title: Leukotriene receptor antagonists pranlukast and montelukast for treating asthma.
abstract: BACKGROUND
  The prevalence of bronchial asthma, which is a chronic inflammatory disorder of the airway, is increasing worldwide. Although inhaled corticosteroids (ICS) play a central role in the treatment of asthma, they cannot achieve good control for all asthmatics, and medications such as leukotriene receptor antagonists (LTRAs) with bronchodilatory and anti-inflammatory effects often serve as alternatives or add-on drugs.
  
  
  METHODS
  Clinical trials as well as basic studies of montelukast and pranlukast in animal models are ongoing. This review report clarifies the current status of these two LTRAs in the treatment of asthma and their future direction.
  
  
  CONCLUSIONS
  LTRAs could replace ICS as first-line medications for asthmatics who are refractory to ICS or cannot use inhalant devices. Further, LTRAs are recommended for asthmatics under specific circumstances that are closely associated with cysteinyl leukotrienes (cysLTs). Considering the low incidence of both severe adverse effects and the induction of tachyphylaxis, oral LTRAs should be more carefully considered for treating asthma in the clinical environment. Several issues such as predicted responses, effects of peripheral airway and airway remodeling and alternative administration routes remain to be clarified before LTRAs could serve a more effective role in the treatment of asthma.
authors.affiliation: Nagasaki University School of Medicine, Second Department of Internal Medicine , 1-7-1 Sakamoto, Nagasaki 852-8501 , Japan +81 95 819 7273 ; +81 95 849 7285 ; hmatsuse@nagasaki-u.ac.jp.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Matsuse
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000085:Acetates / Q000627:therapeutic use*; D000818:Animals; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D002867:Chromones / Q000627:therapeutic use*; D003521:Cyclopropanes; D003545:Cysteine / Q000378:metabolism; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D015289:Leukotrienes / Q000378:metabolism; D011804:Quinolines / Q000627:therapeutic use*; D013440:Sulfides
chemical_list: D000085:Acetates; D018927:Anti-Asthmatic Agents; D002867:Chromones; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D015289:Leukotrienes; D011804:Quinolines; D013440:Sulfides; C112381:cysteinyl-leukotriene; D003545:Cysteine; C093875:montelukast; C047681:pranlukast