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Cough, asthma, and cysteinyl-leukotrienes
1Dept of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. a.niimi@med.nagoya-cu.ac.jp
Pulmonary Pharmacology & Therapeutics
|June 19, 2013
Summary
Leukotriene receptor antagonists (LTRAs) like montelukast reduce cough in cough variant asthma (CVA) by decreasing airway inflammation, not by bronchodilation. This suggests a novel anti-inflammatory mechanism for cough suppression in CVA patients.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Pharmacology
Background:
- Asthma is a chronic airway inflammatory disease.
- Leukotrienes are key mediators in asthma pathophysiology.
- Cough variant asthma (CVA) presents solely with cough, with elevated leukotrienes.
Purpose of the Study:
- To investigate the mechanism of action of leukotriene receptor antagonists (LTRAs) in cough variant asthma (CVA).
- To determine if LTRAs exert antitussive effects through anti-inflammatory actions or bronchodilation.
Main Methods:
- A 4-week treatment with montelukast (an LTRA) was administered to CVA patients.
- Evaluated changes in sputum eosinophils, cough visual analog scale (VAS), capsaicin cough sensitivity, spirometry, and airway responsiveness.
- Measured sputum levels of various inflammatory mediators.
Main Results:
- Montelukast significantly reduced sputum eosinophils and attenuated cough VAS and capsaicin cough sensitivity.
- No significant changes were observed in spirometry, airway responsiveness, or sputum mediator levels.
- The anti-inflammatory effect of montelukast in CVA appears independent of bronchodilation.
Conclusions:
- The antitussive effect of montelukast in CVA is primarily mediated by its anti-inflammatory properties, not bronchodilation.
- LTRAs may offer a distinct therapeutic mechanism for cough suppression in CVA compared to corticosteroids.
- Further research is needed to fully elucidate the non-specific antitussive effects of LTRAs.
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