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Seyfinejad B, Nemutlu E, Taghizadieh A, Khoubnasabjafari M, Ozkan SA, Jouyban A. Biomarkers in exhaled breath condensate as fingerprints of asthma, chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap: a critical review. Biomark Med 2023; 17:811-837. [PMID: 38179966 DOI: 10.2217/bmm-2023-0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap are the third leading cause of mortality around the world. They share some common features, which can lead to misdiagnosis. To properly manage these conditions, reliable markers for early and accurate diagnosis are needed. Over the past 20 years, many molecules have been investigated in the exhaled breath condensate to better understand inflammation pathways and mechanisms related to these disorders. Recently, more advanced techniques, such as sensitive metabolomic and proteomic profiling, have been used to obtain a more comprehensive understanding. This article reviews the use of targeted and untargeted metabolomic methodology to study asthma, COPD and asthma-COPD overlap.
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Affiliation(s)
- Behrouz Seyfinejad
- Pharmaceutical Analysis Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara, 06100, Turkiye
| | - Ali Taghizadieh
- Tuberculosis & Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Internal Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Khoubnasabjafari
- Tuberculosis & Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anesthesiology & Intensive Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sibel A Ozkan
- Ankara University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara, 06560, Turkiye
| | - Abolghasem Jouyban
- Pharmaceutical Analysis Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
- Faculty of Pharmacy, Near East University, PO Box 99138 Nicosia, North Cyprus, Mersin 10, Turkiye
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Guo X, Huang S, Luo Q, Lin H. Lifestyles and the risk of an asthma attack in adult asthma patients: a cross-sectional study using NHANES database. J Sports Med Phys Fitness 2023; 63:1118-1125. [PMID: 37382411 DOI: 10.23736/s0022-4707.23.15015-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND The influence of physical activity, diet and sleep on asthma has been well documented by recent studies respectively. However, few studies focus on the relationship between asthma attack and the overall lifestyle, which comprises interrelated lifestyle factors. This study aims to investigate the influence of lifestyles on the ratio of asthma attack. Data were extracted from the NHANES database (2017 to May 2020). METHODS A total of 834 asthmatic patients were enrolled and divided into non-asthma attack (N.=460) and asthma attack (N.=374) groups. The risk factors for asthma attacks were preliminarily identified by univariate logistic analysis, then multivariate logistic analysis was employed to select independent risk factors other than lifestyles and further determine the association between lifestyles and asthma attacks. RESULTS After multivariate logistic analysis, engagement of vigorous activity (Model 1 P=0.010, Model 2 P=0.016, Model 3 P=0.012), engagement of moderate activity (Model 1 P=0.006, Model 2 P=0.008, Model 3 P=0.003) and sleep disorder (Model1 P=0.001, Model 2 P<0.001, Model 3 P=0.008) were determined as independent risk factors of lifestyles for an asthma attack in the past year. CONCLUSIONS This research documented that, for asthmatic patients, engagement of vigorous activity, engagement of moderate activity, and sleep disorder will make an asthma attack more likely to happen.
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Affiliation(s)
- Xuequn Guo
- Department of Respiratory Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China -
| | - Songping Huang
- Department of Respiratory Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Qiu Luo
- Department of Emergency Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Hongsheng Lin
- Department of Respiratory Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
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Sokolowska M, Rovati GE, Diamant Z, Untersmayr E, Schwarze J, Lukasik Z, Sava F, Angelina A, Palomares O, Akdis CA, O’Mahony L, Sanak M, Dahlen S, Woszczek G. Current perspective on eicosanoids in asthma and allergic diseases: EAACI Task Force consensus report, part I. Allergy 2021; 76:114-130. [PMID: 32279330 DOI: 10.1111/all.14295] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/13/2020] [Accepted: 03/25/2020] [Indexed: 12/25/2022]
Abstract
Eicosanoids are biologically active lipid mediators, comprising prostaglandins, leukotrienes, thromboxanes, and lipoxins, involved in several pathophysiological processes relevant to asthma, allergies, and allied diseases. Prostaglandins and leukotrienes are the most studied eicosanoids and established inducers of airway pathophysiology including bronchoconstriction and airway inflammation. Drugs inhibiting the synthesis of lipid mediators or their effects, such as leukotriene synthesis inhibitors, leukotriene receptors antagonists, and more recently prostaglandin D2 receptor antagonists, have been shown to modulate features of asthma and allergic diseases. This review, produced by an European Academy of Allergy and Clinical Immunology (EAACI) task force, highlights our current understanding of eicosanoid biology and its role in mediating human pathology, with a focus on new findings relevant for clinical practice, development of novel therapeutics, and future research opportunities.
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Affiliation(s)
- Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
- Christine Kühne ‐ Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - G. Enrico Rovati
- Department of Pharmaceutical Sciences University of Milan Milan Italy
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology Skane University Hospital Lund Sweden
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Jargen Schwarze
- Child Life and Health and Centre for Inflammation Research The University of Edinburgh Edinburgh UK
| | - Zuzanna Lukasik
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
| | - Florentina Sava
- London North Genomic Laboratory Hub Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Alba Angelina
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
- Christine Kühne ‐ Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Liam O’Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland
| | - Marek Sanak
- Department of Medicine Jagiellonian University Medical College Krakow Poland
| | - Sven‐Erik Dahlen
- Institute of Environmental Medicine Karolinska Institute Stockholm Sweden
- Centre for Allergy Research Karolinska Institute Stockholm Sweden
| | - Grzegorz Woszczek
- MRC/Asthma UK Centre in Allergic Mechanisms of Asthma School of Immunology & Microbial Sciences King's College London London UK
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Nalini CN, Kumar V. A Review of Different Analytical Techniques for Fexofenadine Hydrochloride and Montelukast Sodium in Different Matrices. Crit Rev Anal Chem 2020; 51:232-245. [PMID: 31899949 DOI: 10.1080/10408347.2019.1709410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Fexofenadine hydrochloride is an antihistamine agent used for the treatment of allergic disorders like rhinitis. It is a second generation antihistamine. Montelukast sodium is an anti-asthmatic agent and leukotriene receptor antagonist used in the treatment of respiratory disorders. This article exemplifies the reported analytical methods like electrometric methods, ultraviolet spectroscopy, mass spectroscopy, thin layer chromatography, high performance liquid chromatography, high performance thin layer chromatography and tandem spectroscopy for determination of fexofenadine HCl and montelukast sodium in dosage form and in biological matrices. This review covers almost all the analytical methods for fexofenadine hydrochloride and montelukast sodium form 1968-2018 years. Complete analytical validation parameters reported are discussed in this review for both analytes. Among various analytical methods, HPLC and UV-visible spectrophotometry were found to be the most extensively used methods by the researchers.
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Affiliation(s)
- C N Nalini
- Pharmaceutical Analysis, C.L. Baid Metha College of Pharmacy, Chennai, India
| | - Vinoth Kumar
- Pharmaceutical Analysis, C.L. Baid Metha College of Pharmacy, Chennai, India
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Licari A, Manti S, Castagnoli R, Marseglia A, Foiadelli T, Brambilla I, Marseglia GL. Immunomodulation in Pediatric Asthma. Front Pediatr 2019; 7:289. [PMID: 31355170 PMCID: PMC6640202 DOI: 10.3389/fped.2019.00289] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 06/27/2019] [Indexed: 01/20/2023] Open
Abstract
Childhood asthma is actually defined as a heterogeneous disease, including different clinical variants and partially sharing similar immune mechanisms. Asthma management is mainly focused on maintaining the control of the disease and reducing the risk of adverse outcomes. Most children achieve good control with standard therapies, such as low doses of inhaled corticosteroids (ICS) and/or one or more controller. These medications are targeted to suppress bronchial inflammation and to restore airway responsiveness. However, they are not disease-modifying and do not specifically target inflammatory pathways of asthma; in addition, they are not significantly effective in patients with severe uncontrolled asthma. The aim of this review is to update knowledge on current and novel therapeutic options targeted to immunomodulate inflammatory pathways underlying pediatric asthma, with particular reference on biologic therapies.
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Affiliation(s)
- Amelia Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Sara Manti
- Unit of Pediatric Genetics and Immunology, Department of Pediatrics, University of Messina, Messina, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Riccardo Castagnoli
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Alessia Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Thomas Foiadelli
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Ilaria Brambilla
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Gian Luigi Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
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Epigenome analysis links gene regulatory elements in group 2 innate lymphocytes to asthma susceptibility. J Allergy Clin Immunol 2018; 142:1793-1807. [DOI: 10.1016/j.jaci.2017.12.1006] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/12/2017] [Accepted: 12/15/2017] [Indexed: 12/19/2022]
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Shen C, Chen F, Wang H, Zhang X, Li G, Wen Z. Individualized treatment for allergic rhinitis based on key nasal clinical manifestations combined with histamine and leukotriene D4 levels. Braz J Otorhinolaryngol 2018; 86:63-73. [PMID: 30467056 PMCID: PMC9422539 DOI: 10.1016/j.bjorl.2018.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/24/2018] [Accepted: 09/25/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction The types of allergic rhinitis are roughly classified based on the causative antigens, disease types, predilection time, and symptom severity. Objective To examine the clinical typing and individualized treatment approach for allergic rhinitis and to determine the optimal treatment method for this disease using various drug combination therapies. Methods A total of 108 participants with allergic rhinitis were divided into three groups based on symptoms. Subsequently, each group was further categorized into four subgroups based on the medications received. The efficacy of the treatments was evaluated using the visual analog scale VAS scores of the total and individual nasal symptoms, decline index of the symptom score, histamine and leukotriene levels, and mRNA and protein expression levels of histamine 1 and cysteinyl leukotriene 1 receptors. Results Loratadine + mometasone furoate and loratadine + mometasone furoate + montelukast significantly improved the sneezing symptom and reduced the histamine levels compared with the other combination therapies (p < 0.05). Meanwhile, montelukast + mometasone furoate and montelukast + mometasone furoate + loratadine considerably improved the nasal obstruction symptom and decreased the leukotriene D4 levels compared with the other combination therapies (p < 0.05). Conclusion Clinical symptom evaluation combined with experimental detection of histamine and leukotriene levels can be an objective and accurate method to clinically classify the allergic rhinitis types. Furthermore, individualized treatment based on allergic rhinitis classification can result in a good treatment efficacy.
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Affiliation(s)
- Congxiang Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Fang Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Huigang Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Xinyu Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Guanxue Li
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China
| | - Zhong Wen
- Department of Otorhinolaryngology Head and Neck Surgery, Southern Medical University, Zhujiang Hospital, Guangzhou, China.
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Magazine R, Surendra VU, Chogtu B. Comparison of oral montelukast with oral ozagrel in acute asthma: A randomized, double-blind, placebo-controlled study. Lung India 2018; 35:16-20. [PMID: 29319028 PMCID: PMC5760861 DOI: 10.4103/lungindia.lungindia_226_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: The need for more effective management of acute asthma has led to research on drugs which are otherwise approved for use in chronic asthma. Objective: To study and compare the effects of oral montelukast with oral ozagrel in acute asthma. Materials and Methods: One hundred and twenty patients with acute asthma were recruited for the study. Out of 120 study patients, forty each were randomized into placebo, montelukast, and ozagrel groups. After the first dose of the drug or placebo was administered, peak expiratory flow rate (PEFR), number of rescue medications and also vital signs were noted at 6 h, 12 h, 24 h, 48 h, and at discharge. In addition, same recordings were done on the morning (8 a.m. – 10 a.m.) following admission. The difference in mean PEFR of each group at above-mentioned time points was the primary endpoint whereas need for rescue medications the secondary end-point. Results: The respective mean PEFR recordings of the placebo, montelukast, and ozagrel groups at various time points were as follows: at 6 h (235.19 ± 3.18, 242.86 ± 3.26, 228.18 ± 3.25); at 12 h (254.37 ± 5.23, 265.62 ± 5.38, 242.99 ± 5.36); at 24 h (267.46 ± 7.41, 291.39 ± 7.61, 268.14 ± 7.58); and at 48 h (277.99 ± 7.35, 303.22 ± 7.56, 285.27 ± 7.53); and discharge (301.94 ± 7.07, 317.32 ± 7.27, 298.99 ± 7.23). The mean PEFR between the treatment groups were not statistically significant (P = 0.102). The mean PEFR in the three groups at 8–10 a.m. following admission was 257.60 ± 5.52, 264.23 ± 5.98, and 249.94 ± 5.96; P = 0.266. Total number of rescue doses needed were 7, 4, and 13, respectively (P = 0.67). Conclusion: Montelukast or ozagrel when added to the standard treatment of acute asthma does not result in any additional benefit.
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Affiliation(s)
- Rahul Magazine
- Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Vyshak Uddur Surendra
- Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Bharti Chogtu
- Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Hoxha M, Rovati GE, Cavanillas AB. The leukotriene receptor antagonist montelukast and its possible role in the cardiovascular field. Eur J Clin Pharmacol 2017; 73:799-809. [PMID: 28374082 DOI: 10.1007/s00228-017-2242-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/22/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cysteinyl leukotrienes (LTC4, LTD4, and LTE4) are pro-inflammatory mediators of the 5-lipooxygenase (5-LO) pathway, that play an important role in bronchoconstriction, but can also enhance endothelial cell permeability and myocardial contractility, and are involved in many other inflammatory conditions. In the late 1990s, leukotriene receptor antagonists (LTRAs) were introduced in therapy for asthma and later on, approved for the relief of the symptoms of allergic rhinitis, chronic obstructive pulmonary disease, and urticaria. In addition, it has been shown that LTRAs may have a potential role in preventing atherosclerosis progression. PURPOSE The aims of this short review are to delineate the potential cardiovascular protective role of a LTRA, montelukast, beyond its traditional use, and to foster the design of appropriate clinical trials to test this hypothesis. RESULTS AND CONCLUSIONS What it is known about leukotriene receptor antagonists? •Leukotriene receptor antagonist, such as montelukast and zafirlukast, is used in asthma, COPD, and allergic rhinitis. • Montelukast is the most prescribed CysLT1 antagonist used in asthmatic patients. • Different in vivo animal studies have shown that leukotriene receptor antagonists can prevent the atherosclerosis progression, and have a protective role after cerebral ischemia. What we still need to know? • Today, there is a need for conducting clinical trials to assess the role of montelukast in reducing cardiovascular risk and to further understand the mechanism of action behind this effect.
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Affiliation(s)
- Malvina Hoxha
- Department of Chemical, Toxicological and Pharmacological Evaluation of Drugs, Catholic University Our Lady of Good Counsel, Rruga. D. Hoxha, Tirana, Albania.
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti, 9-20133, Milan, Italy.
| | - G Enrico Rovati
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti, 9-20133, Milan, Italy
| | - Aurora Bueno Cavanillas
- IBS Granada, University of Granada, CIBER of Epidemiology and Public Health (CIBERESP), Granada, Spain
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Pyasi K, Tufvesson E, Moitra S. Evaluating the role of leukotriene-modifying drugs in asthma management: Are their benefits 'losing in translation'? Pulm Pharmacol Ther 2016; 41:52-59. [PMID: 27651322 DOI: 10.1016/j.pupt.2016.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 09/13/2016] [Accepted: 09/16/2016] [Indexed: 02/06/2023]
Abstract
Leukotrienes (LTs) initiate a cascade of reactions that cause bronchoconstriction and inflammation in asthma. LT-modifying drugs have been proved very effective to reduce inflammation and associated exacerbation however despite some illustrious clinical trials the usage of these drugs remains overlooked because the evidence to support their utility in asthma management has been mixed and varied between studies. Although, there are plenty of evidences which suggest that the leukotriene-modifying drugs provide consistent improvement even after just the first oral dose and reduce asthma exacerbations, the beneficial effect of these drugs has remained sparse and widely debated. And these beneficial effects are often overlooked because most of the clinical studies include a mixed population of asthmatics who do not respond to LT-modifiers equally. Therefore, in the present era of personalized medicine, it is important to properly stratify the patients and non-invasive measurements of biomarkers may warrant the possibility to characterize biological/pathological pathway to direct treatment to those who will benefit from it. Endotyping based on individual's leukotriene levels should probably ascertain a subgroup of patients that would clearly benefit from the treatment even though the trial fails to show overall significance. In this article, we have methodically evaluated contemporary literature describing the efficacy of LT-modifying drugs in the management of asthma and highlighted the importance of phenotyping the asthmatics for better treatment outcomes.
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Affiliation(s)
- Kanchan Pyasi
- Molecular Respiratory Research Laboratory, Chest Research Foundation, Pune, India
| | - Ellen Tufvesson
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Subhabrata Moitra
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden; Department of Pneumology, Allergy and Asthma Research Centre, Kolkata, India.
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Magazine R, Shahul HA, Chogtu B, Kamath A. Comparison of oral montelukast with oral zileuton in acute asthma: A randomized, double-blind, placebo-controlled study. Lung India 2016; 33:281-6. [PMID: 27185992 PMCID: PMC4857564 DOI: 10.4103/0970-2113.180805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Leukotriene modifiers have an established role in the management of chronic asthma but their role in acute asthma is still under evaluation. Objective: To study and compare the effects of oral montelukast with oral zileuton in acute asthma. Materials and Methods: This study included 120 asthmatics and was conducted from September 2012 to March 2014. Patients were randomized into three different groups to receive montelukast or zileuton or placebo in addition to standard treatment for asthma exacerbation. Peak expiratory flow rate (PEFR) values, details of rescue medication and vital signs were recorded at 6 h, 12 h, 24 h, and 48 h of drug or placebo administration and at discharge. Additional recording was done in the morning (8–10 am) following admission. The primary endpoint was the mean PEFR of each group at these time points; the secondary end point being the need for rescue medications. Results: The mean PEFR recordings of the three study groups – placebo, montelukast, and zileuton – respectively, at various time points were as follows: at 6 h (223.25 ± 90.40, 199.00 ± 82.52, 233.75 ± 84.05; P = 0.240); at 12 h (271.00 ± 109.38, 251.50 ± 101.44, 309.50 ± 129.63; P = 0.048); at 24 h (288.25 ± 114.26, 269.00 ± 107.51, 324.50 ± 127.88; P = 0.080); and at 48 h (295.00 ± 114.80, 293.50 ± 113.24, 344.75 ± 119.91; P = 0.015); discharge (305.00 ± 118.56, 305.25 ± 119.51, 361.25 ± 119.70; P = 0.010). The mean PEFR for the three study groups at 8–10 am on the morning following admission was 268.75 ± 111.43, 252.50 ± 99.99, 306.75 ± 114.44; P = 0.047. Total rescue doses needed were 10, 1, and 0, respectively (P = 0.049). Conclusion: Zileuton is better than montelukast as an additional drug in acute asthma and results in significant improvement in lung function, and reduction in the need for rescue medications.
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Affiliation(s)
- Rahul Magazine
- Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Hameed Aboobackar Shahul
- Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Bharti Chogtu
- Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Asha Kamath
- Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Draft Genome Sequence of Marine Bacterium Streptomyces sp. Strain CNQ431, a Producer of the Cytokine Inhibitor Splenocin. GENOME ANNOUNCEMENTS 2015; 3:3/1/e01383-14. [PMID: 25614558 PMCID: PMC4319611 DOI: 10.1128/genomea.01383-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Currently, corticosteroids are the most potent anti-inflammatory drugs on the market. Here, we announce the draft genome sequence of the marine-derived Streptomyces sp. strain CNQ431, which produces cytokine inhibitors, termed splenocins, which display potent suppression of cytokine production at a comparable level to that of corticosteroids. The genome is approximately 498,750 bp with 72.03% G+C content.
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Mougey E, Lang JE, Allayee H, Teague WG, Dozor AJ, Wise RA, Lima JJ. ALOX5 polymorphism associates with increased leukotriene production and reduced lung function and asthma control in children with poorly controlled asthma. Clin Exp Allergy 2013; 43:512-20. [PMID: 23600541 DOI: 10.1111/cea.12076] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 11/06/2012] [Accepted: 12/14/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Identification of risk factors for reduced asthma control could improve the understanding and treatment of asthma. A promoter polymorphism in the 5-lipoxygenase gene affects gene expression and response to asthma therapy, but its impact on disease control remains unclear. OBJECTIVE We sought to determine if the ALOX5 promoter SP1 tandem repeat polymorphism was associated with changes in cysteinyl leukotriene production, lung function, airway inflammation and asthma control score. METHODS We analysed 270 children, 6- to 17-years old, with poorly controlled asthma enrolled in a 6-month clinical trial (NCT00604851). In secondary analysis, we associated the ALOX5 promoter SP1 tandem repeat polymorphism genotype (rs59439148) with asthma outcomes using both additive and recessive genetic models. We evaluated FEV1 percent predicted, symptom control, exhaled nitric oxide and urinary LTE4 levels. RESULTS Of all children, 14.8% (40/270) (and 28% (38/135) of African Americans) carried two non-5-repeat variant alleles of rs59439148. Children who were homozygous for variant alleles had significantly higher urinary LTE4 levels (38 vs. 30 nmol/mol creatinine, P = 0.0134), significantly worse FEV1% predicted (84 vs. 91, P = 0.017) and a trend towards worse asthma control. FEV1% predicted values were significantly negatively correlated with urinary LTE4 (r = -0.192, P = 0.009). CONCLUSION AND CLINICAL RELEVANCE Carrying two copies of a minor variant ALOX5 promoter SP1 tandem repeat allele contributes to increased cysLT exposure as determined by urinary LTE4 levels, reduced lung function and potentially worse asthma control. ALOX5 promoter SP1 tandem repeat genotype may be a risk factor for worse asthma outcomes.
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Affiliation(s)
- E Mougey
- Center for Pharmacogenomics & Translational Research, Nemours Children's Clinic, Jacksonville, FL 32207, USA
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Lang JE, Blake KV. Role of biomarkers in understanding and treating children with asthma: towards personalized care. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2013; 6:73-84. [PMID: 24019751 PMCID: PMC3760446 DOI: 10.2147/pgpm.s30626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Asthma is one of the most common chronic diseases affecting children. Despite publicized expert panels on asthma management and the availability of high-potency inhaled corticosteroids, asthma continues to pose an enormous burden on quality of life for children. Research into the genetic and molecular origins of asthma are starting to show how distinct disease entities exist within the syndrome of "asthma". Biomarkers can be used to diagnose underlying molecular mechanisms that can predict the natural course of disease or likely response to drug treatment. The progress of personalized medicine in the care of children with asthma is still in its infancy. We are not yet able to apply stratified asthma treatments based on molecular phenotypes, although that time may be fast approaching. This review discusses some of the recent advances in asthma genetics and the use of current biomarkers that can help guide improved treatment. For example, the fraction of expired nitric oxide and serum Immunoglobulin E (IgE) (including allergen-specific IgE), when evaluated in the context of recurrent asthma symptoms, are general predictors of allergic airway inflammation. Biomarker assays for secondhand tobacco smoke exposure and cysteinyl leukotrienes are both promising areas of study that can help personalize management, not just for pharmacologic management, but also education and prevention efforts.
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Affiliation(s)
- Jason E Lang
- Division of Pulmonary and Sleep Medicine, Nemours Children's Hospital, Orlando, FL, USA
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Kahnt AS, Rörsch F, Diehl O, Hofmann B, Lehmann C, Steinbrink SD, Angioni C, Geisslinger G, Grösch S, Steinhilber D, Maier TJ. Cysteinyl leukotriene-receptor-1 antagonists interfere with PGE2 synthesis by inhibiting mPGES-1 activity. Biochem Pharmacol 2013; 86:286-96. [PMID: 23684692 DOI: 10.1016/j.bcp.2013.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 04/07/2013] [Accepted: 05/07/2013] [Indexed: 01/28/2023]
Abstract
Because of their favourable safety profile and beneficial anti-inflammatory properties, the CysLT1 receptor antagonists (LTRA), montelukast, zafirlukast and pranlukast are approved for the treatment of asthma and are frequently prescribed as add-on therapeutics to reduce the amount of inhaled glucocorticoids and β2-agonists. There is evidence that some of these anti-inflammatory properties might be of a secondary nature and therefore, unrelated to the CysLT1 antagonism. Here, we show that LTRA inhibit PGE2 formation in cytokine-stimulated Hela and A549 carcinoma cells and in lipopolysaccharide (LPS)-stimulated human leukocyte preparations (IC50∼20μM). Neither expression of enzymes involved in PGE2 synthesis nor arachidonic acid release and COX activities were inhibited by the compounds. In contrast, mPGES-1 activity was suppressed at low micromolar levels (IC50 between 2 and 4μM). This suppression was specific for PGE2 synthesis, since PGD2 and PGI2 levels in LPS-stimulated leukocyte preparations were not negatively affected. PGF2α levels were concomitantly inhibited, probably due to its direct synthesis from PGE2. Several major conclusions can be drawn from this study: (A) clinical trials investigating elevated doses of the compounds are helpful to confirm suppression of PGE2 synthesis in vivo; (B) studies investigating the role of CysLTs in cell culture or animal models of inflammation and cancer have to be reassessed carefully, if higher doses of LTRA were applied or serum levels in cell culture assays were low; and (C) LTRA may serve as new scaffolds for the development of potent, selective and well tolerated mPGES-1 inhibitors.
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Affiliation(s)
- Astrid Stefanie Kahnt
- Goethe-University, Institute of Pharmaceutical Chemistry, ZAFES, Max-von-Laue-Str. 9, D-60438 Frankfurt/Main, Germany.
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16
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Kim CK, Seo JK, Ban SH, Fujisawa T, Kim DW, Callaway Z. Eosinophil-derived neurotoxin levels at 3 months post-respiratory syncytial virus bronchiolitis are a predictive biomarker of recurrent wheezing. Biomarkers 2013; 18:230-5. [PMID: 23557131 DOI: 10.3109/1354750x.2013.773078] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To determine whether eosinophil-derived neurotoxin (EDN) is a predictive marker of recurrent wheezing episodes in post-respiratory syncytial virus (RSV) bronchiolitis. METHODS EDN levels and recurrent wheezing episodes were serially measured in 200 infants hospitalized with RSV bronchiolitis. RESULTS Serum EDN levels at 3 months correlated significantly with total wheezing episodes at 12 months in the RSV-PLC (n = 71; r = 0.720, p < 0.0001) and RSV-MONT groups (n = 79; r = 0.531, p < 0.001). Positive predictive value of 3-mo EDN level for total wheezing episodes was 57%; negative predictive value, 76%; sensitivity, 72%; specificity, 62%. CONCLUSION EDN levels have predictive value for the development of recurrent wheezing post-RSV bronchiolitis.
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Affiliation(s)
- Chang-Keun Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
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17
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Fortunato LR, Alves CDF, Teixeira MM, Rogerio AP. Quercetin: a flavonoid with the potential to treat asthma. BRAZ J PHARM SCI 2012. [DOI: 10.1590/s1984-82502012000400002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Allergic asthma is a complex inflammatory disorder characterized by airway hyperresponsiveness, eosinophilic inflammation and hypersecretion of mucus. Current therapies include β2-agonists, cysteinyl leukotriene receptor 1 antagonists and corticosteroids. Although these drugs demonstrate beneficial effects, their adverse side effects limit their long-term use. Thus, the development of new compounds with similar therapeutic activities and reduced side effects is both desirable and necessary. Natural compounds are used in some current therapies, as plant-derived metabolites can relieve disease symptoms in the same manner as allopathic medicines. Quercetin is a flavonoid that is naturally found in many fruits and vegetables and has been shown to exert multiple biological effects in experimental models, including the reduction of major symptoms of asthma: bronchial hyperactivity, mucus production and airway inflammation. In this review, we discuss results from the literature that illustrate the potential of quercetin to treat asthma and its exacerbations.
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Dumitru C, Chan SMH, Turcanu V. Role of leukotriene receptor antagonists in the management of pediatric asthma: an update. Paediatr Drugs 2012; 14:317-30. [PMID: 22897162 DOI: 10.2165/11599930-000000000-00000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
At present, the main indications for leukotriene receptor antagonists (LTRA) in pediatric asthma are as add-on therapy to inhaled corticosteroids (ICS) and as initial controller therapy in children with mild asthma, especially those who cannot or will not use ICS. LTRA are also useful for patients who have concomitant rhinitis, and patients with viral-induced wheeze and exercise-induced asthma. It should be noted that the benefits of LTRA therapy have been demonstrated in children as young as 6 months of age and recent clinical trials have further proven the benefits of LTRA in acute asthma exacerbations. However, considering the important pro-inflammatory effects that leukotrienes (LT) have in experimental models of asthma, it may seem surprising that LTRA treatment outcomes are not better and that in some clinical trials only a minority of patients could be classified as full responders. This could be explained by potential additional LT receptors that are not affected by LTRA. Such receptors could represent new therapeutic targets in asthma. Furthermore, progress in differentiating between asthma phenotypes that result from different pathogenic mechanisms, some of which may involve LT to a lesser degree, should lead to an improved, personalized use of LTRA for treating asthma.
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Affiliation(s)
- Catalina Dumitru
- Kings College London, Kings Health Partners, Asthma-UK Centre in Allergic Mechanisms of Asthma, Department of Asthma, Allergy and Respiratory Science, Guys Hospital, London, UK
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Guan W, Zheng J, Gao Y, Jiang C, An J, Yu X, Liu W. Leukotriene D4 bronchial provocation test: methodology and diagnostic value. Curr Med Res Opin 2012; 28:797-803. [PMID: 22435894 DOI: 10.1185/03007995.2012.678936] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although leukotriene D4 (LTD4) is a potent bronchoconstrictor, little is known about airway responsiveness to LTD4 in asthmatics with different inflammation phenotypes. OBJECTIVES To establish the methodology and investigate the distribution characters of airway responsiveness, diagnostic value and safety of LTD4 bronchial provocation test. METHODS LTD4 bronchial provocation tests were performed in 62 asthmatics and 21 normal controls. Airway responsiveness was assessed based on the cumulative dosage causing a 20% fall in FEV(1) (PD(20)FEV(1)-LTD4) and was expressed as (median, interquartile range). The fall in spirometric parameters was plotted showing the distribution characters. The diagnostic value was assessed using receiver operation characteristic (ROC) curve. All adverse events were recorded during the test. RESULTS Airway responsiveness to LTD4 was significantly higher in asthmatics (0.410 nmol, 0.808 nmol) as compared with normal controls (5.00 nmol, 0.00 nmol). The decrease in spirometric parameters varied after bronchoprovocation, which was negatively correlated with PD(20)FEV(1)-LTD4, among which FEV(1) had a maximal slope (r = -0.524, P = 0.000). High diagnostic value (AUC: 0.914, 95%CI: [0.855, 0.974]) was revealed by ROC curve. The major adverse events were dyspnea (82.3%), chest tightness (72.6%), wheezing (32.3%) and coughing (25.8%) in asthmatics, which could overall be recovered within 15.0 minutes after inhalation of 200 ∼ 400 mcg salbutamol MDI. No serious adverse event was reported. CONCLUSION The established procedure of LTD4 bronchial provocation test is effective in the diagnosis of asthma and is well tolerated. Future studies are necessary to provide more evidences in terms of safety and efficacy. This may be helpful upon further application in clinical practice.
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Affiliation(s)
- Weijie Guan
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China
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Role of leukotrienes on protozoan and helminth infections. Mediators Inflamm 2012; 2012:595694. [PMID: 22577251 PMCID: PMC3337730 DOI: 10.1155/2012/595694] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 01/30/2012] [Indexed: 01/21/2023] Open
Abstract
Leukotrienes (LTs), formed by the 5-lipoxygenase-(5-LO-) catalyzed oxidation of arachidonic acid, are lipid mediators that have potent proinflammatory activities. Pharmacologic or genetic inhibition of 5-LO biosynthesis in animals is associated with increased mortality and impaired clearance of bacteria, fungi, and parasites. LTs play a role in the control of helminth and protozoan infections by modulating the immune system and/or through direct cytotoxicity to parasites; however, LTs may also be associated with pathogenesis, such as in cerebral malaria and schistosomal granuloma. Interestingly, some proteins from the saliva of insect vectors that transmit protozoans and secreted protein from helminth could bind LTs and may consequently modulate the course of infection or pathogenesis. In addition, the decreased production of LTs in immunocompromised individuals might modulate the pathophysiology of helminth and protozoan infections. Herein, in this paper, we showed the immunomodulatory and pathogenic roles of LTs during the helminth and protozoan infections.
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Tomita K, Sano H, Iwanaga T, Ishihara K, Ichinose M, Kawase I, Kimura H, Hirata K, Fujimura M, Mishima M, Tohda Y. Association between episodes of upper respiratory infection and exacerbations in adult patients with asthma. J Asthma 2012; 49:253-9. [PMID: 22376075 DOI: 10.3109/02770903.2012.661009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Asthma has several phenotypical features, including recurrent exacerbations and recurrent episodes of upper respiratory infection (URI). PURPOSE A retrospective study was performed to identify the characteristics of adult patients with recurrent exacerbations of asthma, especially in association with recurrent episodes of URI. METHODS Information was collected using a self-administered questionnaire given to 7070 patients in autumn-winter 2006, 4859 patients in spring-summer 2007, and 4452 patients in autumn-winter 2007. The patients reported the degree of symptoms and the frequency of febrile episodes of URI and exacerbations. Severe exacerbations were defined as a self-report of asthma-related hospitalization, an emergency department visit, or a requirement for systemic corticosteroids. Recurrent febrile URI and exacerbations were defined as two or more episodes within the previous 6 months. A Poisson regression model was used to identify the factors that were predictors of a risk for exacerbations. RESULTS Of the 6266 patients who completed the questionnaire, the frequencies of febrile URI and episodes of severe exacerbations were 1.54 and 0.54 per subject per year, respectively. Logistic regression analysis showed that an older age [odds ratio (OR): 1.57; 95% confidence interval (CI): 1.15-2.13], female sex (OR: 1.58; 95% CI: 1.20-2.08), recurrent febrile episodes of URI (OR: 2.68; 95% CI: 1.47-4.91), a history of previous exacerbation within 1 year (OR: 1.74; 95% CI: 1.28-2.34), disuse of inhaled corticosteroids (ICSs) (OR: 2.63; 95% CI: 1.68-4.12), and disuse of add-on leukotriene receptor antagonists (LTRAs) (OR: 1.42; 95% CI: 1.06-1.74) were independently associated with moderate to severe symptom-severity. Poisson regression analysis showed that the independent factors that contributed to the frequency of recurrent severe exacerbations were female sex (regression coefficient β = 0.62, p < .01), an episode of sputum with coughing (β = 1.23, p < .01), nocturnal awakening (β = 1.22, p < .01), and severe exacerbation (β = 0.78, p < .01) within the previous 6 months. CONCLUSION Symptom-severity of asthma and the frequency of severe exacerbations were associated with previous exacerbations and susceptibility to URI.
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Affiliation(s)
- Katsuyuki Tomita
- Department of Respiratory Medicine and Allergology, Faculty of Medicine, Kinki University, Osaka, Japan.
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Xue L, Barrow A, Fleming VM, Hunter MG, Ogg G, Klenerman P, Pettipher R. Leukotriene E4 activates human Th2 cells for exaggerated proinflammatory cytokine production in response to prostaglandin D2. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2012; 188:694-702. [PMID: 22174450 PMCID: PMC3272457 DOI: 10.4049/jimmunol.1102474] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PGD(2) exerts a number of proinflammatory responses through a high-affinity interaction with chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2) and has been detected at high concentrations at sites of allergic inflammation. Because cysteinyl leukotrienes (cysLTs) are also produced during the allergic response, we investigated the possibility that cysLTs may modulate the response of human Th2 cells to PGD(2). PGD(2) induced concentration-dependent Th2 cytokine production in the absence of TCR stimulation. Leukotrienes D(4) and E(4) (LTE(4)) also stimulated the cytokine production but were much less active than PGD(2). However, when combined with PGD(2), cysLTs caused a greater than additive enhancement of the response, with LTE(4) being most effective in activating Th2 cells. LTE(4) enhanced calcium mobilization in response to PGD(2) in Th2 cells without affecting endogenous PGD(2) production or CRTH2 receptor expression. The effect of LTE(4) was inhibited by montelukast but not by the P2Y(12) antagonist methylthioadenosine 5'-monophosphate. The enhancing effect was also evident with endogenous cysLTs produced from immunologically activated mast cells because inhibition of cysLT action by montelukast or cysLT synthesis by MK886, an inhibitor of 5-lipoxygenase-activating protein, reduced the response of Th2 cells to the levels produced by PGD(2) alone. These findings reveal that cysLTs, in particular LTE(4), have a significant proinflammatory impact on T cells and demonstrate their effects on Th2 cells are mediated by a montelukast-sensitive receptor.
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Affiliation(s)
- Luzheng Xue
- Oxford Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, United Kingdom.
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23
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Pasaje CFA, Kim JH, Park BL, Cheong HS, Park TJ, Lee JS, Kim Y, Bae JS, Kim JM, Park JS, Park CS, Shin HD. Association of the variants in AGT gene with modified drug response in Korean aspirin-intolerant asthma patients. Pulm Pharmacol Ther 2011; 24:595-601. [PMID: 21624492 DOI: 10.1016/j.pupt.2011.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 12/17/2010] [Accepted: 05/14/2011] [Indexed: 11/30/2022]
Abstract
The angiotensinogen (AGT) gene enhances the effect of several bronchoconstrictors and produces a peptide that is accumulated in the airways of asthma patients; events that may underpin the pathogenesis of aspirin-intolerant asthma (AIA). To carry out a case-control analysis between AGT and aspirin-induced bronchospasm following treatment with an anti-asthma drug, montelukast (MLK), 38 single nucleotide polymorphisms (SNPs) in AGT were genotyped in 56 AIA cohort. Genotyping was performed with TaqMan assay and haplotypes were inferred using PHASE algorithm ver. 2.0. Statistical analyses of each SNPs and haplotypes were performed using SAS version 9.1. Among 13 variants displaying significant signals, two SNPs (+2401C>G and +2476C>T) in the intronic region of AGT were significantly associated with modification of drug response even after correction for multiple testing (P=0.0009-0.002; P(corr)=0.02-0.03). Furthermore, the two variants also exhibited associations with MLK response rate (P=0.0003-0.0006; P(corr)=0.006-0.01). Although our results are preliminary and further replication in a larger-scale group of subjects should be warranted, these observations provide evidence that AGT variants might be one of genetic factors involved in the response of anti-asthma drugs in AIA patients.
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Jung JY, Lee KY, Lee MY, Jung D, Cho ES, Son HY. Antioxidant and antiasthmatic effects of saucerneol D in a mouse model of airway inflammation. Int Immunopharmacol 2011; 11:698-705. [PMID: 21295171 DOI: 10.1016/j.intimp.2011.01.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 12/30/2010] [Accepted: 01/14/2011] [Indexed: 10/18/2022]
Abstract
Chronic airway inflammation is a hallmark of asthma, which is an immune-based disease. We evaluated the ability of saucerneol D, a tetrahydrofuran-type sesquilignan isolated from Saururus chinensis, to regulate airway inflammation in an ovalbumin (OVA)-induced airway inflammation model. Furthermore, we determined whether heme oxygenase (HO)-1 was required for the protective activity of saucerneol D. The airways of OVA-sensitized mice exposed to an OVA challenge developed eosinophilia and mucus hypersecretion and exhibited increased cytokine levels. Mice were administered saucerneol D orally at doses of 20 and 40mg/kg once daily on days 26-30. Saucerneol D administered orally significantly inhibited the number of OVA-induced inflammatory cells and the production of immunoglobulin E as well as Th2-type cytokines. Histopathology studies revealed a marked decrease in lung inflammation and goblet cell hyperplasia after saucerneol D treatment. In addition, saucerneol D induced HO-1 and led to a marked decrease in OVA-induced reactive oxygen species and malondialdehyde and an increase in superoxide dismutase and glutathione in lung tissues. These antioxidant effects were correlated with HO-1 induction. In our experiments, saucerneol D treatment reduced airway inflammation and suppressed oxidative stress in an OVA-induced asthma model.
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Affiliation(s)
- Ju-Young Jung
- Research Institute of Veterinary Medicine and College of Veterinary Medicine, Chungnam National University, Yusung-gu, Daejeon, Korea
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25
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Rogerio AP, Sá-Nunes A, Faccioli LH. The activity of medicinal plants and secondary metabolites on eosinophilic inflammation. Pharmacol Res 2010; 62:298-307. [PMID: 20450976 DOI: 10.1016/j.phrs.2010.04.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Revised: 04/16/2010] [Accepted: 04/27/2010] [Indexed: 01/21/2023]
Abstract
Eosinophils are leukocytes that are present in several body compartments and in the blood at relatively low numbers under normal conditions. However, an increase in the number of eosinophils, in the blood or in the tissues, is observed in allergic or parasitic disorders. Although some progress has been made in understanding the development of eosinophil-mediated inflammation in allergic and parasitic diseases, the discovery of new compounds to control eosinophilia has lagged behind other advances. Plant-derived secondary metabolites are the basis for many drugs currently used to treat pathologic conditions, including eosinophilic diseases. Several studies, including our own, have demonstrated that plant extracts and secondary metabolites can reduce eosinophilia and eosinophil recruitment in different experimental animal models. In this review, we summarize these studies and describe the anti-eosinophilic activity of various plant extracts, such as Ginkgo biloba, Allium cepa, and Lafoensia pacari, as well as those of secondary metabolites (compounds isolated from plant extracts), such as quercetin and ellagic acid. In addition, we highlight the medical potential of these plant-derived compounds for treating eosinophil-mediated inflammation, such as asthma and allergy.
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Affiliation(s)
- Alexandre P Rogerio
- Universidade Federal do Triângulo Mineiro, Av. Getúlio Guaritá s/n, Uberaba, MG 38025-440, Brazil.
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Natural anti-inflammatory products and leukotriene inhibitors as complementary therapy for bronchial asthma. Clin Biochem 2010; 43:887-90. [PMID: 20430018 DOI: 10.1016/j.clinbiochem.2010.04.061] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 04/14/2010] [Accepted: 04/15/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the efficacy of a combination of Boswellia serrata, licorice root (Glycyrrhiza glabra) and Tumeric root (Curcuma longa) as natural leukotriene inhibitor, antiinflammatory and antioxidant products respectively in controlling bronchial asthma. SUBJECTS AND METHODS The study comprised 63 patients with bronchial asthma that are further subdivided into two groups .Group 1 receiving oral capsule (combined herb) in a soft-gelatin capsule 3 times daily for 4weeks and group 2 receiving placebo. Plasma leukotriene C(4) (LTC(4))(,) nitric oxide (NO) and malondialdehyde (MDA) levels were measured and pulmonary function was also assessed in all patients enrolled in the study. RESULTS There was a statistically significant decrease in the plasma levels of LTC(4), (MDA), and NO in target therapy group when compared with placebo group. CONCLUSION The used extract contained Boswellia serrata, Curcuma longa and Glycyrrhiza has a pronounced effect in the management of bronchial asthma.
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Malaviya R, Laskin DL, Malaviya R. Janus kinase-3 dependent inflammatory responses in allergic asthma. Int Immunopharmacol 2010; 10:829-36. [PMID: 20430118 DOI: 10.1016/j.intimp.2010.04.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 03/25/2010] [Accepted: 04/20/2010] [Indexed: 12/14/2022]
Abstract
Allergic asthma is a chronic inflammatory condition of the lung characterized by reversible airway obstruction, high serum immunoglobulin (Ig) E levels, and chronic airway inflammation. A number of cells including mast cells, T cells, macrophages and dendritic cells play a role in the pathogenesis of the disease. Janus kinase (JAK)-3, a non-receptor protein tyrosine kinase, traditionally known to mediate cytokine signaling, also regulates functional responses of these cells. In this review the role of JAK-3 in regulating various pathogenic processes in allergic asthma is discussed. We propose that targeting JAK-3 is a rationale approach to control the inflammatory responses of multiple cell types responsible for the pathogenesis of allergic asthma.
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Affiliation(s)
- Rama Malaviya
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 08854, USA.
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Meltzer EO, Caballero F, Fromer LM, Krouse JH, Scadding G. Treatment of congestion in upper respiratory diseases. Int J Gen Med 2010; 3:69-91. [PMID: 20463825 PMCID: PMC2866555 DOI: 10.2147/ijgm.s8184] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Indexed: 12/19/2022] Open
Abstract
Congestion, as a symptom of upper respiratory tract diseases including seasonal and perennial allergic rhinitis, acute and chronic rhinosinusitis, and nasal polyposis, is principally caused by mucosal inflammation. Though effective pharmacotherapy options exist, no agent is universally efficacious; therapeutic decisions must account for individual patient preferences. Oral H1-antihistamines, though effective for the common symptoms of allergic rhinitis, have modest decongestant action, as do leukotriene receptor antagonists. Intranasal antihistamines appear to improve congestion better than oral forms. Topical decongestants reduce congestion associated with allergic rhinitis, but local adverse effects make them unsuitable for long-term use. Oral decongestants show some efficacy against congestion in allergic rhinitis and the common cold, and can be combined with oral antihistamines. Intranasal corticosteroids have broad anti-inflammatory activities, are the most potent long-term pharmacologic treatment of congestion associated with allergic rhinitis, and show some congestion relief in rhinosinusitis and nasal polyposis. Immunotherapy and surgery may be used in some cases refractory to pharmacotherapy. Steps in congestion management include (1) diagnosis of the cause(s), (2) patient education and monitoring, (3) avoidance of environmental triggers where possible, (4) pharmacotherapy, and (5) immunotherapy (for patients with allergic rhinitis) or surgery for patients whose condition is otherwise uncontrolled.
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Affiliation(s)
- Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA and Department of Pediatrics, University of California, San Diego, USA
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Abstract
BACKGROUND Suicide is a serious public health problem. Prevention of suicide depends to a great degree on identification and mitigation of its risk factors. Allergy has been associated with mood and anxiety disorders, risk factors for suicidality. Antiallergic medication could modulate or mediate these predictive associations. Recently, the FDA issued a warning raising concerns about the suicidality potential of montelukast and other leukotriene (LT) antagonists. OBJECTIVE The purpose of this review is to integrate the emerging interpretations of the link between suicidality, suicide risk factors, allergy and treatment of allergy in particular, with LT antagonists. METHODS We reviewed the available reports on the possible relationships between montelukast, allergy, suicide, suicidality and suicide risk factors. We also present the positions of the FDA, manufacturer, and national organizations of allergists and immunologists on the possible role of montelukast in suicidality. CONCLUSION At present, there is insufficient data to prove that there is a link between montelukast and suicidality. Inquiring about mood changes and suicidal ideation should be integrated in general medical practice.
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Affiliation(s)
- Partam Manalai
- Mood and Anxiety Program, University of Maryland School of Medicine, Department of Psychiatry, 685 West Baltimore Street, MSTF Building Room 930, Baltimore, MD 21201, USA
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Sokolowska M, Wodz-Naskiewicz K, Cieslak M, Seta K, Bednarek AK, Pawliczak R. Variable expression of cysteinyl leukotriene type I receptor splice variants in asthmatic females with different promoter haplotypes. BMC Immunol 2009; 10:63. [PMID: 20003473 PMCID: PMC2805608 DOI: 10.1186/1471-2172-10-63] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Accepted: 12/15/2009] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cysteinyl leukotrienes are potent inflammatory mediators implicated in the pathogenesis of asthma. Human cysteinyl leukotriene receptor 1 (CYSLTR1) gene contains five exons that are variably spliced. Within its promoter few polymorphisms were described. To date, there has been no evidence about the expression of different splice variants of CysLT1 in asthma and their association with CYSLTR1 promoter polymorphisms.The goal of our study was to investigate CysLT1 alternative transcripts expression in asthmatic patients with different CYSLTR1 promoter haplotypes.The study groups consisted of 44 patients with asthma, diagnosed according to GINA 2008 criteria and 18 healthy subjects. Genomic DNA and total RNA was extracted from peripheral blood mononuclear cells. Real-time PCR was performed with specific primers for transcript I [GenBank:DQ131799] and II [GenBank:DQ131800]. Fragments of the CYSLTR1 promoter were amplified by PCR and sequenced directly to identify four single nucleotide polymorphisms: C/T [SNP:rs321029], A/C [SNP:rs2637204], A/G [SNP:rs2806489] and C/T [SNP:rs7066737]. RESULTS The expression of CysLT1 transcript I and II in asthma did not differ from its expression in healthy control group. However, in major alleles homozygotic CAAC/CAAC women with asthma we found significantly higher expression of transcript I as compared to heterozygous CAAC/TCGC women in that loci. CysLT1 transcript I expression tended to negative correlation with episodes of acute respiratory infection in our asthmatic population. Moreover, expression of CysLT1 transcript II in CAAC/CAAC homozygotic women with asthma was significantly lower than in CAAC/CAAC healthy control females. CONCLUSIONS Genetic variants of CYSLTR1 promoter might be associated with gender specific expression of CysLT1 alternative transcripts in patients with asthma. CysLT1 splice variants expression might also correlate with the susceptibility to infection in asthmatic population.
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Affiliation(s)
- Milena Sokolowska
- Department of Immunopathology, Chair of Allergology, Immunology and Dermatology, Faculty of Medical Science and Postgraduate Training, Medical University of Lodz, Pomorska 251 str, 92-213 Lodz, Poland
| | - Karolina Wodz-Naskiewicz
- Department of Immunopathology, Chair of Allergology, Immunology and Dermatology, Faculty of Medical Science and Postgraduate Training, Medical University of Lodz, Pomorska 251 str, 92-213 Lodz, Poland
| | - Malgorzata Cieslak
- Department of Immunology, Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Faculty of Medicine, Medical University of Lodz, Pomorska 251 str, 92-213 Lodz, Poland
| | - Karolina Seta
- Department of Molecular Carcinogenesis, Chair of Molecular Medicine and Biotechnology, Faculty of Medical Science and Postgraduate Training, Medical University of Lodz, Mazowiecka 6/8 str, 92-215 Lodz, Poland
| | - Andrzej K Bednarek
- Department of Molecular Carcinogenesis, Chair of Molecular Medicine and Biotechnology, Faculty of Medical Science and Postgraduate Training, Medical University of Lodz, Mazowiecka 6/8 str, 92-215 Lodz, Poland
| | - Rafal Pawliczak
- Department of Immunopathology, Chair of Allergology, Immunology and Dermatology, Faculty of Medical Science and Postgraduate Training, Medical University of Lodz, Pomorska 251 str, 92-213 Lodz, Poland
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Strangman WK, Kwon HC, Broide D, Jensen PR, Fenical W. Potent inhibitors of pro-inflammatory cytokine production produced by a marine-derived bacterium. J Med Chem 2009; 52:2317-27. [PMID: 19323483 DOI: 10.1021/jm801110j] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cytokines produced through the antigen presenting cell (APC)-T-cell interaction play a key role in the activation of the allergic asthmatic response. Evaluating small molecules that inhibit the production of these pro-inflammatory proteins is therefore important for the discovery of novel chemical structures with potential antiasthma activity. We adapted a mouse splenocyte cytokine assay to screen a library of 2,500 marine microbial extracts for their ability to inhibit T(H)2 cytokine release and identified potent activity in a marine-derived strain CNQ431, identified as a Streptomyces species. Bioactivity guided fractionation of the organic extract of this strain led to the isolation of ten new 9-membered bis-lactones, splenocins A-J (1-10). The new compounds display potent biological activities, comparable to that of the corticosteroid dexamethasone, with IC(50) values from 2 to 50 nM in the splenocyte cytokine assay. This study provides the foundation for the optimization of these potent anti-inflammatory compounds for development in the treatment of asthma.
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Affiliation(s)
- Wendy K Strangman
- Center for Marine Biotechnology and Biomedicine, Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California 92093-0204, USA
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Dougherty RH, Fahy JV. Acute exacerbations of asthma: epidemiology, biology and the exacerbation-prone phenotype. Clin Exp Allergy 2009; 39:193-202. [PMID: 19187331 PMCID: PMC2730743 DOI: 10.1111/j.1365-2222.2008.03157.x] [Citation(s) in RCA: 274] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Asthma is a highly prevalent chronic respiratory disease affecting 300 million people world-wide. A significant fraction of the cost and morbidity of asthma derives from acute care for asthma exacerbations. In the United States alone, there are approximately 15 million outpatient visits, 2 million emergency room visits, and 500,000 hospitalizations each year for management of acute asthma. Common respiratory viruses, especially rhinoviruses, cause the majority of exacerbations in children and adults. Infection of airway epithelial cells with rhinovirus causes the release of pro-inflammatory cytokines and chemokines, as well as recruitment of inflammatory cells, particularly neutrophils, lymphocytes, and eosinophils. The host response to viral infection is likely to influence susceptibility to asthma exacerbation. Having had at least one exacerbation is an important risk factor for recurrent exacerbations suggesting an 'exacerbation-prone' subset of asthmatics. Factors underlying the 'exacerbation-prone' phenotype are incompletely understood but include extrinsic factors: cigarette smoking, medication non-compliance, psychosocial factors, and co-morbidities such as gastroesophageal reflux disease, rhinosinusitis, obesity, and intolerance to non-steroidal anti-inflammatory medications; as well as intrinsic factors such as deficient epithelial cell production of the anti-viral type I interferons (IFN-alpha and IFN-beta). A better understanding of the biologic mechanisms of host susceptibility to recurrent exacerbations will be important for developing more effective preventions and treatments aimed at reducing the significant cost and morbidity associated with this important global health problem.
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Affiliation(s)
- R H Dougherty
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, CA 94143, USA
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33
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Van Hoecke H, Vandenbulcke L, Van Cauwenberge P. Histamine and leukotriene receptor antagonism in the treatment of allergic rhinitis: an update. Drugs 2008; 67:2717-26. [PMID: 18062720 DOI: 10.2165/00003495-200767180-00006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Allergic rhinitis represents a global health burden. The disease can seriously affect quality of life and is associated with multiple co-morbidities. Histamine and leukotrienes are important pro-inflammatory mediators in nasal allergic inflammation. Their actions on target cells are mediated through specific receptors and, consequently, molecules that block the binding of histamine and leukotrienes to their receptors have been important areas of pharmacological research. The published literature of the pathophysiology of histamine and leukotrienes, and the effects of histamine H(1)-receptor antagonists (H(1) antihistamines) and leukotriene antagonists in monotherapy or in combination therapy in the treatment of allergic rhinitis was reviewed. The presented results are based on the best available evidence. The efficacy of H(1) antihistamines and leukotriene antagonists (montelukast in particular) in allergic rhinitis has been established in numerous randomised placebo-controlled trials. Results from meta-analyses indicate that H(1) antihistamines and leukotriene antagonists are equally effective in improving symptoms of allergic rhinitis and quality of life, but that both drugs are less effective than intranasal corticosteroids. Data on the combination of H(1) antihistamines and leukotriene antagonists in allergic rhinitis are limited. The available evidence shows that a combined mediator inhibition has additional benefits over the use of each agent alone, but is still inferior to intranasal corticosteroids. More well designed studies are needed to fully understand the benefits of a concomitant use of these agents.
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Affiliation(s)
- Helen Van Hoecke
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
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34
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Colucci R, Fornai M, Tuccori M, Antonioli L, Pasqualetti G, Blandizzi C, Del Tacca M. Tolerability profiles of leukotriene receptor antagonists and long-acting beta2-adrenoceptor agonists in combination with inhaled corticosteroids for treatment of asthma: a review. J Asthma 2007; 44:411-22. [PMID: 17654125 DOI: 10.1080/02770900701247178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Inhaled corticosteroids, long-acting beta2-adrenoceptor agonists, and leukotriene receptor antagonists are widely used for treatment of asthma. Inhaled corticosteroids are recommended as first-line therapy, whereas long-acting beta2-adrenoceptor agonists and leukotriene receptor antagonists are indicated as add-on therapy in patients not adequately controlled with corticosteroids alone. A number of studies have investigated the efficacy of combinations of these drugs in asthma, but several issues concerning the safety of these treatments are highly debated. This review provides a critical appraisal of the tolerability profiles of long-acting beta2-agonists and leukotriene receptor antagonists used in combination with inhaled corticosteroids for the treatment of asthma.
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Affiliation(s)
- R Colucci
- Interdepartmental Centre for Research in Clinical Pharmacology and Experimental Therapeutics, University of Pisa, Pisa, Italy
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35
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Capra V, Thompson MD, Sala A, Cole DE, Folco G, Rovati GE. Cysteinyl-leukotrienes and their receptors in asthma and other inflammatory diseases: critical update and emerging trends. Med Res Rev 2007; 27:469-527. [PMID: 16894531 DOI: 10.1002/med.20071] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cysteinyl-leukotrienes (cysteinyl-LTs), that is, LTC4, LTD4, and LTE4, trigger contractile and inflammatory responses through the specific interaction with G protein-coupled receptors (GPCRs) belonging to the purine receptor cluster of the rhodopsin family, and identified as CysLT receptors (CysLTRs). Cysteinyl-LTs have a clear role in pathophysiological conditions such as asthma and allergic rhinitis (AR), and have been implicated in other inflammatory conditions including cardiovascular diseases, cancer, atopic dermatitis, and urticaria. Molecular cloning of human CysLT1R and CysLT2R subtypes has confirmed most of the previous pharmacological characterization and identified distinct expression patterns only partially overlapping. Interestingly, recent data provide evidence for the immunomodulation of CysLTR expression, the existence of additional receptor subtypes, and of an intracellular pool of CysLTRs that may have roles different from those of plasma membrane receptors. Furthermore, genetic variants have been identified for the CysLTRs that may interact to confer risk for atopy. Finally, a crosstalk between the cysteinyl-LT and the purine systems is being delineated. This review will summarize and attempt to integrate recent data derived from studies on the molecular pharmacology and pharmacogenetics of CysLTRs, and will consider the therapeutic opportunities arising from the new roles suggested for cysteinyl-LTs and their receptors.
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MESH Headings
- Adult
- Animals
- Asthma/drug therapy
- Asthma/physiopathology
- Cardiovascular Diseases/physiopathology
- Child
- Child, Preschool
- Dermatitis, Atopic/drug therapy
- Dermatitis, Atopic/etiology
- Female
- Humans
- Hydroxyurea/adverse effects
- Hydroxyurea/analogs & derivatives
- Leukotriene Antagonists/adverse effects
- Leukotriene Antagonists/therapeutic use
- Leukotriene C4/physiology
- Leukotriene D4/physiology
- Leukotriene E4/physiology
- Membrane Proteins/drug effects
- Membrane Proteins/genetics
- Membrane Proteins/physiology
- Pharmacogenetics
- Receptors, Leukotriene/drug effects
- Receptors, Leukotriene/genetics
- Receptors, Leukotriene/physiology
- Receptors, Purinergic/physiology
- Recombinant Proteins/pharmacology
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/physiopathology
- SRS-A/biosynthesis
- Tissue Distribution
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Affiliation(s)
- Valérie Capra
- Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy.
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36
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Thompson MD, Capra V, Takasaki J, Maresca G, Rovati GE, Slutsky AS, Lilly C, Zamel N, McIntyre Burnham W, Cole DE, Siminovitch KA. A functional G300S variant of the cysteinyl leukotriene 1 receptor is associated with atopy in a Tristan da Cunha isolate. Pharmacogenet Genomics 2007; 17:539-49. [PMID: 17558309 DOI: 10.1097/fpc.0b013e328012d0bf] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Atopy is a well-defined immune phenotype that is reported to be a risk factor for asthma. Among the many loci that contribute to a genetic predisposition to asthma, the cysteinyl leukotriene receptor genes and their variants have been important subjects of study because they are functionally and pharmacologically implicated in the atopy phenotype affecting many asthma subjects. Moreover, the product of cysteinyl-leukotriene 1 receptor gene (CysLT1), located at Xq13.2, is targeted by LT receptor antagonists. In our earlier association study, the M201V variant of the cysteinyl-leukotriene 2 receptor gene (CysLT2), located at 13q14, was implicated in atopic asthma. Here we report the screening of the coding region of the CysLT1, gene in the highly asthmatic Tristan da Cunha population. In this population, we discovered a CysLT1 G300S variant that is carried with a significantly higher frequency in atopics and asthmatics from the Tristan da Cunha population. Furthermore, we report the asthma independent association of the CysLT1 G300S variant with atopy. Subsequently, we compared the changes conferred by each SNP on CysLT function. The CysLT1 300S receptor interacts with LTD4 with significantly greater potency. For the 300S variant, a statistically significant decrease in the effector concentration for half-maximum response (EC50) for intracellular Ca flux and total InsP generation is observed. Other aspects of the receptor function and activity, such as desensitization, pharmacologic profile in response to montelukast, and cellular localization, are unchanged. These in vitro analyses provide evidence that the 300S CysLT1 variant, found more commonly in atopics in the Tristan da Cunha population, encodes a functionally more sensitive variant.
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Affiliation(s)
- Miles D Thompson
- Laboratory Medicine, Banting Institute, Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada.
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37
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Cai C, Yang J, Hu S, Zhou M, Guo W. Relationship between urinary cysteinyl leukotriene E4 levels and clinical response to antileukotriene treatment in patients with asthma. Lung 2007; 185:105-12. [PMID: 17393242 DOI: 10.1007/s00408-006-0001-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2006] [Indexed: 12/17/2022]
Abstract
The aim of this study was to investigate and identify the relationship between urinary cysteinyl leukotriene E(4) levels and clinical response to antileukotriene treatment in patients with asthma. Forty-eight patients with stable mild to moderate asthma were treated with montelukast in a four-week trail. Asthmatic symptom score, beta(2)-agonist usage, percentage of eosinophil, total serum IgE concentration, forced expiratory volume in the first second (FEV(1)), peak expiratory flow rate (PEFR), and urinary leukotriene E(4) (uLTE(4)) were measured before and after treatment. Clinical response was assessed by the improvement of asthma symptom scores, beta(2)-agonist usage, and FEV(1). Responders were defined as patients who had to fit the following three criteria: a reduction of more than 20% in mean symptom score; a reduction of more than 20% in beta(2)-agonist usage, and a mean improvement of FEV(1) of more than 10% from baseline value. Others were classified as nonresponders. Logistic analysis was used to access the various clinical factors correlated with the clinical response. There were 25 responders and 23 nonresponders. The mean uLTE(4) level from the responders was higher than that from the nonresponders (224.5 +/- 34.4 vs. 175.3 +/- 37.1 pg/mg creatinine, p < 0.05). There was a significant correlation between the clinical response and the uLTE(4) level but not demographic features, percentage of eosinophils, serum IgE concentration, or spirometry (p > 0.05). Subjects with a uLTE(4) level of >/= 200 pg/mg creatinine were 3.5 times more likely to respond to montelukast than those with less than 200 pg/mg creatinine (95% confidence interval [CI] = 1.7-15.8). The uLTE(4) level is closely correlated with antileukotriene treatment. uLTE(4) is a good biomarker for selecting this drug to treat asthma.
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Affiliation(s)
- Chang Cai
- Division of Pulmonary Medicine, Renmin Hospital, Wu Han University, Jiefang Road No. 238, Wu Han, Hubei, China.
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38
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Failla M, Crimi N, Vancheri C. Exhaled bronchial cysteinyl leukotrienes in allergic patients. Curr Opin Allergy Clin Immunol 2007; 7:25-31. [PMID: 17218807 DOI: 10.1097/aci.0b013e328012c570] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE OF REVIEW To review the current knowledge of noninvasive monitoring of allergic airway inflammation by analysis of leukotrienes in the exhaled breath condensate. RECENT FINDINGS Treatment of respiratory allergies involves chronic treatment based on clinical symptoms and pulmonary function tests. Evaluation of local inflammation would be desirable but is currently not feasible because of the difficulty in sampling the airways. Recently, exhaled breath condensate collection and analysis has polarized much interest in the respiratory field. Although some methodological issues are still under scrutiny, airways inflammatory markers can be assayed with this technique. In particular, exhaled breath condensate leukotrienes have been thoroughly investigated in the setting of bronchial asthma and allergic rhinitis in adults and children. Exhaled leukotrienes are increased in patients with asthma and rhinitis during the pollen season, correlate with exacerbations and asthma severity, and are reduced by specific anti-inflammatory treatment and allergen avoidance. SUMMARY Some issues still prevent the use of exhaled breath condensate in clinical practice but in the research setting it has been proved to be useful for noninvasive monitoring of allergic inflammation in the lung. In particular, exhaled leukotrienes may represent valuable biomarkers for diagnostic and therapeutic purposes in allergic patients.
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Affiliation(s)
- Marco Failla
- Department of Internal and Specialist Medicine, Section of Respiratory Medicine, University of Catania, Catania, Italy
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39
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Rubin P, Mollison KW. Pharmacotherapy of diseases mediated by 5-lipoxygenase pathway eicosanoids. Prostaglandins Other Lipid Mediat 2007; 83:188-97. [PMID: 17481554 DOI: 10.1016/j.prostaglandins.2007.01.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Inflammatory eicosanoids generated by the 5-lipoxygenase (5-LO) pathway of arachidonic acid metabolism are now known to have at least 6 receptors: OXE, which recognizes 5-HETE and 5-oxo-ETE; a putative receptor recognizing a potent 5-oxo-ETE metabolite, FOG(7); the LTB(4) receptors, BLT1 and BLT2; the cysteinyl leukotriene receptors, CysLT(1) and CysLT(2), which recognize leukotrienes LTC(4), LTD(4), LTE(4) and LTF(4). The 5-LO pathway is activated in many diseases and invokes inflammatory responses not affected by glucocorticoids, but therapy with selective BLT1 or CysLT(1) antagonists in asthma has met with variable success. Studies show that 5-LO pathway eicosanoids are not primary mediators in all cases of asthma, but may be especially important in severe persistent asthma, aspirin- and exercise-induced asthma, allergic rhinitis, COPD, idiopathic pulmonary fibrosis, atherosclerosis, atopic dermatitis, acne and ischemia-related organ injury. These disorders appear to involve multiple 5-LO pathway eicosanoids and receptor subtypes, suggesting that inhibition of the pathway at the level of 5-LO may be necessary for maximal efficacy.
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Affiliation(s)
- Paul Rubin
- Critical Therapeutics, Inc., 60 Westview Street, Lexington, MA 02421, USA.
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40
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Hardwick C, White D, Morris E, Monteiro EF, Breen RA, Lipman M. Montelukast in the treatment of HIV associated immune reconstitution disease. Sex Transm Infect 2007; 82:513-4. [PMID: 17151039 PMCID: PMC2563887 DOI: 10.1136/sti.2005.017863] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The pathogenesis of immune reconstitution disease (IRD) is not well understood and it can be difficult to manage. Leukotrienes exert proinflammatory effects, have an important role in the innate immune response, and are relatively deficient in HIV infection. Montelukast is a leukotriene receptor antagonist (LTRA) currently licensed for the treatment of asthma. We report a series of three patients with severe HIV associated IRD (cases 1 and 2 associated with starting HAART and unresponsive to steroids), who obtained clinically dramatic responses to treatment with montelukast. The first case is of IRD to secondary syphilis and the second and third to tuberculosis. Cases 1 and 3 both relapsed after a temporary break from montelukast and resolved on restarting. Montelukast should be considered in HIV associated IRD as an alternative to steroids and where these are not effective. Leukotriene overactivity may be implicated in IRD.
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Affiliation(s)
- C Hardwick
- Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.
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41
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Choi JH, Park HS, Lee KH, Shim JJ, Uh ST, Lee SP, Lee YC, Choi WI, Kim JI, Lee JH, Lee MG, Jung KS. The Efficacy of Added Montelukast in Persistent Asthmatics Who Were Not Completely Controlled on Inhaled Corticosteroids and Inhaled Long-acting β 2-agonists. Tuberc Respir Dis (Seoul) 2007. [DOI: 10.4046/trd.2007.63.4.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jeong-Hee Choi
- Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Hae-Sim Park
- Department of Internal Medicine, College of Medicine, Ajou Univerity, Korea
| | - Kwan-Ho Lee
- Department of Internal Medicine, College of Medicine, Yeungnam University, Korea
| | - Jae-Jeong Shim
- Department of Internal Medicine, College of Medicine, Korea Universitiy, Korea
| | - Soo-Taek Uh
- Department of Internal Medicine, College of Medicine, Soonchunhyang University, Korea
| | - Sang-Pyo Lee
- Department of Internal Medicine, College of Medicine, Gachon University, Korea
| | - Yong-Chul Lee
- Department of Internal Medicine, College of Medicine, Chonbuk National University, Korea
| | - Won-Il Choi
- Department of Internal Medicine, College of Medicine, Keimyung University, Korea
| | - Joo-In Kim
- Department of Internal Medicine, College of Medicine, Seoul National University, Korea
| | - Jae-Ho Lee
- Department of Internal Medicine, College of Medicine, Inje University, Korea
| | - Myung-Goo Lee
- Department of Internal Medicine, College of Medicine, Hallym University, Korea
| | - Ki-Suck Jung
- Department of Internal Medicine, College of Medicine, Hallym University, Korea
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42
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Rovati GE, Baroffio M, Citro S, Brichetto L, Ravasi S, Milanese M, Crimi E, Brusasco V. Cysteinyl-leukotrienes in the regulation of beta2-adrenoceptor function: an in vitro model of asthma. Respir Res 2006; 7:103. [PMID: 16875498 PMCID: PMC1557489 DOI: 10.1186/1465-9921-7-103] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2006] [Accepted: 07/28/2006] [Indexed: 11/24/2022] Open
Abstract
Background The response to β2-adrenoceptor agonists is reduced in asthmatic airways. This desensitization may be in part due to inflammatory mediators and may involve cysteinyl-leukotrienes (cysteinyl-LTs). Cysteinyl-LTs are pivotal inflammatory mediators that play important roles in the pathophysiology of asthma, allergic rhinitis, and other inflammatory conditions. We tested the hypothesis that leukotriene D4 (LTD4) and allergen challenge cause β2-adrenoceptor desensitization through the activation of protein kinase C (PKC). Methods The isoproterenol-induced cAMP accumulation was evaluated in human airway smooth muscle cell cultures challenged with exogenous LTD4 or the PKC activator phorbol-12-myristate-13-acetate with or without pretreatments with the PKC inhibitor GF109203X or the CysLT1R antagonist montelukast. The relaxant response to salbutamol was studied in passively sensitized human bronchial rings challenged with allergen in physiological salt solution (PSS) alone, or in the presence of either montelukast or GF109203X. Results In cell cultures, both LTD4 and phorbol-12-myristate-13-acetate caused significant reductions of maximal isoproterenol-induced cAMP accumulation, which were fully prevented by montelukast and GF109203X, respectively. More importantly, GF109203X also prevented the attenuating effect of LTD4 on isoproterenol-induced cAMP accumulation. In bronchial rings, both montelukast and GF109203X prevented the rightward displacement of the concentration-response curves to salbutamol induced by allergen challenge. Conclusion LTD4 induces β2-adrenoceptor desensitization in human airway smooth muscle cells, which is mediated through the activation of PKC. Allergen exposure of sensitized human bronchi may also cause a β2-adrenoceptor desensitization through the involvement of the CysLT1R-PKC pathway.
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Affiliation(s)
- G Enrico Rovati
- Laboratory of Molecular Pharmacology, Section of Eicosanoid Pharmacology, Dept. of Pharmacological Sciences, University of Milan, Italy
| | - Michele Baroffio
- Respiratory Pathophysiology Unit, Dept. of Internal Medicine, University of Genoa, Italy
| | - Simona Citro
- Laboratory of Molecular Pharmacology, Section of Eicosanoid Pharmacology, Dept. of Pharmacological Sciences, University of Milan, Italy
| | - Lorenzo Brichetto
- Respiratory Pathophysiology Unit, Dept. of Internal Medicine, University of Genoa, Italy
| | - Saula Ravasi
- Laboratory of Molecular Pharmacology, Section of Eicosanoid Pharmacology, Dept. of Pharmacological Sciences, University of Milan, Italy
| | - Manlio Milanese
- Respiratory Pathophysiology Unit, Dept. of Internal Medicine, University of Genoa, Italy
| | - Emanuele Crimi
- Respiratory Pathophysiology Unit, Dept. of Internal Medicine, University of Genoa, Italy
| | - Vito Brusasco
- Respiratory Pathophysiology Unit, Dept. of Internal Medicine, University of Genoa, Italy
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Harmanci K, Bakirtas A, Turktas I, Degim T. Oral montelukast treatment of preschool-aged children with acute asthma. Ann Allergy Asthma Immunol 2006; 96:731-5. [PMID: 16729788 DOI: 10.1016/s1081-1206(10)61073-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Increased amounts of cysteinyl leukotrienes have been demonstrated in urine samples from asthmatic patients, particularly during exacerbations of asthma. Although the use of leukotriene receptor antagonists has been recommended in the treatment of chronic asthma, no guidelines are available regarding their use in the treatment of acute asthma. OBJECTIVE To investigate the safety and effectiveness of a 4-mg tablet of oral montelukast in addition to short-acting beta2-agonist bronchodilator as the initial treatment in mild to moderate asthma exacerbations in children between 2 and 5 years old. METHODS Fifty-one patients who were experiencing mild to moderate asthma exacerbation were included in a randomized, double-blind, placebo-controlled, parallel-group study. Each patient received either a 4-mg tablet of montelukast or placebo in addition to inhaled salbutamol and were followed up for 4 hours. The pulmonary index score, respiratory rate, and pulse were determined at baseline and throughout 4 hours after administration. RESULTS Compared with placebo, the pulmonary index scores and respiratory rates were significantly lower in the montelukast group starting at 90 minutes (P = .01). This difference persisted at 120, 180, and 240 minutes of the study (P = .008, P = .02, and P = .048, respectively). At the end of the first hour of treatment, oral steroid need was 20.8% and 38.5% in patients randomized to the montelukast and placebo groups, respectively (P = .22). Hospitalization rates were not different between the 2 treatment groups. CONCLUSION A single 4-mg tablet of montelukast had the potential to provide additive clinical benefit in mild to moderate acute asthma in preschool-aged children when administered concomitantly with short-acting beta2-agonist bronchodilators as the initial treatment.
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Affiliation(s)
- Koray Harmanci
- Faculty of Medicine, Department of Pediatric Allergy and Asthma, Gazi University, Ankara, Turkey.
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Keskin O, Alyamac E, Tuncer A, Dogan C, Adalioglu G, Sekerel BE. Do the leukotriene receptor antagonists work in children with grass pollen-induced allergic rhinitis? Pediatr Allergy Immunol 2006; 17:259-68. [PMID: 16771779 DOI: 10.1111/j.1399-3038.2006.00397.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Although cysteinyl-leukotriene receptor antagonists were recently approved for use in allergic rhinitis (AR), there has been no study to date investigating their application in children. The aim was to evaluate whether montelukast provides any benefit in nasal allergen challenge-induced symptoms in children, and whether it could improve the control provided by an antihistamine during pollen season. Two randomized studies, one a double-blind, placebo-controlled, nasal allergen challenge study and one an open-label, cross-over, parallel-group clinical study, were performed in 18 (11.7+/-0.7 years) and 32 children (10.5+/-0.5 years), respectively, with grass pollen allergy. In the first study, the effect of a single dose of montelukast and its combination with loratadine were compared with placebo on nasal responses induced by allergen challenge. In the second study, the additive effect of montelukast to loratadine was tested in an open-label cross-over clinical study. In the challenge study, early-phase and late-phase nasal reactions peaked at 15 min and 4 h after the challenge respectively. During the early phase, combination improved total nasal symptoms (p=0.004) during the first hour and sneezing (p=0.012) at 15 min compared with placebo group. During the late phase, montelukast (p=0.017) and combination (p=0.011) caused less nasal obstruction at 4 h and combination caused less sneezing at 6 h (p=0.015). In the clinical trial, montelukast provided protection on seasonal increase in pulmonary symptoms [0 (0, 14) vs. 6.5 (0, 27.7); p=0.016] and on the decrease in FEF25-75 [-0.09 (-0.34, 0.17) vs. -0.28 (-0.66, 0.02); p=0.002]. However, there was no improvement in nasal symptoms and flows. Although we showed protection against nasal challenge-induced congestion with montelukast, we were not able to show the same in the clinical study possibly because of low pollen counts and mildness of the symptoms of the patients with AR. However, montelukast provided better control of pulmonary symptoms and protection from seasonal decrease in lung function, indicating its potential therapeutic benefit in children with AR.
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Affiliation(s)
- Ozlem Keskin
- Hacettepe University Faculty of Medicine, Pediatric Allergy and Asthma Unit, Hacettepe, Ankara, Turkey
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Gupta SK, Peters-Golden M, Fitzgerald JF, Croffie JM, Pfefferkorn MD, Molleston JP, Corkins MR, Lim JR. Cysteinyl leukotriene levels in esophageal mucosal biopsies of children with eosinophilic inflammation: are they all the same? Am J Gastroenterol 2006; 101:1125-8. [PMID: 16573772 DOI: 10.1111/j.1572-0241.2006.00557.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Allergic eosinophilic esophagitis (AEE) is characterized by intense eosinophilic inflammation of the esophageal mucosa. Cysteinyl leukotrienes (CysLT) are eosinophil chemoattractants. We studied CysLT levels in esophageal mucosa of children with AEE and controls. METHODS CysLT levels (pg CysLT/microg protein) were quantified by Enzyme-linked Immunosorbent Assay (ELISA) on endoscopically obtained esophageal mucosal biopsies. RESULTS Twelve children with AEE (eight boys, mean age 6.6 yr, range 1.0-14.5 yr) and 10 controls (six boys, mean age 9.56 yr, range 1.08-15.08 yr) were enrolled. None were on anti-LT or corticosteroid therapy. All controls had histologically normal mucosal biopsies of the esophagus, stomach, and duodenum. Patients with AEE had intense eosinophilic inflammation of the esophageal mucosa (mean 39 eosinophils/hpf, range 15-70 eosinophils/hpf) and a normal 24-h pH probe study. CysLT levels were similar between the two groups: mean levels were 12.44 (median 10.87, range 2.54-28.29) in AEE patients and 9.52 (median 9.26, range 1.71-21.64) in controls. CysLT levels did not correlate with the degree of esophageal eosinophilic inflammation. Incidentally, five patients with eosinophilic gastroduodenitis, in addition to esophagitis, were enrolled; their CysLT levels were statistically higher than those of controls. CONCLUSIONS This is the first study to examine CysLT levels in esophageal mucosal biopsies of children with AEE and normal children. CysLT levels in AEE patients are similar to those in controls, and independent of the severity of inflammation. While this would argue against the use of CysLT antagonists in the treatment of AEE, further studies into the expression of the CysLT receptor itself are needed.
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Affiliation(s)
- Sandeep K Gupta
- Division of Pediatric Gastroenterology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202, USA
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Abstract
UNLABELLED Leukotriene modifiers (receptor antagonist and biosynthesis inhibitor) represent the first mediator specific therapeutic option for asthma. Montelukast, a leukotriene receptor antagonist is the only such agent approved for use in pediatric patients. Montelukast modifies action of leukotrienes, which are the most potent bronchoconstrictors, by blocking Cysteinyl leukotriene receptors. Systemic drug like mountelukast can reach lower airways and improves the peripheral functions which play a crucial role in the evolution of asthma. Review of existing literature showed that montelukast compared to placebo has proven clinical efficacy in better control of day time asthma symptoms, percentage of symptom free days, need for rescue drugs and improvement in FEV 1. Studies also demonstrated improvement in airway inflammation as indicated by reduction in fractional exhaled nitric oxide, a marker of inflammation. Studies comparing low dose inhaled corticosteroids (ICS) with montelukast are limited in children and conclude that it is not superior to ICS. For moderate to severe persistent asthma, montelukast has been compared with long acting beta agonists (LABA) as an add-on therapy to ICS, montelukast was less efficacious and less cost-effective. It has beneficial effects in exercise induced asthma and aspirin-sensitive asthma. Montelukast has onset of action within one hour. Patient satisfaction and compliance was better with montelukast than inhaled anti-inflammatory agents due to oral, once a day administration. The recommended doses of montelukast in asthma are- children 1-5 years: 4 mg chewable tablet, children 6-14 years: 5mg chewable tablet, ADULTS 10mg tablet; administered once daily. The drug is well tolerated. Based on the presently available data montelukast may be an alternative treatment for mild persistent asthma as monotherapy where ICS cannot be administered. It is also an alternative to LABA as an add-on therapy to ICS for moderate to severe persistent asthma. The other indications for use of montelukast include: allergic rhinitis, exercise induced bronchoconstriction and aspirin-induced asthma.
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Affiliation(s)
- Mandeep Walia
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Mamedova L, Capra V, Accomazzo MR, Gao ZG, Ferrario S, Fumagalli M, Abbracchio MP, Rovati GE, Jacobson KA. CysLT1 leukotriene receptor antagonists inhibit the effects of nucleotides acting at P2Y receptors. Biochem Pharmacol 2005; 71:115-25. [PMID: 16280122 PMCID: PMC4967539 DOI: 10.1016/j.bcp.2005.10.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2005] [Revised: 09/29/2005] [Accepted: 10/03/2005] [Indexed: 11/23/2022]
Abstract
Montelukast and pranlukast are orally active leukotriene receptor antagonists selective for the CysLT1 receptor. Conversely, the hP2Y(1,2,4,6,11,12,13,14) receptors represent a large family of GPCRs responding to either adenine or uracil nucleotides, or to sugar-nucleotides. Montelukast and pranlukast were found to inhibit nucleotide-induced calcium mobilization in a human monocyte-macrophage like cell line, DMSO-differentiated U937 (dU937). Montelukast and pranlukast inhibited the effects of UTP with IC50 values of 7.7 and 4.3 microM, respectively, and inhibited the effects of UDP with IC50 values of 4.5 and 1.6 microM, respectively, in an insurmountable manner. Furthermore, ligand binding studies using [3H]LTD4 excluded the possibility of orthosteric nucleotide binding to the CysLT1 receptor. dU937 cells were shown to express P2Y2, P2Y4, P2Y6, P2Y11, P2Y13 and P2Y14 receptors. Therefore, these antagonists were studied functionally in a heterologous expression system for the human P2Y receptors. In 1321N1 astrocytoma cells stably expressing human P2Y(1,2,4,6) receptors, CysLT1 antagonists inhibited both the P2Y agonist-induced activation of phospholipase C and intracellular Ca2+ mobilization. IC50 values at P2Y1 and P2Y6 receptors were <1 microM. In control astrocytoma cells expressing an endogenous M3 muscarinic receptor, 10 microM montelukast had no effect on the carbachol-induced rise in intracellular Ca2+. These data demonstrated that CysLT1 receptor antagonists interact functionally with signaling pathways of P2Y receptors, and this should foster the study of possible implications for the clinical use of these compounds in asthma or in other inflammatory conditions.
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Affiliation(s)
- Liaman Mamedova
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Valérie Capra
- Section of Eicosanoid Pharmacology, Laboratory of Molecular Pharmacology, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Maria Rosa Accomazzo
- Section of Eicosanoid Pharmacology, Laboratory of Molecular Pharmacology, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Zhan-Guo Gao
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Silvia Ferrario
- Laboratory of Molecular and Cellular Pharmacology of Purinergic Transmission, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Marta Fumagalli
- Laboratory of Molecular and Cellular Pharmacology of Purinergic Transmission, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Maria P. Abbracchio
- Laboratory of Molecular and Cellular Pharmacology of Purinergic Transmission, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - G. Enrico Rovati
- Section of Eicosanoid Pharmacology, Laboratory of Molecular Pharmacology, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Kenneth A. Jacobson
- Molecular Recognition Section, Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
- Corresponding author. Tel.: +1 301 496 9024; fax: +1 301 480 8422. (K.A. Jacobson)
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Fernandez J, Reyes R, Ponce H, Oropeza M, Vancalsteren MR, Jankowski C, Campos MG. Isoquercitrin from Argemone platyceras inhibits carbachol and leukotriene D4-induced contraction in guinea-pig airways. Eur J Pharmacol 2005; 522:108-15. [PMID: 16202993 DOI: 10.1016/j.ejphar.2005.08.046] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2005] [Revised: 08/16/2005] [Accepted: 08/29/2005] [Indexed: 11/21/2022]
Abstract
Argemone platyceras is used in Mexico as a remedy for cough, bronchitis and pneumonia. The present study was performed to investigate the pharmacological anti-asthmatic properties of Argemone platyceras on airways and to identify its active principles. Methanol extracts of leaves and flowers, subsequent organic and aqueous extraction phases, and silica gel chromatography fractions were assayed on the carbachol-induced response, and/or on ovalbumin antigenic challenge, and on leukotriene D(4)-induced response of tracheae from sensitized and non-sensitized guinea-pigs. Methanol extracts, ethyl-acetate phase, and its fractions 6 and 7 inhibited the carbachol-induced contractile response. Isoquercitrin and rutin were the main compounds found in fractions 6 and 7 respectively. Isoquercitrin (fraction 6) abolished the response to ovalbumin, and decreased the contractile response to leukotriene D(4). Because of its effect on carbachol-induced contractile response, on the late-phase response to ovalbumin, and on leukotriene D(4)-induced contractile response, isoquercitrin might be highly useful in treatment of asthma.
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Affiliation(s)
- Jacquelina Fernandez
- Unidad de Investigación Médica en Farmacología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Piedimonte G, Renzetti G, Auais A, Di Marco A, Tripodi S, Colistro F, Villani A, Di Ciommo V, Cutrera R. Leukotriene synthesis during respiratory syncytial virus bronchiolitis: influence of age and atopy. Pediatr Pulmonol 2005; 40:285-91. [PMID: 16106356 DOI: 10.1002/ppul.20285] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Respiratory syncytial virus (RSV) infection is the most common cause of bronchiolitis in infants and an important risk factor for the development of recurrent wheezing and asthma. Cysteinyl leukotrienes were implicated in the pathophysiology of these diseases, and are being targeted for their diagnosis and therapy. We measured urinary leukotriene E4 (LTE4) in infants with RSV bronchiolitis in comparison with controls without respiratory infection, and investigated whether medical and family history, age, and passive exposure to tobacco smoke are related to urinary leukotriene excretion. We studied 33 infants with bronchiolitis and 25 controls, 1-12 months of age. Demographic and historical data were obtained from informed-consent forms and questionnaires completed by the parents. RSV was detected in nasal secretions by enzyme-linked immunoassay. Urine samples were collected on day of admission and were analyzed for LTE4 with an enzyme-linked immunoassay. Urinary LTE4 was 8-fold higher in infants with bronchiolitis than in controls. Leukotriene excretion was significantly higher in infected infants <6 months of age with a medical history of eczema or dry cough and/or family history of asthma. Multivariate analysis revealed that eczema and dry cough are independently associated with high LTE4 excretion during bronchiolitis. Exposure to tobacco smoke did not affect urinary LTE4. Our study shows that leukotriene synthesis during bronchiolitis is particularly elevated in younger infants with an atopic/asthmatic background. Urinary LTE4 may become a valuable, noninvasive marker for the identification of patients who will benefit most from therapy with leukotriene modifiers for management of bronchiolitis.
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Affiliation(s)
- Giovanni Piedimonte
- Pediatric Pulmonary Research, Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33136, USA.
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Gaga M, Papageorgiou N, Zervas E, Gioulekas D, Konstantopoulos S. Control of asthma under specialist care: is it achieved? Chest 2005; 128:78-84. [PMID: 16002919 DOI: 10.1378/chest.128.1.78] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The goal of asthma treatment is control of asthma and good quality of life for asthmatic patients; however, many asthmatic patients experience symptoms and limitations. STUDY OBJECTIVES To examine treatment outcome in asthmatic patients under specialist care. DESIGN Multicenter, cross-sectional study. SETTING Four large outpatient asthma clinics in teaching hospitals in three Greek cities. PATIENTS Three hundred seventy-eight randomly selected patients with mild or moderate asthma (265 female patients; mean age, 42.3 years). INTERVENTIONS None. MEASUREMENTS AND RESULTS Patients completed a questionnaire structured with eight domains covering patient characteristics, drug use at baseline and during exacerbations, regular follow-up, emergency visits, asthma control, symptoms, and limitations. Results show that the majority of patients have symptoms and limitations in their physical and social activities and have frequent exacerbations, while > 40% of patients think that their asthma is not well controlled. Most of our patients receive preventive medication (primarily inhaled corticosteroids, but less so long-acting beta2-agonists [LABAs] and leukotriene antagonists), increase their use of medication in case of exacerbations and have regular follow-up. However, the report shows that 48% of patients tried to reduce their medication dose, a fact implying that compliance is not always good. CONCLUSIONS These data indicate that the goals of asthma treatment are not achieved, even under specialist care. Perhaps more effort should be invested in patient education while an increase in the use of LABAs and leukotriene antagonists, medications that have been shown to prevent exercise-induced bronchoconstriction and improve quality of life, may help better asthma outcomes.
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Affiliation(s)
- Mina Gaga
- Respiratory Medicine Department, Athens University, Sotiria Hospital, 152 Mesogion Ave, Athens 11527, Greece.
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