Paediatric Pulmonology and Allergology

2003 October, Vol. VI, No. 2 (pp.2256-2260)

Antitussive effects of leukotriene receptor antagonists

Peter V. Dicpinigaitis

The leu­kot­rie­ne re­cep­tor an­ta­go­nists rep­re­sent the ne­west class of phar­ma­co­lo­gi­cal agents avai­lab­le for the tre­at­ment of ast­hma. The leu­kot­rie­ne re­cep­tor an­ta­go­nists ha­ve be­en shown in cli­ni­cal trials to im­pro­ve ast­hma­tic symp­toms, pul­mo­na­ry func­tion, and bron­chial hy­per­res­pon­si­ve­ness. In a sub­group of ast­hma­tics with cough-va­riant ast­hma, cough is the so­le or pre­do­mi­nant symp­tom. Ini­tial anec­do­tal re­ports sug­ges­ted that leu­kot­rie­ne re­cep­tor an­ta­go­nists we­re par­ti­cu­la­ry ef­fec­ti­ve in tre­a­ting ast­hma­tic cough. A re­cent­ly pub­lis­hed stu­dy has con­fir­med the the­ra­peu­tic ef­fi­ca­cy of za­fir­lu­kast in cough-va­riant ast­hma, even in pa­tients who­se cough had be­en ref­rac­to­ry to in­ha­led bron­cho­di­la­tors and cor­ti­cos­te­roids. The me­cha­nism by which leu­kot­rie­ne re­cep­tor an­ta­go­nists sup­press ast­hma­tic cough re­mains spe­cu­la­ti­ve, but may in­vol­ve in­hi­bi­tion of eosi­nop­hi­lic air­way in­flam­ma­tion-in­du­ced sti­mu­la­tion of af­fe­rent cough re­cep­tors. The ro­le of leu­kot­rie­ne re­cep­tor an­ta­go­nists in the chro­nic  tre­at­ment of cough-va­riant ast­hma awaits de­fi­ni­tion. Long term stu­dies eva­lu­a­ting the ef­fect of leu­kot­rie­ne re­cep­tor an­ta­go­nist the­ra­py on chro­nic air­way in­flam­ma­tion and air­way re­mo­del­ling are re­qui­red (Eur Res­pir Rev 2002, 12: 272-277).

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