Leukotriene Inhibitors

Mendes and coworkers investigated the effects of inhaled fluticasone and oral montelukast on airway blood flow in a double-blind, crossover study. They assessed airway blood flow using a previously validated soluble inert gas uptake method before and after treatment for 2 weeks with montelukast, fluticasone, their combination, and placebo in 12 subjects with mild intermittent asthma. The investigators found that both agents reduced bronchial blood flow modestly and equally; the effects were not additive and were not associated with improvement in FEV₁, suggesting that vascular modulation can be assessed independently of lung function in patients with mild asthma. The authors suggested that the impact of montelukast and fluticasone on airway blood flow were caused by an antiinflammatory effect of the agents.

To examine the mechanisms by which cysteinyl leukotrienes contribute to airway eosinophilia, Parameswaran and colleagues examined sputum and blood eosinophils, bone marrow eosinophil progenitors, and levels of chemotactic and eosinophilopoietic cytokines in 15 subjects with mild asthma who were treated with the cysteinyl leukotriene-1 receptor antagonist, pranlukast, for 2 weeks. Pranlukast decreased mean sputum eosinophils from 5.3 to 0.7%, and blocked the allergen-induced increase in airway eosinophils by decreasing both eosinophil progenitor cells (IL-5–responsive eosinophil cfu and CD34⁺CCR3 cells) in the bone marrow and the levels of eosinophilopoietic and chemotactic cytokines (IL-5, regulated on activation normal T-cell expressed and secreted, or RANTES, eotaxin) in the airway. On the basis of their data, the authors suggested that cysteinyl leukotrienes play a role in the IL-5 signal transduction pathway.

Citations 1-2 of 2 total displayed.

Effect of Montelukast and Fluticasone Propionate on Airway Mucosal Blood Flow in Asthma

Eliana S. Mendes, Michael A. Campos, Andres Hurtado, and Adam Wanner
Am. J. Respir. Crit. Care Med. 169: 1131 -1134. First published online as doi:10.1164/rccm.200311-1544OC [Abstract] [Full text]

The Effect of Pranlukast on Allergen-induced Bone Marrow Eosinophilopoiesis in Subjects with Asthma

Krishnan Parameswaran, Richard Watson, Gail M. Gauvreau, Roma Sehmi, and Paul M. O'Byrne
Am. J. Respir. Crit. Care Med. 169: 915 -920. First published online as doi:10.1164/rccm.200312-1645OC [Abstract] [Full text]

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