Currie G P, Srivastava P, Dempsey O J, Lee D K C
Department of Respiratory Medicine, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN.
QJM. 2005 Mar;98(3):171-82. doi: 10.1093/qjmed/hci024.
Although asthma is one of the most common chronic respiratory conditions, it often remains unrecognized and undertreated, while patients are often reluctant to comply with regular inhaled anti-inflammatory and bronchodilator therapy. Allergic rhinitis co-exists with asthma in as many as 40% of patients, and can be regarded as a continuum of the same inflammatory disease process. Corticosteroids are the 'gold standard' first-line treatment for both conditions, and have a significant impact upon underlying inflammation, symptoms and long-term outcome. Cysteinyl leukotrienes are potent airway inflammatory mediators, suggesting that treatment antagonizing their effects could play a role in disease management. In recent years, leukotriene receptor antagonists have provided a further therapeutic option in the management of allergic airways disease. These drugs are orally active, can be administered once daily, and provide a systemic approach to the management of patients with asthma and allergic rhinitis. We review the pharmacology of leukotriene receptor antagonists, their potential role in clinical practice in patients with allergic airways disease, and likely areas for further research.
尽管哮喘是最常见的慢性呼吸道疾病之一，但它常常未被识别和治疗不足，而患者往往不愿遵守常规的吸入抗炎和支气管扩张剂治疗。在多达40%的患者中，过敏性鼻炎与哮喘并存，可被视为同一炎症性疾病过程的延续。皮质类固醇是这两种疾病的“金标准”一线治疗药物，对潜在炎症、症状和长期预后有重大影响。半胱氨酰白三烯是强效的气道炎症介质，这表明拮抗其作用的治疗可能在疾病管理中发挥作用。近年来，白三烯受体拮抗剂为过敏性气道疾病的管理提供了进一步的治疗选择。这些药物口服有效，可每日给药一次，并为哮喘和过敏性鼻炎患者的管理提供了一种全身性方法。我们综述了白三烯受体拮抗剂的药理学、它们在过敏性气道疾病患者临床实践中的潜在作用以及可能的进一步研究领域。
