哮喘联盟

   摘要
   尽管组胺能模拟过敏性支气管收缩和严重过敏反应的症状，大部分组胺拮抗剂对这些疾病却无治疗作用。白三烯拮抗剂能有效预防过敏性哮喘发作。在采用人支气管建立的哮喘模型中，体外研究支持组胺H1受体拮抗剂和白三烯拮抗剂具有一定协同作用。此外，在人过敏原激发试验中也能观察到类似结果。我们认为，有必要进行大规模临床试验，研究二代抗组胺药联合白三烯拮抗剂在预防和/或治疗过敏性哮喘发作中的作用。如果有疗效，这些药物可作为近期抗哮喘治疗的一个候选方案，同时具有较好的成本-效益。由于哮喘病理生理学涉及多种机制，也可以考虑使用其他联合治疗方案（包括血栓烷或血小板活化因子拮抗剂）。

（刘国梁 审校）
EurJPharmacol.2013Jan23.pii:S0014-2999(13)00015-0.doi:10.1016/j.ejphar.2013.01.009. [Epub ahead of print]

 

Should antihistamines be re-considered as antiasthmatic drugs as adjuvants to anti-leukotrienes?
 
Bartho L, Benko R.

Source
Department of Pharmacology and Pharmacotherapy, University Medical School of Pécs, Pécs, Hungary. Electronic address: Lorand.Bartho@aok.pte.hu.

Abstract 
In spite of histamine mimicking the symptoms of allergic bronchoconstriction and severe anaphylaxis, histamine antagonists most probably represent no effective treatment for these conditions. Anti-leukotrienes proved effective for preventing attacks of allergic asthma. In vitro evidence supports a supra-additive effect of histamine H(1) receptor antagonists and anti-leukotrienes in vitro, in asthma models utilizing human bronchi. The same seems to hold true for human allergen provocation tests in vivo. We conclude that combinations of second-generation antihistamines and anti-leukotrienes deserve a large-scale clinical trial for preventing and/or treating attacks of allergic asthma. If useful, these drugs could provide a cost-effective alternative to some recent antiasthmatics. Given that redundant mechanisms may be included in asthma pathophysiology, other combinations (including thromboxane or platelet activating factor antagonists) could also be considered.
 

EurJPharmacol.2013Jan23.pii:S0014-2999(13)00015-0.doi:10.1016/j.ejphar.2013.01.009. [Epub ahead of print]