Sulphidopeptide leukotrienes in asthma.

No single mediator is responsible for the clinical and pathological events in bronchial asthma. Nevertheless, there is now substantial evidence that the sulphidopeptide leukotrienes play an important role in the pathophysiology of the disease. They are potent in eliciting bronchoconstriction, mucus production and vasodilatation, and may enhance the airways hyperresponsiveness that is characteristic of the disease. The sulphidopeptide leukotrienes are present in the airways of asthmatic patients and their release has been demonstrated in acute severe asthma. They are released during asthmatic attacks provoked by a range of stimuli. The evidence from studies using sulphidopeptide leukotriene antagonists and 5-LO inhibitors suggests strongly that sulphidopeptide leukotrienes contribute to the resting asthmatic airways tone and to the asthmatic responses elicited by exercise, allergen, aspirin and cold, dry air challenges. These mediators may also contribute to the airways hyperresponsiveness induced by allergen challenge of sensitized subjects. Preliminary results indicate that the administration of leukotriene receptor antagonists and 5-LO inhibitors may benefit patients with chronic asthma. Further studies are now needed to define better the role of these novel drugs in the management of the disease.