The leukotriene receptor antagonist montelukast and its possible role in the cardiovascular field

Background Cysteinyl leukotrienes (LTC4, LTD4, and LTE4) are pro-inflammatory mediators of the 5-lipooxygenase (5-LO) pathway, that play an important role in bronchoconstriction, but can also enhance endothelial cell permeability and myocardial contractility, and are involved in many other inflammat...

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Bibliographic Details
Published in:European journal of clinical pharmacology 2017-07, Vol.73 (7), p.799-809
Main Authors: Hoxha, Malvina, Rovati, G. Enrico, Cavanillas, Aurora Bueno
Format: Article
Language:English
Subjects:
Acetates - pharmacology
Acetates - therapeutic use
Allergic rhinitis
Animals
Antagonist drugs
Arachidonate 5-Lipoxygenase - metabolism
Arachidonic Acid - metabolism
Arteriosclerosis
Asthma
Atherosclerosis
Biomedical and Life Sciences
Biomedicine
Bronchoconstriction
Cardiovascular disease
Cardiovascular Diseases - metabolism
Cardiovascular Diseases - prevention & control
Cell permeability
Chronic obstructive pulmonary disease
Clinical trials
Contractility
Disease prevention
Humans
Inflammation
Leukotriene Antagonists - pharmacology
Leukotriene Antagonists - therapeutic use
Leukotrienes
Lung diseases
Montelukast
Obstructive lung disease
Permeability
Pharmacology
Pharmacology/Toxicology
Quinolines - pharmacology
Quinolines - therapeutic use
Review
Rhinitis
Signal Transduction
Urticaria
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Summary:Background Cysteinyl leukotrienes (LTC4, LTD4, and LTE4) are pro-inflammatory mediators of the 5-lipooxygenase (5-LO) pathway, that play an important role in bronchoconstriction, but can also enhance endothelial cell permeability and myocardial contractility, and are involved in many other inflammatory conditions. In the late 1990s, leukotriene receptor antagonists (LTRAs) were introduced in therapy for asthma and later on, approved for the relief of the symptoms of allergic rhinitis, chronic obstructive pulmonary disease, and urticaria. In addition, it has been shown that LTRAs may have a potential role in preventing atherosclerosis progression. Purpose The aims of this short review are to delineate the potential cardiovascular protective role of a LTRA, montelukast, beyond its traditional use, and to foster the design of appropriate clinical trials to test this hypothesis. Results and Conclusions What it is known about leukotriene receptor antagonists? •Leukotriene receptor antagonist, such as montelukast and zafirlukast, is used in asthma, COPD, and allergic rhinitis. • Montelukast is the most prescribed CysLT 1 antagonist used in asthmatic patients. • Different in vivo animal studies have shown that leukotriene receptor antagonists can prevent the atherosclerosis progression, and have a protective role after cerebral ischemia. What we still need to know? • Today, there is a need for conducting clinical trials to assess the role of montelukast in reducing cardiovascular risk and to further understand the mechanism of action behind this effect.
ISSN:0031-6970
1432-1041
DOI:10.1007/s00228-017-2242-2