Nasser S M, Bell G S, Hawksworth R J, Spruce K E, MacMillan R, Williams A J, Lee T H, Arm J P
Department of Allergy and Allied Respiratory Disorders, UMDS, Guy's Hospital, London.
Thorax. 1994 Aug;49(8):743-8. doi: 10.1136/thx.49.8.743.
Leukotrienes are lipid mediators generated from arachidonic acid by the 5-lipoxygenase pathway which may play an important part in the pathophysiology of asthma. Previous studies have demonstrated attenuation of the allergen-induced early and late asthmatic responses by leukotriene receptor antagonists. The effect of the 5-lipoxygenase inhibitor ZD2138, a non-redox lipoxygenase inhibitor which inhibits leukotriene synthesis for 24 hours after single doses of 350 mg, on allergen-induced early and late asthmatic responses has been assessed.
Eight asthmatic subjects with baseline FEV1 > 70% were studied. On screening, all subjects developed an allergen-induced biphasic asthmatic response to grass pollen, cat dander, or house dust mite. ZD2138 (350 mg) or placebo was given on two occasions separated by two weeks in a randomised double blind fashion. Allergen inhalation challenge was performed four hours after dosing and FEV1 was measured for eight hours. The inhibitory activity of ZD2138 on the 5-lipoxygenase pathway was assessed by measurements of calcium ionophore-stimulated generation of LTB4 in whole blood ex vivo and by analysis of urinary LTE4 levels before administration of drug or placebo and at regular intervals after oral drug dosing and allergen challenge.
ZD2138 produced no significant bronchodilatation or attenuation of the early or late asthmatic response, although there was 82% inhibition of whole blood generation of LTB4 in response to calcium ionophore stimulation and 52% reduction in urinary excretion of LTE4.
In asthmatic subjects the 5-lipoxygenase inhibitor ZD2138 did not protect against allergen-induced asthmatic responses, despite substantial inhibition of 5-lipoxygenase.
白三烯是由花生四烯酸通过5-脂氧合酶途径生成的脂质介质,可能在哮喘的病理生理学中起重要作用。先前的研究已证明白三烯受体拮抗剂可减轻变应原诱导的哮喘早发和迟发反应。已评估了5-脂氧合酶抑制剂ZD2138(一种非氧化还原脂氧合酶抑制剂,单次服用350 mg后可抑制白三烯合成24小时)对变应原诱导的哮喘早发和迟发反应的影响。
研究了8名基线第一秒用力呼气容积(FEV1)>70%的哮喘患者。在筛查时,所有受试者对草花粉、猫毛屑或屋尘螨均出现变应原诱导的双相哮喘反应。ZD2138(350 mg)或安慰剂以随机双盲方式分两次给药,间隔两周。给药后4小时进行变应原吸入激发试验,并测量FEV1达8小时。通过体外测量钙离子载体刺激全血中白三烯B4(LTB4)的生成以及分析给药前或安慰剂前及口服药物给药和变应原激发后定期测量的尿白三烯E4(LTE4)水平,评估ZD2138对5-脂氧合酶途径的抑制活性。
尽管ZD2138对钙离子载体刺激的全血LTB4生成有82%的抑制作用,尿LTE4排泄减少52%,但未产生明显的支气管扩张作用,也未减轻哮喘早发或迟发反应。
在哮喘患者中,5-脂氧合酶抑制剂ZD2138尽管对5-脂氧合酶有显著抑制作用,但并未预防变应原诱导的哮喘反应。