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Montelukast: more than a cysteinyl leukotriene receptor antagonist?Tintinger GR; Feldman C; Theron AJ; Anderson RScientificWorldJournal 2010[Dec]; 10 (ä): 2403-13The prototype cysteinyl leukotriene receptor antagonist, montelukast, is generally considered to have a niche application in the therapy of exercise- and aspirin-induced asthma. It is also used as add-on therapy in patients whose asthma is poorly controlled with inhaled corticosteroid monotherapy, or with the combination of a long-acting beta(2)-agonist and an inhaled corticosteroid. Recently, however, montelukast has been reported to possess secondary anti-inflammatory properties, apparently unrelated to conventional antagonism of cysteinyl leukotriene receptors. These novel activities enable montelukast to target eosinophils, monocytes, and, in particular, the corticosteroid-insensitive neutrophil, suggesting that this agent may have a broader spectrum of anti-inflammatory activities than originally thought. If so, montelukast is potentially useful in the chemotherapy of intermittent asthma, chronic obstructive pulmonary disease, cystic fibrosis, and viral bronchiolitis, which, to a large extent, involve airway epithelial cell/neutrophil interactions. The primary objective of this mini-review is to present evidence for the cysteinyl leukotriene-independent mechanisms of action of montelukast and their potential clinical relevance.|Acetates/pharmacology/*therapeutic use[MESH]|Anti-Asthmatic Agents/pharmacology/*therapeutic use[MESH]|Anti-Inflammatory Agents/pharmacology/*therapeutic use[MESH]|Asthma/drug therapy[MESH]|Cyclopropanes[MESH]|Humans[MESH]|Leukotriene Antagonists/pharmacology/therapeutic use[MESH]|Neutrophils/drug effects/metabolism[MESH]|Pulmonary Disease, Chronic Obstructive/drug therapy[MESH]|Quinolines/pharmacology/*therapeutic use[MESH]|Receptors, Leukotriene/metabolism[MESH]|Sulfides[MESH] |
