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Miscellaneous

Antileukotrienes in clinical development for asthma

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Pages 49-58 | Published online: 24 Feb 2005

Bibliography

  • Surveillance for Asthma-United States 1960-95. Morbidity and Mortality Weekly Report (1998) 47:(SS–1).
  • HENDERSON W, JR: The role of leukotrienes in inflammation. Ann. Intern. Med. (1994) 121:684–697.
  • •Biological role of LTs on inflammatory substrate.
  • DAHLEN B, DAHLEN SE: Leukotrienes as mediators of airway obstruction and inflammation in asthma. Chu. Exp. Allergy (1995) 2:50–54.
  • •LTs and pathogenesis of asthma.
  • DENNIS E: Diversity of group types, regulation and function of phospholipases A2. j Biol. Chem. (1994) 269:13057–13060.
  • SAMUELSSON B, GOLDYNE NE, GRONSTROM E et al.: Prostaglandins and thromboxane. Ann. Rev Biochem. (1978) 47:997–1003.
  • FORD-HUTCHINSON A, GRESSER M, YOUNG R: 5-Lipoxigenase. Ann. Rev Biochem. (1994) 63:383–417.
  • KUHN H, THIELE BJ: Arachidonate 15-lipoxigenase. j Lipid Mediat. Cell. Signal (1995) 12:157–170.
  • LAVIOLETTE M, FERLAND C, COMTOIS JF et al.: Blood eosinophil leukotriene C4 production in asthma of different severities. Eur. Respir. j (1995) 8:1465–1472.
  • WARDLAW AJ, HAY H, CROMWELL 0et al: Leukotrienes, LTC4 and LTB4, in bronchoalveolar lavage in bronchial asthma and other respiratory diseases. I Allergy Clin. Immuriol (1989) 84:19–26.
  • WENZEL SE, LARSEN GL, JOHNSTON K et al.: Elevated levels of leukotriene C4 in bronchoalveolar lavage lid from atopic asthmatics after endobronchial allergen challenge. Am. Rev Respir. Dis. (1990) 142:112–119.
  • SZCZEKLIK A, MASTALERZ L, NIZANKOWSKA E, CMIEL A: Protective and bronchodilator effects of prostaglandin E and salbutamol in aspirin-induced asthma. Am. J. Respir: Crit. Care Med. (1996) 153:567–571.
  • DRAZEN JM, O'BRIEN J, SPARROW D et al.: Recovery of leukotriene E4 from the urine of patients with airway obstruction. Am. Rev. Respir Dis. (1992) 146:104–108.
  • DAHLEN SE, HEDQUIST P, HAMMARSTROM S, SAMUELSON B: Leukotrienes are potent constrictors of human bronchi. Nature (1980) 288:484–486.
  • MAROM Z, SHELHAMER JH, BACK MKet al.: Slow-reacting substance, leukotrienes C4 and D4, increase the release of mucus from human airways in vitro. Am. Rev. Resp. Dis. (1982) 126:449–451.
  • ADELROTH E, MORRIS MM, HARGREAVE FE, O'BYRNE PM: Airway responsiveness to leukotrienes C4 and D4 and to methacoline in patients with asthma and normal controls. N Eng] I Med. (1986) 315:480–484.
  • O'HICKEY SP, HAWKS WORTH RJ, FONG CY, ARM JP, SPUR BW, LEE TH: Leukotrienes C4, D4 and E4 enhance histamine responsiveness in asthmatic airways. Am. Rev Respir Dis. (1991) 144:1053–1057.
  • LAITINEN LA, LAITINEN A, HAAHTELA T, VILKKA V, SPUR BW, LEE TH: Leukotriene E4 and granulocytic infiltration into asthmatic airways. Lancet (1993) 341:989–990.
  • COHEN P, NOVERAL JP, BHALA A, NUNN SE, HERRICK DJ, GRUNSTEIN MM: Leukotriene D4 facilitates airway smooth muscle cell proliferation via modulation of the IGF axis. Am. I Physiol. (1995) 269:L151–L157.
  • LEIKAUF GD, CLAESSON HE, DOUPNIK CA et al.: Cysteinyl leukotrienes enhance growth of human airway epithelial cells. Am. J Physiol (1990) 2591255–L261.
  • TAYLOR IK, SHAW RJ: The mechanism of action of corticosteroids in asthma. Respir Med. (1993) 87:261–277.
  • PALMER RMJ, STEPNEY RJ, HIGGS GA, EAKINS KE: Chemokinetic activity for arachidonic acid lipoxygenase products on leukocytes of different species. Prostaglandins (1980) 20:411–418.
  • NAGY L, LEE TH, GOETZE EJ, PICKETT WC, KAY AB: Complement receptor enhancement and chemotaxis of human neutrophils and eosinophils and other lipoxygenase products. Clin. Exp. Immuriol (1982) 47:541–547.
  • GOLDMAN DW, GOETZE EJ: Selective transduction of human polymorphonuclear leukocyte functions by subsets of receptors for leukotriene B4. I Allergy Chia. Immunol (1984) 74:373–377.
  • HOOVER RL, KARNOVSKY MJ, AUSTEN KF, COREY EJ, LEWIS RA: Leukotriene B4 action of endothelium mediates augmented neutrophil/endothelial adhesion. Proc. Nat] Acad. Sci. USA (1984) 81:2191–2193.
  • UNDERWOOD DC, OSBORN RR, NEWSHALME SJ, TORPHY TJ, HAY DWP: Persistant airway eosinophilia after leukotriene D4 administration in conscious guinea-pigs: Modulation by a peptidoleukotriene antagonist and interleukin (IL-5) monoclonal antibody. Asthma, Theory to Treatment, ably 15–17,1995).
  • COWBURN AS, HOLGATE ST, SAMPSON AP: IL-5 increases expression of 5-lipoxygenase protein and translocates 5-lipoxygenase to the nucleus in human blod eosinophils. j Immunol (1999) 163:456–465.
  • SANAK M, SAMPSON AP: Biosynthesis of cysteinyl-leucotrienes in aspirin-intollerant asthma. Clin. Esp. Allergy (1999) 29:306–313.
  • SHAW RJ, FITZHARRIS P, CROMWELL 0 eta].: Allergen-induced release of sulphidapeptide leukotrienes (SRS-A) and LTB4 in allergic rhinitis. Allergy (1985) 40:1–6.
  • MIADONNA A, TEDESCHI A, LEGGIERI E et al.: Behaviour and clinical relevance of histamine and leukotrienes C4 and B4 in grass pollen-induced rhinitis. Am. Rev Respir: Dis. (1987) 114:522–524.
  • HUI KP, BARNES NC: Lung function improvement in asthma with a cysteinyl-leukotriene receptor antagonist. Lancet (1991) 337:1062–1063.
  • REISS TF, CHERVINSKY P, DOCKHORN RJ, SHINGO S, SEIDENBERG B, EDWARDS TB: Montelukast, a once-daily leukotriene receptor antagonist, in the treatment of chronic asthma; a multicenter, randomized, double-blind trial. Montelukast Clinical research Study Group. Arch. Intern. Med. (1998) 158:1213–1220.
  • SUISSA S, DENNIS R, ERNST P, SHEEHY 0, WOOD-DAUPHINEE S: Effectiveness of the leukotriene receptor antagonist zafirlukast for mild-to-moderate asthma. A randomized, double-blind, placebo-controlled trial. Ann. Int. Med. (1997) 126:177–183.
  • GROSSMAN J, FAIFERMAN I, DUBB JW et al: Results of the first U.S. double-blind, placebo-controlled, multicenter clinical study in asthma with pranlukast, a novel leukotriene receptor antagonist. I Asthma (1997) 34:321–328.
  • TUDHOPE SR, CUTHBURT NJ, ABRAM TS et al: BAY u9773, a novel antagonist of cysteinyl-leukotrienes with activity against two receptor subtypes. Eur. I Pharmacol (1994) 264:317–323.
  • LYNCH KR, O'NEILL GP, LIU Q eta].: Characterization of the human cysteinyl leukotriene CysLT1 receptor. Nature (1999) 399:789–79.
  • COLEMAN RA, EGLEN RIVI, JONES RE et al: Prostanoid and leukotriene receptors: a progress report from the IUPHAR working parties on classification and nomenclature. Adv. Prostaglandin Thromboxarie Leukotriene Res. (1995) 23:283–285.
  • LABAT C, ORTIZ L, NOREL X et A second cysteinyl leukotriene receptor in human lung. I Pharmacol Exp. Ther. (1992) 263:800–805.
  • WALCH L, NOREL X, GAS CARD JP, BRINK C: Cysteinyl-leukotriene receptors in pulmonary vessels. j Physiol Pharmacol. (1999) 50:567–573.
  • HEISE CE, O'DOWD BF, FIGUEROA DJ et al.: Characterization of the human cysteinyl leukotriene 2 receptor. _J. Biol. Chem. (2000) 275:30531–30536.
  • CENTANNI S, SANTUS P, DI MARCO F, FUMAGALLI E ZARINI S, SALA A: The potential role of tocopherol in asthma and allergy. Modifcation of the leukotriene pathway. BioDrugs (2001) 15:81–86.
  • KIKAWA JP, MIYANOMAE T, INOUE Y et al.: Urinary leukotriene E4 after exercise challenge in children with asthma. j Allergy Chu. Immuriol (1992) 89:1111–1119.
  • FINNERRTY JP, WOOD-BAKER R, THOMSON H, HOLGATE ST: Role of leukotrienes in exercise-induced asthma: Inibitory effect of ICI 204219, a potent leukotriene D4 receptor antagonist. Am. Rev Respir: Dis. (1992) 145:746–749.
  • REISS TF, HILL JB, HARMAN E etal.: Increased urinary excretion of LTE4 after exercise-induced bronchospasm by montelukast, a cysteinyl leukotriene receptor antagonist. Thorax (1997) 52:1030–1035.
  • KNAPP HR, SLADEK K, FITZGERALD GA: Increased excretion of leukotriene E4 during aspirin-induced asthma. j Lab. Chu. Med. (1992) 119:48–51.
  • DAHLEN B, MARGOLSKEE DJ, ZETTESTROM 0, DAHLEN SE: Effect of the leukotriene receptor antagonist MK-0679 on baseline pulmonary function in aspirin-sensitive asthmatic subjects. Thorax (1993) 48:1205–1210.
  • LIU MC, DUBE LM, LANCASTER J, ZILEUTON STUDY GROUP: Acute and chronic effects of a 5-lipoxigenase inhibitor in asthma: a 6-month randomised multicenter trial. ..J. Allergy Chu. Immuriol (1996) 98:859–871.
  • CALHOUN WJ, WEISBERG SC, FAIFERMAN I et al.: Pranlukast (Utak TM) is effective in improving asthma: results of a 12-week, multicenter, dose ranging study. j Allergy Clio. Immuriol (1997) 99:S318 (Abstract).
  • SPECTOR SL, SMITH LJ, GLASS M: Effect of 6 weeks of therapy with oral doses of ICI 204,219, a leukotriene D4 receptor antagonist, in subjects with bronchial asthma. Am. j Resp. Grit. Care Med. (1994) 150:618–623.
  • •Clinical use of a LTD4 receptor antagonist.
  • TASHKIN DP, NELSON HS, COHN J et al.: Efficacy and safety of zafirlukast (Accolate) in patients with mild to moderate asthma. Am. j Resp. Grit. Care Med. (1996) 153:A534 (Abstract).
  • SUISSA S, DENNIS R, ERNST P etal.: Effectiveness of the leukotriene receptor antagonist zafirlukast for mild-to-moderate asthma- a randomised double-blind, placebo-controlled trial. Ann. Intern. Med. (1997) 126:177–183.
  • CENTANNI S, SANTUS P, CASANOVA E DI MARCO E BRAZZOLA G, CANONICA GW: Evaluation of the effects of zafirlukast 40 mg bid in addition to preexisting therapy of high-dose inhaled steroids on symptomatic patients with reversible respiratory obstructin: preliminary data. Drugs Evil Clin. Res. (2000) 26(4):133–138.
  • SANTUS P, CENTANNI S, PIATTI G et al.: Effect of zafirlukast on Ciliary Beat Frequency (CBF) in stable mild asthmatic allergic subjects. ACAAI Annual Meeting. Seattle (2000).
  • SANAK M, SAMPSON AP: Biosynthesis of cysteinyl-leucotrienes in aspirin-intollerant asthma. Clin. Exp. Allergy (1999) 29:306–313.
  • SANAK M, SIMON HU, SZEZEKLIK A: Leukotriene C4 synthase promoter polymorphism and risk of aspirin-induced asthma. Lancet (1997) 350: 1599-1600.
  • SAMPSON AP SIDDIQUI S, BUCHANAN D et al: Variant LTC4 synthase allele modifies cysteinyl leukotriene synthesis in eosinophils and predicts clinical response to zafirlukast. Thorax (2000) 55\(Suppl. 2):528–531.
  • •Possible genetic correlation between antiLTs and clinical responses in asthma.
  • EDELMAN JM, PRESTON SR, TURPIN JA et al.: Parent and child preference for montelukast, a leukotriene receptor antagonist, compared to inhaled cromolyn in asthmatic children ages 6 to 11. Eur. Respir. (1998) 12:18s (Abstract).
  • REISS TF, CHERVINSKY P, EDWARDS T et al.: Montelukast Study Group. Montelukast (MK-0476), a cysLT1 receptor antagonist, improves asthma outcomes over a 3-month treatment period. Am. I Resp. Grit. Care Med. (1997) 155:A662 (Abstract).
  • STORMS W, MICHELE TM, KNORR B et al: Clinical safety and tolerability of montelukast, a leukotriene receptor antagonist, in controlled clinical trials in patients aged 6 years. Clin. Exper. Allergy (2001) 31:77–87.
  • ••A recent clinical study in a mixed asthmatic population with montelukast.
  • SHAN S, GALANT S, MURRAY J etal., ON BEHALF OF THE ULTAIR STUDY GROUP: Pranlukast (UltairTM) improves FEV1 in patients with asthma: results of 12-week multicenter study vs Nedocromil. Am. Resp. Grit. Care Med. (1997) 155:A665 (Abstract).
  • NATHAN RA, GLASS M, SANDER L: Effects of 13 weeks of treatment with ICI 204,219 (AccolateTM) or cromolyn sodium (IntalTM) in patients with mild to moderate asthma. I Allergy Clin. Immuriol (1995) 95:S388 (Abstract).
  • TAMAOKI J, KONDO M, SAKAI N etal.: Leukotriene antagonist prevents exacerbation of asthma during reduction of high-dose inhaled corticosteroid. Am. I Resp. Grit. Care Med. (1997) 155:1235–1240.
  • ••Importance of leukotriene antagonistduring reduction of ICS.
  • LAITININ LA, ZETTERSTROM 0, HOLGATE ST, BINKS SM, WHITNEY JG: Effect of AccolateTM (Zafirlukast; 20 mg BD) in permitting reduced therapy with inhaled steroids: a multicenter trial in patients with doses of inhaled steroid optimised between 800 and 2000 mcg per day. Allergy (1995) 50:P–0710.
  • LIPWORTH BJ: Leukotriene-receptor antagonist. Lancet (1999) 353:57–62.
  • MISSON J, CLARK W, KENDAL MJ: Therapeutic advances: leukotriene antagonist for the treatment of asthma. j Cliii. Pharm. Ther. (1992) 24:17–22.
  • CALHOUN WJ, NELSON HS, NATHAN RA et al.: Comparison of fluticasone proprionate-salmeterol combination therapy and montelukast in patients who are symptomatic on short-acting beta-2 agonist alone. Am. J. Respir: Grit. Care Med. (2001) 164:759–763.
  • ••An important and recent study about acomparison of two new but different drugs for asthma therapy.
  • NELSON HS, BUSSE WW, KERVIN E et al.: Fluticasone proprionate/salmeterol combination provides more effective asthma control than low-dose inhaled corticosteroid plus motelukast. I Allergy Chu. Immunol (2000) 106:1088–1095.
  • DAHLEN B, NIZANKOWSKAE E, SZCZEKLIK A et al.: Benefit from adding the 5-lipoxygenase inhibithor zileuton to conventional therapy in aspirin-intollerant asthmatics. Am. I Respir Grit. Care Med. (1998) 157:1187–1194.
  • LEFF JA, BUSSE WW, PEARLMAN D et al.: Montelukast, a leukotriene-receptor antagonist, for the treatment of mild asthma and exercise-induced bronchoconstriction. N. Erigl. J. Med. (1998) 339:147–152.
  • SOMTER M, BEERS RF: Intolerance to aspirin: clinical stusies and consideration of its pathogenesis. Ann. Intern. Med. (1968) 68:975–983.
  • STEVENSON DD: Diagnosis, prevention and treatment of adverse reactions to aspirin and non steroidal anti-inflammatorydrugs. Allergy Clin Immuriol (1984) 74:617–622.
  • SZCZEKLIK A: Mechanism of aspirin-induced asthma. Allergy (1997) 52:613–619.
  • BUSSE WW: The role of leukotrienes in asthma and allergic rhinitis. Clin Exp. Allergy (1996) 26:868–879.
  • SMITH CM, HAWKSWORTH RJ, THIEN FC, CHRISTIE PE, LEE TH: Urinary leukotriene E4 in bronchial asthma. Eur. Respir. J. (1992) 5:693–699.
  • PICADO C, RAMIS I, ROSELLO J etal.: Release of peptide leukotriene into vasal secretions after local instillation of aspirin in aspirin-sensitive asthmatic patients. Am. Rev Respir Dis. (1992) 145:65–69.
  • DAHLEN B, KUMLIN M, MARGOLSKEE DJ et al.: The leukotriene-receptor antagonist MK-0679 blocks airway obstruction induced by inhaled lysine-aspirin in aspirin-sensitive asthmatics. Eur. Respir: (1993) 6:1018–1026.
  • DAHLEN B, MARGOLSKEE DJ, ZETTERSTRAM 0, DAHLEN SE: Effect of the leukotriene receptor antagonist MK-0679 on baseline pulmonary function in aspirin sensitive asthmatic subjects. Thorax (1993) 48:1205–1210.
  • KUNA P, MALMSTROM K, DAHLEN SE et al.: Montelukast (MK-0476), a cysLT1 receptor antagonist, improves asthma control in aspirin-intollerant asthmatic patients. Am. Resp. Grit. Care Med. (1997) 155:A975 (Abstract).
  • DAHLEN SE, NIZANKOWSKA E, DAHLEN B etal.: The Swedish-Polish treatment study with the 5-lipoxygenase inhibitor Zileuton in aspirin-intollerant asthmatics. Am. J. Resp. Grit. Care Med. (1995) 151:A376 (Abstract).
  • YOSHIDA S, SAKAMOTO H, ISHIZAKI Y et al.: Efficacy of leukotriene receptor antagonist in bronchial hyperresponsiveness and hypersensitivity to analgesic in aspirin-intolerant asthma. Clin Exper. Allergy (2000) 30:64–70.
  • ISHIOKA S, HOZAWA S, HARUTA Y et al.: Effects of pranlukast, a cysteinyl leukotriene antagonist, on bronchial responsiveness to methacholine in aspirin-intolerant asthmatics treated with corticosteroids. Hiroshima J. Med. Li. (2000) 49:105–108.
  • McFADDEN ER JR, GILBERT IA: Exercise-induced asthma. N Engl. J. Med. (1994) 330:1362–1367.
  • ••An interesting paper about ETA.
  • KIKAWA Y, MIYANOMAE T, INOUE Yet al.: Urinary leukotriene E4 after exercise challenge in children with asthma. J. Allergy Immuriol (1992) 89:1111–1119.
  • MELTZER SS, HASDAY JD, COHN J, BLEECKER ER: Inhibition of exercise-induced bronchospasm by zileuton: a 5-lipoxigenase inhibitor. Am. J. Respir. Grit. Care Med. (1996) 153:931–935.
  • JONES TR, LABELLE M, BELLEY Met al.: Pharmacology of montelukast sodium (Singulair), a potent and selective leukotriene D4 receptor antagonist. Can. J. Physiol Pharmacol (1995) 73:191–201.
  • DE LEPELEIRE I, REISS TF, ROCHETTE F et al.: Montelukast causes prolonged, potent leukotriene D4-receptor antagonism in the airways of patients with asthma. OM. Pharmacol Ther. (1997) 61:83–92.
  • STERK PJ, FABBRI LM, QUANJER PH et al.: Airway responsiveness: standardized challengetesting with pharmacological, physical and sensitizing stimuli in adults. Eur. Respir: J. (1993) 16:53–83.
  • HANSEN-FLASCHEN J: New treatmentsfor Exercise-Induced Asthma. N Eng] J. Med. (1998) 339:192–193.
  • ADELMAN A: Montelukast for mild and exercise-induced asthma. J. Fam. Practice (1998) 47:335.
  • PEARLMAN DS, OSTROM NK, BRONSKY EA, BONUCCELLI CM, HANBY LA: The leukotriene D4-receptor antagonist zafirlukast attenuates exercise-induced bronchoconstriction in children. J. Pediam (1999) 134:273–279.
  • CORENO A, SKOWRONSKI M, KOTARU C, McFADDEN ER JR: Comparative effects of long-acting beta2-agonists, leukotriene reeceptor antagonists, and a 5-lipoxigenase inhibitor on exercise-induced asthma. J. Allergy Clin. Immunol (2000) 106:500–506.
  • ADELROTH E, INMAN MD, SUMMERS E, PACED, MODI M, O'BYRNE PM: Prolonged protection against exercise- induced bronchoconstriction by the leukotriene D4-receptor antagonist cinalukast. j Allergy OM. Immuriol (1997) 99:210–215.
  • WILSON AM, DEMPSEY OJ, SIMS EJ, LIPWORTH BJ: A comparison of topical budesonide and oral montelukast in seasonal allergic rhinitis and asthma. OM. Exper. Allergy (2001) 31:616–624.
  • ••A recent study on the use of montelukastand topical steroid in allergic rhinitis and asthma with particular interest on both efficacy on lower airway and rhinitis symptoms.
  • MANAGEMENT OF ALLERGIC RHINITIS AND ITS IMPACT ON ASTHMA WORKSHOP REPORT (ARIA): In: A Pocket Guide For Physicians And Nurse (2001).
  • INTERNATIONAL CONSENSUS REPORT ON THE DIAGNOSIS AND MANAGEMENT OF RHINITIS: INTERNATIONAL RHINITIS MANAGEMENT WORKING GROLP. Allergy (1994) 49\(Suppl. 19):1–34.
  • ISRAEL E, COHN J, DUBE L, DRAZEN JM, THE ZILEUTON STUDY GROUP: Effect of treatment with zileuton, a 5-lipoxygenase inhibitor, in patients with asthma. JAMA (1996) 275:931–936.
  • ADKINS J, BROGDEN R: Zafirlukast. A review of its pharmacology and therapeutic potential in the management of asthma. Drugs (1998) 55:121–124.
  • STIRLING RG, CHUNG KF: Leukotriene antagonist and Churg-Strauss syndrome: the smoking gun. Thorax (1999) 54:865–866.
  • •Consideration on the Churg-Strauss syndrome and its relation to antiLT therapy.
  • KNOELL DL, LUCAS J, ALLEN JN: Churg-Strauss syndrome associated with zafirlukast. Chest (1998) 114:332–334.
  • WECHSLER ME, GARPESTAD E, FLIER SR et al.: Pulmonary infiltrates, eosinophilia and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA (1998) 279:455–457.
  • GREEN R, VAYONIS A: Churg-Strauss syndrome after zafirlukast in two patients not receiving systemic steroid treatment. Lancet (1999) 353:725-726. Dm. D'CRUZ DP, BARNES NC, LOCKWOOD CM: Difficult asthma or Churg-Strauss syndrome? BMJ(1999) 318:475–476.
  • MERCK SHARP & DOHME: Montelukast product monograph. New Jersey, USA (March 1998).
  • GLOBAL INITIATIVE FOR ASTHMA MANAGEMENT AND PREVENTION (GINA): NHI publication no 97–4051, (April 1997).
  • PASSALACQUA G, CIPRANDI G, CANONICA GW: United airways disease: therapeutic aspects. Thorax (2000) 55\(Suppl. 2):S26–S27.
  • •A new approach for the evaluation of the respiratory system in vivo.

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