Efficacy of leukotriene receptor antagonists and synthesis inhibitors in asthma

J Allergy Clin Immunol. 2009 Sep;124(3):397-403. doi: 10.1016/j.jaci.2009.05.029. Epub 2009 Jul 16.


Cysteinyl leukotrienes are important mediators of asthmatic responses. They are the most potent bronchoconstrictors known; their release is triggered by exposure to inhaled allergens after exercise and after aspirin ingestion by subjects with aspirin-sensitive asthma. The cysteinyl leukotrienes promote inflammatory cell migration into the airways, as well as bone marrow eosinophilopoiesis after allergen inhalation. Leukotriene inhibitors are effective at attenuating asthmatic responses to all of these stimuli and are also effective at treating persistent asthma. These drugs are a viable alternative to low-dose inhaled corticosteroid (ICS) treatment but should be reserved for patients who cannot or will not use ICSs, often because of concerns about potential side effects of ICS treatment, which limits their use, particularly in children. Leukotriene receptor antagonists are also alternatives to long-acting inhaled beta(2)-agonists as add-on therapy to ICSs, but their efficacy together with ICSs is less than that of ICS/long-acting inhaled beta(2)-agonist combinations. Leukotriene receptor antagonists have an excellent safety profile.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Allergens / immunology
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / immunology
  • Cysteine / immunology
  • Cysteine / metabolism
  • Eosinophils / cytology
  • Eosinophils / immunology
  • Humans
  • Immunologic Factors / immunology
  • Immunologic Factors / metabolism
  • Leukotriene Antagonists / therapeutic use*
  • Leukotrienes / immunology
  • Leukotrienes / metabolism


  • Adrenal Cortex Hormones
  • Allergens
  • Anti-Asthmatic Agents
  • Immunologic Factors
  • Leukotriene Antagonists
  • Leukotrienes
  • cysteinyl-leukotriene
  • Cysteine