The role of cysteinyl leukotrienes in asthma: From the molecule to the bedside

ABSTRACTThere is increasing interest in the role played by the cysteinyl leukotrienes in the pathogenesis of bronchial asthma. They have been demonstrated to have a bronchoconstrictor effect both in vitro and in vivo and have been isolated from bronchoalveolar lavage fluid and urine from stable asthmatics and from asthmatics during exacerbations and after endobronchial challenge. Pharmacological intervention has been studied through antagonism of leukotriene receptors and inhibition of leukotriene synthesis. Both have been shown to have an effect on the asthmatic response after challenge with allergen, exercise and inhalation of cold air and to have an effect on aspirin sensitive asthmatics and on the symptoms and markers of severity of chronic asthma. The differences between receptor antagonism and synthesis inhibition are discussed