therapy. Curr Opin Allergy Clin Immunol. 2010;10(4):370-6.
Scadding, G. W., & Scadding, G. K. (2010). Recent advances in antileukotriene therapy. Current Opinion in Allergy and Clinical Immunology, 10(4), 370-6. https://doi.org/10.1097/ACI.0b013e32833bfa20
Scadding GW, Scadding GK. Recent Advances in Antileukotriene Therapy. Curr Opin Allergy Clin Immunol. 2010;10(4):370-6. PubMed PMID: 20585242.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recent advances in antileukotriene therapy. AU - Scadding,Guy W, AU - Scadding,Glenis K, PY - 2010/6/30/entrez PY - 2010/6/30/pubmed PY - 2010/10/22/medline SP - 370 EP - 6 JF - Current opinion in allergy and clinical immunology JO - Curr Opin Allergy Clin Immunol VL - 10 IS - 4 N2 - PURPOSE OF REVIEW: Despite profound effects of leukotrienes in experimental models, clinical responses to antileukotriene drugs are highly heterogeneous. This review discusses recent advances concerning the molecular mechanisms of antileukotrienes as well as their efficacy in various clinical scenarios and patient groups. RECENT FINDINGS: Appreciation of the role of leukotriene E4 and the existence of its distinct receptors may explain the limited efficacy of current leukotriene receptor antagonists. Pharmacogenetic studies highlight the influence of several leukotriene pathway genes on clinical responsiveness. Benefits of addition of antileukotrienes to inhaled corticosteroids in chronic adult asthmatics have been shown, but their role in acute asthma is unclear. Evidence suggests they are not a first-line treatment for allergic rhinitis or urticaria, but may provide useful additional therapy. In children antileukotrienes provide symptomatic benefit in preschool wheezers, but have no clear role in bronchiolitis or acute asthma. Adherence to montelukast appears superior to inhaled corticosteroids. Use in sleep-disordered breathing and eosinophilic gastroenteropathies warrants further investigation. Despite recent concerns thorough analysis of existing data suggests antileukotrienes are well tolerated drugs. The possible link with Churg-Strauss syndrome requires further investigation. SUMMARY: The leukotriene pathway remains an attractive target in asthma and allergic disease, particularly in light of renewed appreciation of the role of leukotriene E4. Clarification of the clinical role of antileukotrienes is needed. SN - 1473-6322 UR - https://www.unboundmedicine.com/medline/citation/20585242/Recent_advances_in_antileukotriene_therapy_ L2 - https://doi.org/10.1097/ACI.0b013e32833bfa20 DB - PRIME DP - Unbound Medicine ER -