Renzi P M
Research Centre, Centre hospitalier de I'Université de Montréal Hospitals, Université de Montréal, Que.
CMAJ. 1999 Jan 26;160(2):217-23.
THE PERSISTENCE OF AIRWAY INFLAMMATION is believed to cause the mechanical changes and symptoms of asthma. After decades of research, a new class of medication has emerged that focuses on leukotrienes, mediators of inflammation. These substances are potent inducers of bronchoconstriction, increased vascular permeability and mucus production, and they potentiate the influx of inflammatory cells in the airways of patients with asthma. In this article the author reviews the development, mechanism of action, and clinical and toxic effects of the leukotriene synthesis inhibitors and receptor antagonists that are entering the North American market. These agents can decrease airway response to antigen, airway hyperresponsiveness and exercise-induced asthma. They are also effective inhibitors of ASA-induced symptoms. Although few published studies are available, the antileukotrienes seem almost as effective in the management of chronic asthma as low-dose inhaled corticosteroids, and their use permits a decrease in the frequency of use or dose of corticosteroids. Further evaluation and clinical experience will determine the position of targeted inhibition of the leukotriene pathway in the treatment of asthma.
气道炎症的持续存在被认为会导致哮喘的机械性改变和症状。经过数十年的研究，一类新的药物出现了，这类药物聚焦于白三烯，即炎症介质。这些物质是支气管收缩、血管通透性增加和黏液产生的强效诱导剂，并且它们会增强哮喘患者气道中炎症细胞的流入。在本文中，作者回顾了即将进入北美市场的白三烯合成抑制剂和受体拮抗剂的研发、作用机制以及临床和毒性作用。这些药物可以降低气道对抗原的反应、气道高反应性以及运动诱发的哮喘。它们也是阿司匹林诱发症状的有效抑制剂。尽管已发表的研究较少，但抗白三烯药物在慢性哮喘的治疗中似乎与低剂量吸入性糖皮质激素一样有效，并且使用它们可以减少糖皮质激素的使用频率或剂量。进一步的评估和临床经验将确定白三烯途径靶向抑制在哮喘治疗中的地位。
