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Allergic Rhinitis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
AR is the most prevalent allergic disease in children and may have significant effects on their quality of life. The treatment algorithm for children is broadly similar to that for adults. Avoidance measures then, if necessary, and an oral non-sedating antihistamine are the first-line therapies, but a trial of a leukotriene receptor antagonist may be considered in children who are already using an inhaled steroid for asthma, or if a topical steroid is not tolerated. Fluticasone (licensed from age 4 years) or mometasone (licensed from 6 years) have low systemic bioavailability and are the topical corticosteroids of choice.
Rosmarinic Acid: A Boon in the Management of Cardiovascular Disease
Published in Mahfoozur Rahman, Sarwar Beg, Mazin A. Zamzami, Hani Choudhry, Aftab Ahmad, Khalid S. Alharbi, Biomarkers as Targeted Herbal Drug Discovery, 2022
Md. Adil Shaharyar, Mahfoozur Rahman, Kumar Anand, Chowdhury Mobaswar Hossain, Imran Kazmi, Sanmoy Karmakar
For long natural compounds have been investigated in the treatment of inflammations specially those having potential either to reduce or eliminate the synthesis of leukotriene. These natural compounds ideally should have no adverse effects.
Non-pharmacological management of asthma-related issues in athletes
Published in John W. Dickinson, James H. Hull, Complete Guide to Respiratory Care in Athletes, 2020
Neil C. Williams, Michael A. Johnson, Emily M. Adamic, Timothy D. Mickleborough
The sodium and chloride ions in dietary salt both play a role in airway reactivity. Reducing either sodium or chloride ions can ameliorate EIB, while reducing both can have an additive effect. While the precise mechanism is unknown, salt could act directly to increase bronchial smooth muscle tone and contractility via disruption of ion balance across the smooth muscle cell membrane. Alternatively, these ions could act indirectly by (1) increasing blood volume and thus pulmonary capillary volume, which increases airway compression and/or (2) increasing airway surface liquid osmolarity and hypertonicity, which induces the release of pro-inflammatory mediators such as leukotrienes and prostaglandins. These leukotrienes are responsible for the inflammatory response.
Montelukast, a cysteinyl leukotriene receptor antagonist, exerts local antinociception in animal model of pain through the L-arginine/nitric oxide/cyclic GMP/KATP channel pathway and PPARγ receptors
Published in International Journal of Neuroscience, 2021
Ehsan Alizamani, Behnam Ghorbanzadeh, Reza Naserzadeh, Mohammad Taghi Mansouri
Leukotrienes are eicosanoids that are generated from arachidonic acid by 5-lipoxygenase via biochemical pathways [2]. Leukotrienes are potent pro-inflammatory mediators involved in the pathophysiology of various inflammatory conditions such as asthma, rheumatoid arthritis, ulcerative colitis, and pain [3–5]. Montelukast, cysteinyl leukotriene (CysLT) receptor antagonist, is widely used in the treatment of bronchial asthma [6]. Moreover, montelukast may possess anti-inflammatory properties that are distinct from conventional antagonism of CysLT receptors including interference with activation of the transcription factor, nuclear factor kappa B in inflammatory cells, promotion of sustained production of interleukin-10 or inhibition of P2Y receptors [7,8]. Furthermore, Fermor et al. (2001) demonstrated the role of nitric oxide (NO) in the regulation of Leukotrienes B4 expression [9]. On the other hand, it has been shown that the cysteinyl leukotrienes LTC4 and LTD4, as well as LTB4, activate NO release from human polymorphonuclear granulocytes by surface receptor [10]. Moreover, it has been reported that montelukast reduces the levels of exhaled nitric oxide in patients with mild asthma [11].
Pediatric use of omalizumab for allergic asthma
Published in Expert Opinion on Biological Therapy, 2020
Giovanni Battista Pajno, Riccardo Castagnoli, Stefania Arasi, Amelia Licari, Lucia Caminiti, Gian Luigi Marseglia
In 2014, a task force of the American Thoracic Society (ATS) and European Respiratory Society (ERS) updated the definition of severe asthma in pediatric patients (older than six years). According to the latter, ‘children affected by severe asthma require treatment with high-dose ICSs and either a long-acting beta-agonist or a leukotriene antagonist for the previous year or systemic corticosteroids for at least 50% of the previous year to prevent uncontrolled asthma or asthma that remains uncontrolled despite this therapy’ [3]. Although severe asthma affects about 5% of children in westernized countries [10,11], it is associated with a relevant economic burden due to frequent and serious symptoms needing increased medical resource use and higher health expenses. Moreover, the increase in the number of parent’s working days lost during pediatric asthma exacerbations is associated with less global economic productivity [12].
The pharmacological management of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS)
Published in Expert Opinion on Pharmacotherapy, 2020
Timothy E. Albertson, James A. Chenoweth, Skyler J. Pearson, Susan Murin
Leukotriene pathway modifiers including both leukotriene synthesis inhibitors and receptor antagonists are widely available and used in asthma and other atopic diseases. The cysteinyl leukotrienes (cys-LT) which include C4, D4 and E4 are formed by arachidonic acid precursors acted on by 5-lipoxygenase enzyme activity that then attract eosinophils and interact at cys-LT receptors on the outer plasma membrane of monocytes, macrophages, eosinophils, mast cells and smooth muscle cells of the airway [106]. Two agents that antagonize the cys-LT receptor (LRA) are available in the US and Europe (montelukast and zafirlukast) and pranlukast is also available in Japan. The second class of leukotriene pathway modulators is an inhibitor of the 5-lipoxygenase enzyme that inhibits the synthesis of both cysteinyl leukotrienes (LTC4, LTD4, and LTE4) and leukotriene B4 (LTB4) (zileuton).