Corticosteroids and leukotrienes: chronobiology and chronotherapy.
Corticosteroids and leukotrienes play opposite roles in asthma. Corticosteroids, both endogenously secreted and exogenously administered, are antiinflammatory and are very effective in the treatment of asthma. They have also been evaluated chronotherapeutically and have been found to be very effective in reducing the enhanced airway inflammation and decrement in lung function associated with nocturnal worsening of asthma. Leukotrienes are potent proinflammatory and spasmogenic mediators that have been shown to be increased at night in patients with nocturnal asthma (NA). Leukotriene modifiers, a new class of medications to treat asthma, improve, but do not abolish, the symptoms and decrement in lung function associated with nocturnal asthma. However, they have not been evaluated chronotherapeutically. This article addresses the roles of corticosteroids and leukotrienes in nocturnal asthma and their position as therapeutic agents or targets for therapy.
Kraft
M
M
Department of Medicine, National Jewish Medical and Research Center, University of Colorado Health Sciences Center, Denver 80206, USA. kraftm@njc.org
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000502:physiology*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology*; D002940:Circadian Rhythm; D004334:Drug Administration Schedule; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage; D015289:Leukotrienes / Q000502:physiology*; D015656:Respiratory Mechanics
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D020024:Leukotriene Antagonists; D015289:Leukotrienes