Prevention of severe premenstrual asthma attacks by leukotriene receptor antagonist☆,☆☆
Section snippets
Subjects
Forty-five consecutive women aged 16 to 43 years attending an outpatient clinic for asthma were asked about the variation of their asthma during the menstrual cycle. The questionnaire included questions about the timing of any exacerbation in relation to menstruation, the frequency with which this occurred, the term of incidence, the frequency of admission, and the use of antiasthma drugs. Patients were also asked to record their peak expiratory flow rates (PEFRs) twice daily with use of a
RESULTS
In 5 patients with PMA, serum levels of LTC4 were significantly higher during PMA compared with those in the midcycle week (69.0 ± 16.0 pg/mL vs 24.0 ± 9.5 pg/mL, P < .05). In contrast, histamine (0.1 ± 0.1 ng/mL vs 0.1 ± 0.1 ng/mL, P > .50), IL-1β (0.3 ± 0.1 pg/mL vs 0.4 ± 0.4 pg/mL, P > .50), IL-4 (not detectable), IL-5 (not detectable), IL-6 (0.8 ± 0.4 pg/mL vs 0.4 ± 0.2 pg/mL, P > .20), GM-CSF (not detectable), LTB4 (151 ± 44 pg/mL vs 263 ± 166 pg/mL, P > .10) or PAF (not detectable) did
DISCUSSION
The current study shows that serum levels of LTC4 were increased during PMA and that PMA was attenuated by the LT receptor antagonist pranlukast. Although the origin of cysteinyl LTs in the sera is uncertain, there are several candidates, including T lymphocytes, basophils, and mast cells, that orchestrate airway inflammation in asthma.
Several studies have shown the influence of female sex steroids on inflammatory cells such as mast cells and basophils. Vliagoftis et al12 reported that estrogen
Acknowledgements
We thank Mr G. Crittenden for correcting the English.
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2017, Pharmacological ResearchPremenstrual asthma and leukotriene variations in the menstrual cycle
2012, Allergologia et ImmunopathologiaCitation Excerpt :Table 1 shows the baseline patient characteristics (age, weight and spirometry readings) of the cases studied. The results reveal that 34 women with asthma (53.4%; 95%CI: 42.4–66.9%) suffered a premenstrual deterioration in symptoms and/or peak flow of ≥20%, although none reached serious levels of more than 40% (severe PMA).15 The frequency of PMA did not increase with the severity of asthma: six women with PMA were mild intermittent (6/20: 30%), 12 mild persistent (12/15: 80%), seven moderate persistent (7/11: 63.6%) and nine severe persistent (9/16: 56.3%), with no linear association (p = 0.171), and where denominators represent the total sample at each level of severity.
Clinical characteristics of women with menstrual-linked asthma
2012, Respiratory MedicineCitation Excerpt :More importantly a majority of published clinical studies have used self-report as a method for identifying women with MLA, and a review of that literature suggests that it is a valid method to define MLA. In Table 4 we identified five studies that measured physiologic parameters in self-identified MLA cohorts confirming non-parallel changes in premenstrual PEF that discriminated MLA from non-MLA.1,3,4,7,12 Despite these reassuring findings, we cannot exclude the possibility that we misclassified some subjects by utilizing self-reported MLA as our case definition.
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Reprint requests: Hidetada Sasaki, MD, Department of Geriatric Medicine, Tohoku University School of Medicine, Aoba-ku Seiryo-machi 1-1, Sendai 980, Japan.
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0091-6749/99 $8.00 + 0 1/1/100802