白三烯调节剂用于哮喘治疗
2010/12/31
摘要
白三烯（LTs）包括半胱氨酰LTs (CysLTs)和LTB(4)，都是较强的脂质介质，在哮喘的病理生理学中起到重要作用。CysLTs 至少有2个受体亚型：CysLT(1)和CysLT(2) 。CysLTs在哮喘中的病理生理学作用大部分由CysLT(1)受体活化所介导，包括气道平滑肌活性增加、微血管通透性增加、气道粘液分泌等。LTB(4)在严重哮喘、哮喘恶化和气道高反应性的发生过程中起到重要作用。CysLT(1)受体拮抗剂能作为一种口服药物，单药治疗轻度持续性哮喘，但这些药物的有效性低于糖皮质激素吸入治疗。联合CysLT(1)受体拮抗剂和糖皮质激素吸入治疗，对于更为严重的哮喘患者，则有助于改善哮喘控制，减少糖皮质激素的吸入剂量，同时保持相似的疗效。由于患者对CysLT(1)受体拮抗剂治疗反应不一致，鉴别那些对CysLT(1)受体拮抗剂治疗有效的哮喘患者有助于哮喘的治疗。CysLT(1)受体拮抗剂可能能够对抗气道重构，对于预防或逆转哮喘患者气道结构改变具有重要作用。本综述讨论了LTs在哮喘中的地位，以及LT调节剂在哮喘治疗中的地位。
（陈欣 审校）
Clin Exp Allergy. 2010 Dec;40(12):1732-41.doi: 10.1111/j.1365-2222.2010.03630.x.
Leukotriene modifiers for asthma treatment.
Montuschi P, Peters-Golden ML.
Department of Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Abstract
Leukotrienes (LTs), including cysteinyl LTs (CysLTs) and LTB(4) , are potent lipid mediators that have a role in the pathophysiology of asthma. At least two receptor subtypes for CysLTs, CysLT(1) and CysLT(2) , have been identified. The activation of the CysLT(1) receptor is responsible for most of the pathophysiological effects of CysLTs in asthma, including increased airway smooth muscle activity, microvascular permeability, and airway mucus secretion. LTB(4) might have a role in severe asthma, asthma exacerbations, and the development of airway hyperresponsiveness. CysLT(1) receptor antagonists can be given orally as monotherapy in patients with mild persistent asthma, but these drugs are generally less effective than inhaled glucocorticoids. Combination of CysLT(1) receptor antagonists and inhaled glucocorticoids in patients with more severe asthma may improve asthma control and enable the dose of inhaled glucocorticoids to be reduced while maintaining similar efficacy. The identification of subgroups of asthmatic patients who respond to CysLT(1) receptor antagonists is relevant for asthma management as the response to these drugs is variable. CysLT(1) receptor antagonists have a potential anti-remodelling effect that might be important for preventing or reversing airway structural changes in patients with asthma. This review discusses the role of LTs in asthma and the role of LT modifiers in asthma treatment.
Clin Exp Allergy. 2010 Dec;40(12):1732-41. doi: 10.1111/j.1365-2222.2010.03630.x.
白三烯（LTs）包括半胱氨酰LTs (CysLTs)和LTB(4)，都是较强的脂质介质，在哮喘的病理生理学中起到重要作用。CysLTs 至少有2个受体亚型：CysLT(1)和CysLT(2) 。CysLTs在哮喘中的病理生理学作用大部分由CysLT(1)受体活化所介导，包括气道平滑肌活性增加、微血管通透性增加、气道粘液分泌等。LTB(4)在严重哮喘、哮喘恶化和气道高反应性的发生过程中起到重要作用。CysLT(1)受体拮抗剂能作为一种口服药物，单药治疗轻度持续性哮喘，但这些药物的有效性低于糖皮质激素吸入治疗。联合CysLT(1)受体拮抗剂和糖皮质激素吸入治疗，对于更为严重的哮喘患者，则有助于改善哮喘控制，减少糖皮质激素的吸入剂量，同时保持相似的疗效。由于患者对CysLT(1)受体拮抗剂治疗反应不一致，鉴别那些对CysLT(1)受体拮抗剂治疗有效的哮喘患者有助于哮喘的治疗。CysLT(1)受体拮抗剂可能能够对抗气道重构，对于预防或逆转哮喘患者气道结构改变具有重要作用。本综述讨论了LTs在哮喘中的地位，以及LT调节剂在哮喘治疗中的地位。
（陈欣 审校）
Clin Exp Allergy. 2010 Dec;40(12):1732-41.doi: 10.1111/j.1365-2222.2010.03630.x.
Leukotriene modifiers for asthma treatment.
Montuschi P, Peters-Golden ML.
Department of Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Abstract
Leukotrienes (LTs), including cysteinyl LTs (CysLTs) and LTB(4) , are potent lipid mediators that have a role in the pathophysiology of asthma. At least two receptor subtypes for CysLTs, CysLT(1) and CysLT(2) , have been identified. The activation of the CysLT(1) receptor is responsible for most of the pathophysiological effects of CysLTs in asthma, including increased airway smooth muscle activity, microvascular permeability, and airway mucus secretion. LTB(4) might have a role in severe asthma, asthma exacerbations, and the development of airway hyperresponsiveness. CysLT(1) receptor antagonists can be given orally as monotherapy in patients with mild persistent asthma, but these drugs are generally less effective than inhaled glucocorticoids. Combination of CysLT(1) receptor antagonists and inhaled glucocorticoids in patients with more severe asthma may improve asthma control and enable the dose of inhaled glucocorticoids to be reduced while maintaining similar efficacy. The identification of subgroups of asthmatic patients who respond to CysLT(1) receptor antagonists is relevant for asthma management as the response to these drugs is variable. CysLT(1) receptor antagonists have a potential anti-remodelling effect that might be important for preventing or reversing airway structural changes in patients with asthma. This review discusses the role of LTs in asthma and the role of LT modifiers in asthma treatment.
Clin Exp Allergy. 2010 Dec;40(12):1732-41. doi: 10.1111/j.1365-2222.2010.03630.x.
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哮喘患儿早期糖皮质激素治疗并不能改善10岁时的肺功能
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无泵体外人工肺辅助技术在治疗严重、难治性哮喘持续状态中的作用
