Pathogenetic Reasoning for Use of Monteleukast (Singlon) in Acute Respiratory Viral Infections with Broncho-Obstructive Syndrome in Infants and Preschool Age Children

Mizernitsky, Yu. L.

doi:10.21508/1027-4065-2020-65-6-129-132

Ross. vestn. perinatol. pediatr.

2021

DOI: 10.21508/1027-4065-2020-65-6-129-132

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Pathogenetic Reasoning for Use of Monteleukast (Singlon) in Acute Respiratory Viral Infections with Broncho-Obstructive Syndrome in Infants and Preschool Age Children

Yu. L. Mizernitsky

Abstract: The Article considers the argumentative issues of the diagnosis of the virus-induced bronchial asthma and recurrent obstructive bronchitis in the children of infant and preschool age, the commonality of their pathogenesis, the feasibility and efficiency of their therapy using the monteleukast – the antileukotriene receptor inhibitor. Along with the anti-inflammatory properties of the monteleukast, the potential antiviral activity discovered in it was considered, in particular, against the SARS-CoV-2 virus, whi… Show more

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Cited by 3 publications

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Clinical efficacy of antileukotriene therapy in children with acute bronchitis

Мизерницкий

Гаймоленко

Markovskaya

et al. 2023

Ross. vestn. perinatol. pediatr.

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Recurrent episodes of bronchial obstruction in preschool children are one of the important risk factors for the development of bronchial asthma.Purpose. The study aimed at investigating the clinical and immunological characteristics of children with acute bronchitis and to determine the clinical effectiveness of course anti-inflammatory therapy.Material and methods. The study was a single-center prospective cohort, including 1–5-year-old patients with acute bronchitis (main group, n = 109): a group with acute simple bronchitis (n = 34) and acute obstructive bronchitis (n = 75). Reference group: children of health group 2 (n = 29). Clinical and anamnestic and laboratory methods were used. Patients with a positive API (Asthma Predictive Index) were administered montelukast at a dose of 4 mg orally once a day for 3 months (control points at 1 and 3 months), reference patients received symptomatic therapy for respiratory infection. The end point of the study is the absence of bronchial obstruction. The effectiveness of the use of Montelukast was evaluated by calculating the clinical index, efficiency coefficient. Results. A statistically significant predominance of intoxication symptoms was found in patients with acute simple bronchitis (p = 0.02), signs of respiratory failure (p < 0.001), and peripheral eosinophilia — in children with acute obstructive bronchitis (p = 0.02). In etiology, rhinovirus significantly prevailed in patients with bronchial obstruction, and RS virus prevailed in patients with acute simple bronchitis (p = 0.02). The cytokine profile of patients with acute obstructive bronchitis is characterized by a decrease in the levels of macrophage inflammatory proteins (p = 0.01) and IL-8 (p = 0.048). A prolonged course of montelukast in children with a positive API significantly reduces the severity of subsequent acute respiratory infections, reduces the frequency of bronchial obstruction and the risk of bronchial asthma (p < 0.001).Conclusion. Evaluation of the results of montelukast therapy demonstrated clinical efficacy in patients with a positive API index.

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Clinical efficacy of antileukotriene therapy in children with acute bronchitis

Мизерницкий

Гаймоленко

Markovskaya

et al. 2023

Ross. vestn. perinatol. pediatr.

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Montelukast: results and prospects for applications in pediatric practice

Mizernitskiy,

Petrova

2024

Medicinskij sovet

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The Centers for Disease Control and Prevention reports that more than 4 million children have been diagnosed with asthma. Currently, there is no treatment that could prevent the development of asthma or change its natural course over long-term follow-up. However, the disease can be controlled using treatments used in clinical practice. For persistent asthma in children aged 5 years and younger, low doses of inhaled glucocorticosteroids are recommended, as well as the administration of montelukast, a leukotriene receptor antagonist. In addition, montelukast is prescribed to patients with allergic rhinitis as an alternative to or in combination with oral antihistamines or nasal corticosteroids. Leukotrienes are lipid mediators that play a key role in acute and chronic inflammation and allergic diseases. They exhibit their biological effects by binding to specific G-protein-coupled receptors. Each subtype of the leukotriene receptor has unique functions and expression patterns. Leukotrienes play an important role in various allergic diseases, including bronchial asthma and allergic rhinitis. Montelukast is a cysteinyl leukotriene receptor-1 antagonist widely used to suppress the inflammatory response in asthma and allergic rhinitis. This review briefly summarizes the biology of leukotrienes and their receptors, recent developments in the field of antileukotriene drugs and the prospects for their different therapeutic applications. The role of antileukotriene drugs and key indications for the use of montelukast in the complex therapy of asthma and allergic rhinitis in children have been determined.

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Leukotriene receptor antagonists in the treatment of bronchial asthma: Consensus agreement “Bronchial Asthma and LEukoTriene receptor antagonists (BALET)”

Ilyina

Avdeev

Геппе

et al. 2023

Russian Journal of Allergy

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Under the auspices of the Russian Association of Allergists and Clinical Immunologists and the Russian Pediatric Respiratory Society, an expert meeting "Leukotriene receptor antagonists in the treatment of bronchial asthma" was held. Asthma is a common non-communicable chronic disorder of the airways and is characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness, and underlying inflammation. The creation and widespread use of inhaled corticosteroids (ICS) and other innovative classes of drugs for the treatment of bronchial asthma has significantly affected the ability to achieve control over the course of the disease. Despite this, in most European countries, more than half of patients with bronchial asthma have suboptimal disease control [1]. In the past decades, a class of leukotriene receptor blockers which contributes to the suppression of chronic allergic inflammation in patients with asthma has been actively studied. The majority of studies confirm the usefulness of montelukast as monotherapy and add-on therapy to ICS in mild to moderate asthma across all age groups [12-19,21-40]. However, experts note that in practical medicine the healthcare providers continue to ask questions regarding the effectiveness and safety of this class of medicines in patients with bronchial asthma. In this consensus document, the experts considered it important to provide an unequivocal answer for clinical practice to several topical questions regarding the use of antileukotriene therapy.

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Pathogenetic Reasoning for Use of Monteleukast (Singlon) in Acute Respiratory Viral Infections with Broncho-Obstructive Syndrome in Infants and Preschool Age Children

Cited by 3 publications

References 14 publications

Clinical efficacy of antileukotriene therapy in children with acute bronchitis

Clinical efficacy of antileukotriene therapy in children with acute bronchitis

Montelukast: results and prospects for applications in pediatric practice

Leukotriene receptor antagonists in the treatment of bronchial asthma: Consensus agreement “Bronchial Asthma and LEukoTriene receptor antagonists (BALET)”

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