Histamine Antagonists ; therapeutic use ; Humans ; Leukotriene Antagonists ; therapeutic use ; Rhinitis, Allergic, Perennial ; drug therapy

Acetates ; adverse effects ; pharmacology ; therapeutic use ; Animals ; Asthma ; drug therapy ; Humans ; Leukotriene Antagonists ; pharmacology ; Quinolines ; adverse effects ; pharmacology ; therapeutic use ; Receptors, Leukotriene ; drug effects

Acetates ; therapeutic use ; Acute Disease ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; prevention & control ; Child ; Child, Preschool ; Female ; Humans ; Leukotriene Antagonists ; therapeutic use ; Male ; Quinolines ; therapeutic use

Eosinophilic esophagitis (EE) is characterized by eosinophilic infiltration of the esophageal wall including mucosa, submucosa, and muscle proper. EE is a condition involving both pediatrics and adults. Patients with EE are predominantly young males, commonly related to atopy. The typical clinical presentation includes dysphasia, food impaction, and symptoms mimicking gastroesophageal reflux disease. Endoscopic examination reveals mucosal fragility, ring or corrugated mucosa, whitish plaques, or small caliber esophagus. Histologic finding of >20 eosinophils/HPF (high power field) is the diagnostic hallmark of EE. Elemental formula, systemic or topical corticosteroid, anti-inflammatory drugs such as leukotriene receptor antagonists, anti-interleukin (IL)-5, and anti-IL-13 monoclonal antibodies have been used to manage EE. Esophageal dilation is considered in adult patients with severe obstructive symptoms due to stricture.
Adolescent ; Adult ; Antibodies, Monoclonal/therapeutic use ; Child ; Eosinophilia/*diagnosis/therapy ; Esophagitis/*diagnosis/pathology/therapy ; Esophagoscopy/methods ; Female ; Humans ; Leukotriene Antagonists/therapeutic use ; Male

OBJECTIVE: To systematically evaluate the efficacy and safety of leukotriene receptor antagonist (LTRA) combined intranasal corticosteroids in the treatment of allergic rhinitis (AR). METHOD: The randomized controlled trials (RCT) about the combined therapy of LTRA and nasal corticosteroids from January 1985 to May 2014 were searched in OVID, PubMed, EMBASE, CNKI, WanFang Data, and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality. Then meta-ana- lyses were conducted by using RevMan 5.1 software. RESULT: A total of 5 RCTs were included upon literature search. The results of meta-analyses showed that the efficacy of nasal corticosteroids plus LTRA was superior to nasal corticosteroids alone in total nasal symptom scores and individual nasal symptom scores (rhinorrhea, sneezing) [WMD = -4.49, 95% CI (-4.95(-)-4.03)-, P < 0.01; WMD = -0.43, 95% CI (-0.78(-)-0.07), P < 0.05; WMD = -0.10, 95% CI (-0.6(-)-0. 04), P < 0.01], with significant differences. However, compa- ring the subgroup treated with nasal corticosteroids combined LTRA against the subgroup treated with nasal corti- costeroids alone, we found no significant differences for RQLQ score and for individual nasal symptom scores (nasal blockage, nasal itching) [WMD = -15.19, 95% CI (-55.37(-)-25. 00), P > 0.05; WMD = 0.01, 95% CI(-) 0.06-0.08), P > 0. 05; WMD = -0.15,95% CI (-0.43(-)-0.13), P > 0.05]. CONCLUSION Based on limited evidence, we preliminary concluded the combined therapy of nasal corticosteroids and LTRA was more effective than nasal corticosteroids alone in the management of AR. Further large-scale, well-designed RCTs were still required to validate the add-on efficacy of LTRA for AR patients.
Administration, Intranasal ; Adrenal Cortex Hormones ; therapeutic use ; Drug Therapy, Combination ; Humans ; Leukotriene Antagonists ; therapeutic use ; Nose ; Randomized Controlled Trials as Topic ; Rhinitis, Allergic ; drug therapy

OBJECTIVE: Study the practicability of non-surgical treatment for adenoidal hypertrophy. METHOD: Fifty-seven children were recruited in a randomized,placebo-controlled trial. Group T1 underwent intranasal corticosteroids treatment, group T2 underwent leukotriene receptor antagonists treatment, group C underwent placebo treatment:the records of 3 groups were analyzed. RESULT: After a 12-week treatment with intranasal corticosteroids or leukotriene receptor antagonists, group T1 and T2 patients demonstrated significant improvements in clinical symptoms and a more-pronounced reduction in adenoid size compared with control group patients, the difference was statistically significant. No statistically significant difference in group T1 and T2 patients. CONCLUSION Intranasal corticosteroids and leukotriene receptor antagonists may be considered useful in decreasing adenoid pad size and the severity of symptoms related to adenoidal hypertrophy. Children with adenoidal hypertrophy should be considered for non-surgical treatment before surgery is planned.
Adenoids ; pathology ; Administration, Intranasal ; Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Hypertrophy ; drug therapy ; Leukotriene Antagonists ; administration & dosage ; therapeutic use ; Male

OBJECTIVESTo assess the hemodynamic, oxygen-dynamic and ventilative effects of Zafirlukast in chronic obstructive pulmonary disease (COPD) induced chronic cor pulmonale at acute exacerbation stage and the mechanisms of Zafirlukast efficacy.

METHODSEleven cases of chronic cor pulmonale at acute exacerbation were examined using Swan-Ganz catheter and peripheral intra-artery catheter. The hemodynamic, oxygen-dynamic parameters and respiratory rate, plasma endothelium-1 (ET-1) level, and urea leukotriene E(4) (LTE(4)) level were measured before and at the 1st, 3rd, 5th, 7th, 9th, 12th hour after taking 40 mg Zafirlukast orally. Arterial and mixed venous blood gas analyses were done correspondingly.

RESULTSThe average pulmonary arterial pressure (mPAP) and pulmonary vascular resistance index (PVRI) were lowered at the 3rd hour after taking Zafirlukast by 23% and 36.5%, respectively. They returned to the baseline around 12th hour. Respiratory rate decreased significantly within the 3rd-7th hour after taking Zafirlukast. LTE(4) and ET-1 levels lowered at the 3rd hour and showed a positive correlation with change of mPAP.

CONCLUSIONSZafirlukast can reduce mPAP, pulmonary vascular resistance (PVR) and does not affect the ambulatory blood pressure monitoring (ABPM) and oxygenation in cases of chronic cor pulmonale at acute exacerbation stage. Zafirlukast may play a role as an alternative to decrease PAP in COPD patients.

Aged ; Female ; Hemodynamics ; drug effects ; Humans ; Hypertension, Pulmonary ; drug therapy ; Leukotriene Antagonists ; therapeutic use ; Leukotriene E4 ; urine ; Male ; Oxygen ; metabolism ; Pulmonary Disease, Chronic Obstructive ; complications ; Respiration ; drug effects ; Tosyl Compounds ; therapeutic use

OBJECTIVE: : To investigate the effects of cysteinyl leukotrienes receptor (CysLTR) antagonists on global cerebral ischemia/reperfusion (CI/R) injury in gerbils, and to explore its mechanism. METHODS: : Totally 40 gerbils weighting 45-65 g were randomized into sham, saline, Pranlukast and HAMI 3379 groups with 10 animals in each. The CI/R model was established in gerbils by bilateral common carotid occlusion for 10 min followed by reperfusion. After ischemia, the CysLTR antagonists Pranlukast (0.1 mg/kg) and HAMI 3379 (0.1 mg/kg) were injected intraperitoneally for 5 consecutive days in the last two groups,while the former two groups were injected with saline only (10 mL/kg). After 24 h or 14 d reperfusion, neurological deficit score was evaluated and the behavioral dysfunction was assessed, respectively. And 14 d after reperfusion, the neuron morphology of cerebral cortex was observed in brain sections stained with Cresyl violet. In addition, the Iba-1 (microgila) and GFAP (astrocyte) positive cells in cerebral cortex were observed by using immunohistochemitry method. RESULTS: : CI/R models were successfully established in 21 out of 30 gerbils with 7 in saline group, 6 in Pranlukast group, and 8 in HAMI 3379 group. Compared with saline group, Pranlukast and HAMI 3379 significantly attenuated neurological deficits, improved the behavioral function 24 h after reperfusion(all <0.01); Pranlukast and HAMI 3379 also significantly improved the behavioral function 14 days after reperfusion(<0.05 or <0.01). Compared with saline group, the neurological symptom scores in Pranlukast and HAMI 3379 groups presented a trend of amelioration 14 d after reperfusion, but it was not significant(>0.05). In addition, Pranlukast and HAMI 3379 also inhibited the neuron loss and injury, suppressed microgila and astrocyte activation 14 d after reperfusion(all <0.01). CONCLUSIONS : CysLTR antagonists Pranlukast and HAMI 3379 have long-term neuroprotective effect on chronic brain injury induced by global cerebral ischemia/reperfusion in gerbils.
Animals ; Behavior, Animal ; drug effects ; Brain Injury, Chronic ; drug therapy ; Brain Ischemia ; Gerbillinae ; Leukotriene Antagonists ; pharmacology ; therapeutic use ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Random Allocation ; Receptors, Leukotriene ; metabolism ; Reperfusion Injury ; drug therapy

OBJECTIVE: To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine. METHOD: The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated. RESULT: The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P < 0.05]. The level of LTD4 in nasal discharge was positively correlated with the percentage of neutrophil (r = 0.453, P < 0.05) and IL-5 (r = 0.364, P < 0.05). The pre- and post-therapy concentrations of nasal discharge and plasma in group CA were (812 +/- 1592) pg, (657 +/- 495) pg and (5422 +/- 935) ng/L, (4589 +/- 1057) ng/L respectively; While in group CB the concentrations were (776 +/- 227) pg, (860 +/- 194) pg and (5074 +/- 1850) ng/L, (6063 +/- 450) ng/L, respectively. There were no significant difference either in the level of LTD4 in nasal discharge or in plasma in both groups (all P > 0.05). CONCLUSION The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.
Adult ; Anti-Allergic Agents ; pharmacology ; Bodily Secretions ; chemistry ; Female ; Histamine H1 Antagonists ; pharmacology ; Humans ; Leukotriene Antagonists ; therapeutic use ; Leukotriene D4 ; analysis ; blood ; metabolism ; Male ; Middle Aged ; Plasma ; chemistry ; Prospective Studies ; Rhinitis, Allergic, Perennial ; blood ; drug therapy ; metabolism

Allergic rhinitis (AR) clinically expressed by sneezing, rhinorrhea, nasal itching and congestion is an allergen-driven mucosal inflammatory disease which is modulated by immunoglobulin E. Epidemiological studies have indicated that prevalence of AR continues to increase, and it has been a worldwide health problem that places a significant healthcare burden on individuals and society. Given the evolving understanding of the process by which an allergen is recognized and the roles of mediators which account for AR progress, the pathogenesis of AR has become clearer. Current studies have demonstrated local allergic rhinitis (LAR) that patients with both sug- gestive symptoms of AR and a negative diagnostic test for atopy may have local allergic inflammation is a prevalent entity in patients evaluated with rhinitis, but further research remains needed. Management of AR includes aller- gen avoidance, pharmacological treatment and allergen-specific immunotherapy. Recently montelukast has exhibited previously undocumented anti-inflammatory properties, leukotriene receptor antagonists therefore may serve a more important role in the treatment of AR. Not only has immunotherapy proved its efficacy, but also been able to alter disease course and thereby mitigate progression to asthma. Thus immunotherapy can be initiated while receiving pharmacotherapy, especially in children with AR. As clinical guidelines, the ARIA (Allergic Rhinitis and its Impact on Asthma) provides basic principles of effective treatment of AR. Besides, choosing an appropriate treatment strategy should be based on the severity and chronicity of patient's symptom. The aim of this review was to provide an update mainly on the pathophysiology, epidemiology, and management of AR.
Acetates ; therapeutic use ; Allergens ; Anti-Inflammatory Agents ; therapeutic use ; Asthma ; prevention & control ; Child ; Humans ; Hypersensitivity, Immediate ; diagnosis ; physiopathology ; Immunoglobulin E ; immunology ; Immunotherapy ; Inflammation ; physiopathology ; Leukotriene Antagonists ; therapeutic use ; Prevalence ; Quinolines ; therapeutic use ; Rhinitis, Allergic ; diagnosis ; immunology ; physiopathology