- Antileucotrieni nell’asma e nella rinite allergica

Summary. The cysteinyl leukotrienes are pro-inflammatory molecules which have been implicated in the pathophysiology of asthma, and whose synthesis is not inhibited by corticosteroids. The leukotriene receptor antagonists are a novel class of anti-inflammatory asthma therapy. A number of studies have documented beneficial effects on inflammatory mediators and bronchial hyper-reactivity. They are inferior to inhaled steroids as monotherapy in older children, but may be useful add-on treatment if symptoms persist despite a moderate dose of inhaled steroids. The response of an individual is unpredictable. In pre-school children, they may also be effective add-on treatments, or be used as the sole agent for viral wheeze. They may be useful in troublesome exercise induced symptoms, but are not indicated for acute severe asthma in children. Unfortunately, much of our information derives from adult studies, and this is a pity because the phenotypes of paediatric asthma are very different. More work is needed for us to understand the optimal roles of these novel and exciting compounds.