POTENTIAL INTEREST OF LEUKOTRIENE ANTAGON ISTS AND INHIBITORS IN TREATMENT OF ASTHMA AND VARIOUS INFLAMMATORY DISEASES - A NEW PHARMACOLOGICAL CLASS

Objectives. - Among the mediators involved in the asthma bronchoconstr iction and inflammation mechanisms, there is now substantial evidence that rite sulfidopeptides leukotrienes (LTs) are important. Antagonist s of their receptors and inhibitors of their synthesis have been devel oped. Important points. - Antagonists of LTs, as well as inhibitors of their synthesis, reduce the LTs actions: bronchoconstriction, bronchi al hyperresponsiveness, hypersecretion and inflammation. They produce an acute bronchodilating effect in mild asthma, reduce the hyperrespon siveness responses due to allergens, aspirin and cold and dry air, and also cutaneous and gastrointestinal reactions. Oral administrations t ested during 4 or 6 weeks diminish the use of the beta-agonists, decre ase the asthma symptom scores and other inflammatory signs, Perspectiv es and projects. - More studies for longer periods, double blind trial s and comparisons with classical treatments will be necessary to defin e the real place of LTs antagonists ill the treatment of asthma. So th eir efficacy has to be confirmed as well as their good tolerance profi le (particularly for hepatic functions. Conclusion. - Antagonists of r eceptors and synthesis inhibitors of LTs have known a recent and impor tant development. They constitue a new therapeutic class: further stud ies are needed to better define the place of these new drugs br the tr eatment of asthma mid other inflammatory diseases. (C) 1998, Elsevier, Paris.