Leukotriene receptor antagonists in asthma therapy白三烯受体拮抗剂在哮喘治疗中的应用.pdfVIP

Leukotriene receptor antagonists in asthma therapy Stephen P. Peters, MD, PhD Philadelphia, Pa In persons with asthma, the cysteinyl leukotrienes possess mul- tiple inflammatory properties in vitro and have long been con- Abbreviations used sidered to be a potentially important mediator of asthma and CysLT: Cysteinyl leukotriene an attractive target for therapeutic intervention. Controlled ICS: Inhaled corticosteroid clinical trials have documented the efficacy of leukotriene LTD : Leukotriene D 4 4 receptor antagonists in asthma treatment, but reservations LTRA: Leukotriene receptor antagonist about their use for asthma therapy center on two main issues: PEFR: Peak expiratory flow rate the heterogeneity of patient responses and their reduced poten- cy relative to other asthma medications. For example, leukotriene receptor antagonists also have been shown to be improvements in a variety of symptom measures (symp- less efficacious than inhaled corticosteroids for several end tom score, nighttime awakenings, and mornings with points, including symptom relief, reduced markers of inflam- asthma), several measures of pulmonary function (morn- mation, and improved pulmonary function. This review ing peak expiratory flow rate, [PEFR], FEV1), rescue β- explores several underappreciated aspects of asthma therapy: agonist use (Fig 1), and asthma exacerbations.2-6,10-19 In heterogeneity of patient responses to medication, the failure of symptoms to correlate with commonly used end points, and the many studies LTRAs have been effective both as potential of delivery to dist