哮喘联盟

   摘要
   鼻炎和其他特定性诱发因素或合并症（烟草暴露、超重、阿司匹林过敏或遗传因素）通常与哮喘未控制有关。哮喘加剧的相关因素似乎与白三烯介导的炎症增加有关。我们使用PubMed数据库检索（使用英语和法语）随机、对照试验，大规模的观察性研究和综述等生物医学文献，回顾了孟鲁司特（白三烯受体拮抗剂）治疗存在这些相关因素的哮喘的作用(至2012年5月发表的文章)。不论单药或联合其他药物，孟鲁司特均是治疗鼻炎相关性哮喘的有效方法。同时，孟鲁司特也对治疗运动诱导性哮喘、烟草暴露相关性哮喘、超重或阿司匹林过敏者有效。因此，对于一些患者，孟鲁司特可能成为皮质激素（治疗金标准）的替换药。白三烯信号通路的多个基因编码蛋白多态性可能导致孟鲁司特应答的改变。总而言之，我们的研究表明，孟鲁司特可能对哮喘相关性鼻炎、运动、烟草暴露、超重或阿司匹林过敏者有特别获益。

 

（刘国梁 审校）
J Asthma. 2013 Jul 8. [Epub ahead of print]

 

Impact of montelukast on asthma associated with rhinitis, and other triggers and co-morbidities.
 

Pacheco Y, Freymond N, Devouassoux G.
 

Abstract
Abstract Rhinitis and other specific triggers or co-morbidities (tobacco exposure, excess weight, aspirin sensitivity or heredity factors) are frequently associated with uncontrolled asthma. Asthma associated with these exacerbating factors appears to be related to an increase in leukotriene-mediated inflammation. We reviewed the role of montelukast, a leukotriene receptor antagonist, in the treatment of asthma associated with these factors by using the PubMed database to search the English and French biomedical literature for articles describing randomized controlled trials, large observational studies and reviews (published up to May 2012, inclusive). Montelukast, either alone or in combination with other drugs, is an effective treatment against rhinitis-associated asthma. Montelukast also offers therapeutic benefits against exercise-induced asthma or in cases of asthma linked to tobacco exposure, excess weight or aspirin hypersensitivity. Thus, for some patients, montelukast may constitute an alternative to the gold-standard treatment of inhaled corticosteroids. Polymorphisms in several genes encoding proteins of the leukotriene signaling pathway may contribute to the variability in response to montelukast. In conclusion, we have shown that montelukast treatment could be of particular benefit to subgroups of patients with asthma associated with rhinitis, exercise, tobacco exposure, being overweight or aspirin hypersensitivity.

J Asthma. 2013 Jul 8. [Epub ahead of print]