LEUKOTRIENE-RECEPTOR-ANTAGONISTS, 5-LIPOX YGENASE-INHIBITORS, AND 5-LIPOXYGENASE-ACTIVATING-PROTEIN-INHIBITORS - A NEW FORM OF THERAPY IN BRONCHIAL-ASTHMA

Several mediators have been implicated in the pathogenesis of bronchia l asthma. In contrast, however, to several of these bronchoconstrictor s experimental as well as clinical studies with leukotriene C4, D4 and E4-antagonists or leukotriene-synthesis-inhibitors have provided clea r evidence that leukotrienes participate in the pathogenesis and patho physiology of asthmatic bronchoconstriction. The mode of action of the se compounds is additive to beta(2)-agonists and inhaled corticosteroi ds. Due to the improvement in lung function and the abrogation of the allergic late phase reaction leukotriene-antagonists as well as 5-lipo xygenase-inhibitors and 5-lipoxygenase-activating-protein-inhibitors m ight also have anti-inflammatory properties. Newer compounds currently in phase II and phase III studies have only minor side effects. Leuko triene-antagonists as well as leukotriene-synthesis-inhibitors are bei ng developed which can also be taken by inhalation. Increasing data su ggests that antagonism of leukotrienes might have disease-modifying pr operties which could lead to the implementation of these compounds as first-line-drugs in the treatment of allergic as well as intrinsic ast hma. Thus, leukotriene-receptor-antagonists, 5-lipoxygenase-inhibitors and FLAP-inhibitors provide a promising new class of drugs for the tr eatment of acute as well as chronic asthma. The majority of compounds currently under investigation provides rapid, long-lasting bronchodila tion. It is likely that this completely new possibility of anti-asthma tic therapy with its remarkable efficacy and its possible anti-inflamm atory properties will revolutionise the treatment of asthma in the fut ure.