Gupta G
Department of Paediatrics, INHS Asvini, Colaba, Mumbai.
Indian J Pediatr. 2000 Feb;67(2):113-7. doi: 10.1007/BF02726180.
Inflammation plays a predominant role in the pathogenesis of asthma. The leukotrienes (LTs) exert their actions by binding to and activating various receptors. Leukotrienes B4, C4, D4, and E4 have been shown experimentally to play a role in inflammatory mechanisms, producing the pathologic changes seen in asthma. Antileukotrienes represent a new class of anti-asthma drugs with anti-inflammatory role. In asthma management, LT modifiers from the groups of 5 lipoxygenase inhibitor and Cys LT1 receptor antagonists are found useful. LAs are of main use in mild to moderate chronic asthma. Their usefulness is also observed in allergic rhinitis and even in severe chronic cases of asthma which are resistant to steroids. In chronic asthma they are required to be used for prolonged periods with other agents viz. inhaled steroids and beta 2 agonists. These agents are essentially safe. Except for Montelukast, which can be used in children above six years of age, the paediatric use of other agents is yet to be established. LAs are gradually becoming available in increasing number of countries. In India, we have to presumably wait for sometime before these drugs reach the market. The cost of LAs is reasonably high. Thus, India awaits arrival of LAs, may be for good, as more concrete information from various trials will permit us to practice more evidence based medicine.
炎症在哮喘的发病机制中起主要作用。白三烯（LTs）通过与各种受体结合并激活受体来发挥作用。实验表明，白三烯B4、C4、D4和E4在炎症机制中起作用，产生哮喘中所见的病理变化。抗白三烯药物是一类具有抗炎作用的新型抗哮喘药物。在哮喘治疗中，发现5-脂氧合酶抑制剂和半胱氨酰白三烯1受体拮抗剂类的白三烯调节剂很有用。白三烯调节剂主要用于轻度至中度慢性哮喘。在过敏性鼻炎甚至对类固醇耐药的重度慢性哮喘病例中也观察到了它们的有效性。在慢性哮喘中，它们需要与其他药物（即吸入性类固醇和β2激动剂）长期联合使用。这些药物基本安全。除孟鲁司特可用于6岁以上儿童外，其他药物在儿科的应用尚未确立。越来越多的国家逐渐有了白三烯调节剂。在印度，可能还需要等待一段时间这些药物才能上市。白三烯调节剂的成本相当高。因此，印度期待白三烯调节剂的到来，也许是好事，因为来自各种试验的更具体信息将使我们能够实施更循证的医学。
