Journal Information
Vol. 5. Issue 3.
Pages 329-339 (May - June 1999)
Share
Share
Download PDF
More article options
Vol. 5. Issue 3.
Pages 329-339 (May - June 1999)
ARTIGO DE REVISÃO/REVIEW ARTICLE
Open Access
Antileucotrienos. As grandes esperanças
Antileukotrienes. Great expectations
Visits
5512
Maria João Marques Gomes*
* Professora Associada de Pneumologia da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. Chefe de Seriço de Pneumologia. Coordenadora do Departamento de Pneumologia do Hospital de Pulido Valente. Lisboa
This item has received

Under a Creative Commons license
Article information
RESUMO

A Autora, numa breve introdução passa em revista a modificação do conceito de asma. Revê o papel dos leucotrienos no processo inflamatório crónico: acção broncoconstrictora, aumento da permeabilidade vascular, quimiotactismo, hipersecreção de muco e aumento da reactividade brônquica. Refere-se aos vários tipos de antileucotrienos – inibidores da síntese e bloqueantes dos receptores - e às suas acções farmacológicas, bem como à sua aplicaçã clínic e seu posicionamento no tratamen-toda asma.

REV PORT PNEUMOL 1999; V (3): 329-339

Palavras-chave:
Terapêutica da asma
Antileucotrienos
Zileuton
Zafirlukast
Montelukast
ABSTRACT

The author reviews the concept of asthma and the role of leukotrienes in chronic inflammation of bronchial asthma: bronchoconstrition, bronchial hyperreadivity, increasing of vascular permeability, mucous hypersecretion and cellular infiltration. Phamacological and clinical characteristics of antileukotrienes and their place in the control of asthma are also reviewed.

REV PORT PNEVMOL 1999; V (3): 329-339

Key-words:
Treatment of asthma
Antileukotrienes
Zileuton
Zafirlukast
Montelukast
Full text is only aviable in PDF
BIBLIOGRAFIA
[1.]
J.P. Arm, B.W. Spur, T.H. Lee.
The effects of inhaled leukotriene E4 on the airway responsiveness to histamine in subjects with asthma and nonnal subjects.
J Allergy Clin Immunol., 82 (1988), pp. 654-660
[2.]
N.C. Barnes.
The place of antileukotriene therapy in asthma management guidelines.
Eur. Respir Rev, 8 (1998), pp. 382-386
[3.]
N.C. Barnes.
The role of leukotriene receptor antagonists in the management of asthma.
Eur Respir Rev, 8 (1998), pp. 356-357
[4.]
P.J. Barnes, S. Pedersen.
Efficacy and safety of inhaled conicosteroids in asthma.
Am Rev Resp Dis, 148 (1993), pp. S1-S26
[5.]
E.H. Bel, H. Van der Veen, J.A. Kramps, et al.
Maximal airway narrowing to inhaled leukotriene D4 in normal subjects.
Am Rev Resp Dis, 136 (1987), pp. 289-297
[6.]
H. Booth, I. Richmond, C. Ward, P.V. Gardiner, R. Harkawat, E.H. Walters.
Effect of high-dose inhaled fluticasone propionate on airway inflammation in asthma.
Am J Respir. Crit Care Med., 152 (1995), pp. 45-52
[7.]
P. Bourgeat, B. Samuelsson.
Metabolism of arachidonic acid in polymorphonuclear leukocytes Structural analysis of novel hydroxylated compound.
J Biol Chem, 254 (1979), pp. 7865-7867
[8.]
E.A. Bronsky, J.P. Kemp, J. Zhang, D. Guerreiro, T.F. Reiss.
Dose-related protection of exercise bronchoconstriction by montelukast, a cysteinyl leukotrienereceptor antagonist, at the end of a once-daily dosing interval Clin Phannacol.
Therapeutics, 62 (1997), pp. 556-561
[9.]
W. Calhoun, C.H.R. Virchow Jr..
A new approach animal and clinical pharmacology of Zafirlukast (Accolate. ICI-204,219).
Eur Respir. Rev, 7 (1997), pp. 264-268
[10.]
K.F. Hung.
Leukotriene receptor antagonists and bio-synthesis inhibitors: potential breakthrough in asthma therapy.
Eur. Respir J, 8 (1995), pp. 1203-1213
[11.]
R. Dahl, E. Lundback, J.L. Malo, et al.
A dose-ranging study of fluticasone propionate in adult patients with moderate asthma.
Chest, 104 (1993), pp. 1352-1358
[12.]
B. Dahlén, M. Kumlin, D.J. Margolskee, et al.
The leukotriene-receptar antagonist MK-0679 blocks airway obstruction induced by inhaled lysine-aspirin in aspirin-sensitive asthmatics.
Eur Respir J, 6 (1993), pp. 1018-1026
[13.]
S.E. Dahlén, E. Nizankowska, et al.
Benefits from adding the 5-LO inhibitor zileuton to conventional therapy in aspirin intolerant asthmatics.
Am J Respir. Crit. Care Med., 157 (1998), pp. 1187-1194
[14.]
S.E. Dahlén, O. Zetterstrom, T. Bjorck, S.E. Dahlen.
The leukotrieneantagonist ICI-204-219 inhibits the early airway reaction to cumulative bronchial challenge with allergen in atopic asthmatics.
Eur. Respir J., 7 (1994), pp. 324-331
[15.]
D.P. D'Cruz, N. Barnes, C.M. Lockwood.
Diffcult asthma or Churg-Strauss syndrome?.
B. Med. J, 318 (1999), pp. 475-476
[16.]
Z. Diamant, M.C. Timmers, H. Van den Veen, et al.
Effect of oral montelukast (MK-0476). a potent leukotriene receptor antagonist, on allergen-induced airway responses in asthmatic subjects.
Am J Respir Crit Care Med, 153 (1996), pp. A346
[17.]
J.M. Drazen.
Comparative contractile responses to sulfidopeptide leukotrienes in normal and asthmatic human subjects.
Ann NY Acad Sci, 524 (1988), pp. 289-297
[18.]
J.M. Draze, E. Israel, P.M. O'byrne.
Treatment of asthma with drugs modifying the leukotriene pathway.
New Engl J. Med, 340 (1999), pp. 197-206
[19.]
J.M. Drazen, E. Israel.
Should leukotriene therapies be used instead of inhalcd corticosteroids in asthma? Yes Am.
J. Respir Crit Care Med, 158 (1998), pp. 1697-1698
[20.]
S.R. Findlay, J.M. Barden, C.B. Easley, et al.
Effect of the oralleukotriene antagonist. ICI-204-219 on antigen-induced bronchoconstriction in subjects with asthma.
J. Allergy Clin. Immunol., 89 (1992), pp. 1040-1045
[21.]
J.P. Finnerty, R. Wood-Baker, H. Thomson, S.T. Holgate.
Role of leukotrienes in exercise-induced asthma.
Am Rev Respir Dis, 145 (1992), pp. 746-749
[22.]
J.E. Fish, J.P. Kemp, R.F. Lockey, M. Glass, L.A. Hanby, C.M. Bonuccelli.
Zafirlukast for symptomatic mild-to-moderate asthma: A 13-weak multicenter study.
Clin Therapeutics, 19 (1997), pp. 675-690
[23.]
T. Haahtela, M. Jarvinen, T. Kava, et al.
Comparison of a β2-agoinst, terbutaline. with an inhaled corticosteroid, budesonide in newly detected asthma.
Engl J Med, 325 (1991), pp. 388-392
[24.]
A.L. Hamilton, I. Faiferman, P. Stober, P.M. Watson, P.M. O'byrne.
Pranlukast (SB205312, Ono 1078) a leukotriene receptor antagonist, attenuates allergen-induced early and late phase bronchoconstriction and airway hyperresponsiveness in asthmatic.
Eur Respir J, 10 (1997), pp. 419S
[25.]
D. Hay, T. Trophy, B. Undem.
Cysteinyl leukotrienes in asthma old mediators up to new tricks.
Trends Pharmacol. Sci, 16 (1995), pp. 304-309
[26.]
K.P. Hui, J. Lotvall, K.F. Chung, et al.
Attenuation of inhaled allergen-induced airway microvascular leakage and airflow obstruction in guinea-pigs by a 5-lipoxy-genase inhibitor (A-63162).
Am. Rev Respir Dis, 143 (1991), pp. 1015-1018
[27.]
E. Israel, J. Cohn, L. Dube, J.M. Drazen.
Effect of treatment with zileuton, a 5-lipoxygenase inhibitor, in patients with asthma.
J.A.M.A, 275 (1996), pp. 931-936
[28.]
E. Israel, P. Rubin, J.P. Kemp, et al.
The effect of inhibition of 5-lipoxygenase by zileuton in mild-to-moderate asthma.
Ann Int Med, 119 (1993), pp. 1059-1066
[29.]
J.P. Kemp, R.J. Dockhorn, G.G. Shapiro, et al.
Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year old children with asthma.
J. Pediatrics, 133 (1998), pp. 424-428
[30.]
Y. Kikawa, T. Miyanomae, M. Saito, A. Nakai, et al.
Urinary leukotriene E4 after exercise challenge in children with asthma.
J.Allergy Clin. Immunol., 89 (1992), pp. 1111-1119
[31.]
B.A. Knorr, J. Matz, J. Bernstein, H. Nguyen, B.C. Seidenberg, T.F. Reiss, A. Becker.
Montelukast for chronic asthma in 6- to 14-year old children.
JAMA, 279 (1998), pp. 1181-1186
[32.]
R.D. Krell, C.J. Dehaas, D.J. Lengel, et al.
Preclinical exploration of the potential anti-inflammatory properties of the peptide leukouiene antagonist ICI-204,219 (AccolateTM).
Ann Ny Acad Sci, 744 (1994), pp. 28
[33.]
P. Kuna, K. Malstrom, S.E. Dahlén, et al.
Montelukast (MK-0476), a cysLTI receptor antagonist, improves asthma control in aspirin-intolerant asthmatic patients.
Am J. Respir Crit. Care Med., 155 (1997), pp. A974
[34.]
L.A. Laitinen, A. Laitinen, T. Haahtela, et al.
Leukotriene E4 and granulocyctic infiltration into asthmatic airways.
Lancet, 341 (1993), pp. 989-999
[35.]
L.A. Laitinen, I.P. Naya, S. Binks, A. Harris.
Comparative efficacy of Zafirlukast and low dose steroids in asthmatics on pm beta2agonists.
Eur Respir J, 10 (1997), pp. 419s
[36.]
J.G. Lanham, K.B. Elkon, et al.
Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg­ Strauss syndrome.
Medicine (Baltimore), 63 (1984), pp. 65-81
[37.]
S.C. Lazarus, B.J. Lavins, H.H. Wong, et al.
Effect of Accolate (Zafidukast) on sulphur dioxide (SO2)-induced bronchoconstriction in patients with mild-to-moderate asthma.
Am J. Respir Crit Care Med, 151 (1995), pp. A41
[38.]
J.A. Leff.
Leukotriene modifiers as novel therapeutics in asthma.
Clinical and Experimental Allergy, 28 (1998), pp. 147-153
[39.]
J.A. Leff, E.A. Bronsky, Kempj, et al.
Montelukast improves patient global assesment and decreases β-agonist requirements in patients with mild asthma and exercise-induced bronchoconstriction.
Eur. Respir. J., 10 (1997), pp. 436s
[40.]
J.A. Leff, W.W. Busse, D. Pearlman, et al.
Montelukast, a leukotriene receptor antagonist, for the treatment of mild asthma and exercise-induced bronchoconstriction.
New Engl. J Med., 339 (1998), pp. 147-152
[41.]
J.A. Leff, E. Israel, M.J. Noonan, et al.
Montelukast allows tapering of inhaled conicosteroids in asthmatic patients while maintaining clinical stability.
Am J. Respir Crit.Care Med., 155 (1997), pp. 2
[42.]
M.C. Liu, L.M. Dube, J. Lancaster.
Acute and chronic effects of a 5 LO inhibitor in asthma a 6-month randomized multicenter trial.
J Allergy Clin Immunol., 98 (1996), pp. 859-871
[43.]
P.J. Manning, R.M. Watson, D.J. Margolskee, et al.
Inhibition of exercise-induced bronchoconstriction by MK­571. a potent leukotriene D4-receptor antagonist.
N Engl J Med, 323 (1990), pp. 1736-1739
[44.]
Z. Marom, J.H. Shelhamer, M.K. Bach, et al.
Slow­reacting substances. leukotrienes C4 and D4, increase the release of mucus from human airways in vitro.
Am Rev Respir Dis, 126 (1982), pp. 449-451
[45.]
R.A. Nathan, M. Glass, L. Snader.
Effects of 13 weeks of treatment with ICI 204, 219 or cromolyn sodium in patients with mild to moderate asthma.
J. Allergy Clin. Immunol, 97 (1995), pp. 388
[46.]
NATIONAL INSTITUTES OF HEALTH. National Heart, Lung and Blood Institute. Global Initiative for asthma Workshop Report 1995
[47.]
National HEART, LUNG, Blood Institute The Expert Panel II Guidelines for the diagnosis and management of asthma National Institutes of Health National Hean, Lung, Blood Institute.
[48.]
National Institutes of Health.
National heart, Lung and Blood Institute Global Initiative for Asthma.
Pocket Guide for asthma management and prevention, (1998),
[49.]
A.S. Nayak, P. Anderson, B.L. Charous, et al.
Equivalence of adding Zafirlukast versus double-dose of inhaled corticosteroids in asthmatic patients symptomatic on owdose inhaled conicosteroids.
J Allergy Clin. Immunol, 101 (1998), pp. 965
[50.]
A. Papi, G. Caramori, L.M. Fabbri.
Current asthma therapies and issues in asthma management.
Eur Respir. Rev, 59 (1998), pp. 341-347
[51.]
J.B. Rasmussen, L.O. Eriksson, et al.
Leukotriene D4 receptor blockade inhibits the immediate and late response to inhaled antigen in patients with asthma.
J. Allergy Clin Immunol., 90 (1992), pp. 193-201
[52.]
T.F. Reiss, P. Chervinsky, R.J. Dockhorn, S. Shingo, B. Seidenberg, T.B. Edwards.
Montelukast, a once daily leukotriene receptor antagonist in the treatment of chronic asthma: A multicenter, randomized. double-blind trial.
Arch Intern Med, 158 (1998), pp. 1213-1220
[53.]
T.F. Reiss, J.B. Hill, et al.
Increased urinary excretion of LTE4 after exercise and attenuation of exercise-induced bronchospasm by montelukast, a cysteinyl leukotriene receptor antagonist.
Thorax, 52 (1997), pp. 1030-1035
[54.]
N. Ringdall, J.G. Whitney, L. Summerton.
A comparison of patient preference for treatment with oral Zafirlukast or inhaled beclomethasone.
Eur. Respir. J., 10 (1997), pp. 437s
[55.]
A.P. Sampson, D.P. Castling, C.P. Green, et al.
Persistent increase in plasma and urinary leukotrienes after acute asthma.
Arch. Dis. Child., 73 (1995), pp. 221-225
[56.]
C.M. Smith, R.J. Hawksworth, F.C.K. Thien, et al.
Urinary leukotriene E4 in bronchial asthma.
Eur Respir J, 5 (1992), pp. 693-699
[57.]
L.J. Smith, S. Geller, L. Ebright, et al.
Inhibition of leukotriene D4-induced bronchoconsrriction in normal subjects by the oral leukotriene receptor antagonist ICI 204-219.
A Rev Resp Dis, 141 (1990), pp. 988-992
[58.]
L.J. Smith, M. Glass, M.C. Minkwitz.
Inhibition of leukotriene D4 - induced bronchoconstriction in subjects with asthma a concentration-effect study of ICI-204-219.
Clin Pharmacol Ther, 54 (1993), pp. 430-436
[59.]
S.L. Spector, L.J. Smith, M. Glass.
Effects of 6 weeks of therapy with oral doses of ICI 204,219, a leukotriene D. receptor antagonist, in subjects with bronchial asthma.
Am J Respir Crit Care Med, 150 (1994), pp. 618-623
[60.]
S.L. Spector.
Management of asthma with zafirlukast.
Drugs, 52 (1996), pp. 36-46
[61.]
J. Tamaoki, M. Kondo, et al.
Leukotriene antagonist prevents exacerbation of asthma during reduction of high-dose inhaled corticosteroids.
Am. J. Respir. Crit. Care Med., 155 (1997), pp. 1235-1240
[62.]
I.K. Taylor, K.M. O'Shaughnessy, R.M. Fuller, C.T. Dollery.
Effect of cysteinylleukotriene receptor antagonist ICI 204-219 on allergen-induced bronchoconstriction and airway hyperreactivity in atopic subjects.
Lancet, 337 (1991), pp. 691-694
[63.]
G.W. Taylor, I. Taylor, P. Black, et al.
Urinary leukotriene E4 after antigen challenge and in acute asthma and allergic rhinitis.
Lancet, 1 (1989), pp. 584
[64.]
J.C. Virchow, S.M. Hassall, L. Summerton, et al.
Zafirlukast reduces the impact of asthma in patients taking inhaled corticosteroids.
J. Allergy Clin Immunol, 9 (1997), pp. 888
[65.]
M.E. Wechsler, E. Garpestad, S.R. Flier, et al.
Pulmonary infiltrates, eosinophilia and cardiomyopathy following conicosteroids withdrawl in patients with asthma receiving Zafirlukast.
JAMA, 279 (1998), pp. 455-457
[66.]
S.E. Wenzel.
Should leukotriene therapies be used instead of inhaled conicosteroids in asthma? Yes.
Am. J. Respir. Crit. Care Med., 158 (1998), pp. 1699-1701
Copyright © 1999. Sociedade Portuguesa de Pneumologia/SPP
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?