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Leukotrienes – Function, Effects and Treatment

Leukotrienes are pro-inflammatory signaling molecules produced by the immune system, playing a key role in asthma, allergies, and other inflammatory conditions.

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Things worth knowing about "Leukotrienes"

Leukotrienes are pro-inflammatory signaling molecules produced by the immune system, playing a key role in asthma, allergies, and other inflammatory conditions.

What Are Leukotrienes?

Leukotrienes are biologically active lipid mediators belonging to the eicosanoid family. They are primarily produced by white blood cells (leukocytes) such as mast cells, eosinophils, basophils, and macrophages. The name is derived from leukocytes and trienes, referring to the three conjugated double bonds in their chemical structure. Leukotrienes are among the most important mediators of inflammation and allergic responses in the human body.

Mechanism of Action

Leukotrienes are synthesized from the fatty acid arachidonic acid, which is stored in cell membranes. When triggered by inflammatory stimuli or allergic signals, arachidonic acid is converted into leukotrienes by the enzyme 5-lipoxygenase (5-LOX). There are two main groups:

LTB4 (Leukotriene B4): Acts as a potent chemotactic agent, attracting additional immune cells to the site of inflammation.
Cysteinyl Leukotrienes (LTC4, LTD4, LTE4): This group causes airway constriction (bronchoconstriction), increased mucus production, and enhanced vascular permeability.

Leukotrienes exert their effects by binding to specific receptors on target cells, including CysLT1, CysLT2, and BLT receptors.

Medical Significance

Bronchial Asthma

In bronchial asthma, cysteinyl leukotrienes play a central role. They cause narrowing of the bronchial airways, mucosal swelling, and excessive mucus secretion, leading to the classic asthma symptoms of breathlessness, wheezing, and coughing.

Allergic Rhinitis

In allergic rhinitis (hay fever), leukotrienes contribute to nasal mucosal swelling, increased runny nose, and nasal congestion.

Other Conditions

Elevated leukotriene levels are also associated with the following conditions:

Chronic obstructive pulmonary disease (COPD)
Exercise-induced asthma
Chronic urticaria (hives)
Atopic dermatitis (eczema)
Aspirin-induced asthma

Leukotrienes as a Therapeutic Target

Because leukotrienes are key inflammatory mediators, they represent an important target in modern therapy. Leukotriene receptor antagonists (also called antileukotrienes), such as montelukast and zafirlukast, block the action of cysteinyl leukotrienes at their receptors. These medications are used for:

Long-term management of bronchial asthma
Relief of symptoms in allergic rhinitis
Prevention of exercise-induced asthma

Additionally, 5-lipoxygenase inhibitors such as zileuton directly suppress leukotriene synthesis by blocking the key enzyme responsible for their production.

Diagnosis and Measurement

Leukotriene concentrations can be measured in urine, blood, or bronchoalveolar lavage fluid (a fluid collected from the lungs during bronchoscopy). Elevated urinary cysteinyl leukotriene levels (particularly LTE4) serve as biomarkers of inflammatory activity in asthma and can be used to monitor treatment response.

References

Global Initiative for Asthma (GINA) - Global Strategy for Asthma Management and Prevention (2023). www.ginasthma.org
Samuelsson B. - Leukotrienes: mediators of immediate hypersensitivity reactions and inflammation. Science, 220(4597):568-575, 1983.
Peters-Golden M., Henderson W.R. - Leukotrienes. New England Journal of Medicine, 357:1841-1854, 2007.

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