Editorial
Leukotriene antagonists and Churg-Strauss syndrome: the smoking gun
| The first 150 words of the full text of this article appear below. |
The cysteinyl leukotrienes, leukotriene C4 (LTC4), LTD4, and LTE4 are pro-inflammatory agents previously known as the "slow reacting substances of anaphylaxis". These arachidonic acid derivatives have broad ranging pro-inflammatory actions including airway smooth muscle contraction and bronchoconstriction, increase in vascular permeability, increase in mucus secretion, and inflammatory cell infiltration of lung tissue.1 The leukotriene receptor antagonists (LTRAs) zafirlukast, pranlukast, and montelukast block the effects of these mediators and are the most recently released agents with potential anti-inflammatory action for use in asthma.2 They are antagonists of LTC4, LTD4, and LTE4 and act as selective competitive antagonists of the cysteinyl leukotriene (CysLT1) receptor, as distinct from the 5-lipoxygenase inhibitor zileuton.
An association between LTRAs and Churg-Strauss syndrome (CSS) has
recently been suggested by a series of published case reports. CSS is a
rare systemic vasculitis whose characteristic features include
extravascular eosinophil infiltration/vasculitis, peripheral eosinophilia, and asthma. The case reports published
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