Sorkness C A
School of Pharmacy, University of Wisconsin, Madison, USA.
Pharmacotherapy. 1997 Jan-Feb;17(1 Pt 2):50S-54S.
With the elucidation of asthma as a chronic inflammatory disease, therapeutic approaches have shifted from treatment of symptoms with bronchodilators to treatment of the underlying disease with antiinflammatory agents. Along with concerns about corticosteroid side effects on the part of both physicians and patients, this shift has motivated researchers to develop and test new agents with antiinflammatory capabilities. The leukotrienes are endogenous mediators with three inflammatory effects: they increase vascular permeability, recruit other inflammatory leukocytes, and induce bronchoconstriction. A number of antileukotriene agents are in various stages of development. Zileuton, a leukotriene synthesis inhibitor, has been shown to improve airway function and reduce asthma-symptoms, although there is some concern over liver toxicity. Zafirlukast, montelukast, and pranlukast, three new leukotriene receptor antagonists, have similar benefits and have not been associated with serious increases in liver enzymes. It is hoped that new antiinflammatory drugs will provide clinicians with targeted and effective asthma treatments that do not bear the potential risks of corticosteroid therapy.
随着哮喘被阐明为一种慢性炎症性疾病，治疗方法已从使用支气管扩张剂治疗症状转向使用抗炎药物治疗潜在疾病。出于医生和患者对皮质类固醇副作用的担忧，这种转变促使研究人员开发和测试具有抗炎能力的新药物。白三烯是具有三种炎症效应的内源性介质：它们增加血管通透性、募集其他炎症白细胞并诱导支气管收缩。多种抗白三烯药物正处于不同的开发阶段。齐留通是一种白三烯合成抑制剂，已被证明可改善气道功能并减轻哮喘症状，不过对其肝毒性存在一些担忧。扎鲁司特、孟鲁司特和普仑司特这三种新型白三烯受体拮抗剂具有类似的益处，且未与肝酶严重升高相关。人们希望新的抗炎药物能为临床医生提供针对性强且有效的哮喘治疗方法，而不具有皮质类固醇疗法的潜在风险。
