Asthma is a chronic inflammatory disease of the airways characterized by an infiltration of the airways by inflammatory cells including eosinophils, mast cells, and T lymphocytes. Inhaled corticosteroids remain a first-line therapy for the control of inflammation in patients with asthma. However, it appears that suppression of inflammation may not be complete, and the effect of inhaled corticosteroids on cysteinyl-leukotriene (cys-LT) biosynthesis is lim-ited. cys-LTs are important inflammatory mediators of asthma produced by the 5-lipoxygenase pathway predominantly in the mast cells and eosinophils. cys-LTs cause constriction of airway muscle, increase microvascular permeability, stimulate mucus secretion, repair ciliary activity, and induce smooth-mus-cle cell proliferation. Allergen-induced eosino-philia and bronchoconstriction are in part mediated by cys-LTs (https://onlineasthmainhalers.com/deliberation-of-the-effect-of-sch-1000-and-disodium-cromoglycate-on-exercise-induced-asthma.html). Increased amounts of cys-LTs have been found in BAL in patients with asthma and in exhaled breath condensate (EBC) in adults and children with asthma.
Leukotriene B4 (LTB4) is a potent chemoattrac-tant and activator of neutrophils but has no significant effects on airway smooth muscle. Inhalation of LTB4 increases the number of neutrophils in the alveolar spaces. LTB4 has been found at sites of inflammation in which neutrophils are in close proximity. LTB4 has also been found to be a potent stimulator of T-cell migration.
Montelukast is a cys-LT antagonist that improves asthma control in children and in adults, and is effective in the prevention of exercise-induced bron-choconstriction. Leukotriene receptor antagonists improve pulmonary function, reduce asthma symptoms, and decrease the use of rescue bronchodila-tors, and may prevent exacerbations of asthma. Influence of passive smoking on pulmonary function see on https://onlineasthmainhalers.com/outcomes-of-passive-smoking-on-lung-function-and-airway-reactivity-in-asthmatic-subjects.html. Addition of a cys-LT antagonist to inhaled corticosteroids in patients with uncontrolled asthma has been shown to improve the control of asthma. However, several studies have shown that not all patients treated with cys-LT antagonists will have a significant clinical improvement, and no factors have been identified to reliably predict the clinical response to cys-LT antagonists. Artile about terbutaline treatment in childhood you can read on our site.
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The aim of this study was to examine the effect of treatment with montelukast on exhaled markers of inflammation (cys-LTs and LTB4), asthma quality of life (AQL), exhaled nitric oxide (NO), and respiratory function in patients with asthma who were already receiving with inhaled corticosteroids. This study was conducted in a primary care setting.