Effect of leukotriene receptor antagonist on airway mucus hypersecretion in patients with acute exacerbation of bronchiectasis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 NIE Xiaohong , XU Zhiqiang , ZHANG Yi , LAI Xiaorong

Department of Respiratory Medicine, The 416 Hospital of Nuclear Industry, Chengdu, Sichuan 610051, P.R.China;

Corresponding?author：

NIE Xiaohong, Email: xhnie1226@sina.com

Keywords：

Leukotriene receptor antagonist; Bronchiectasis; Montelukast; Neutrophil elastase; Mucus hypersecretion; Airway resistance

DOI：

10.7507/1671-6205.201702005

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effect of leukotriene receptor antagonist montelukast on physicochemical property of sputum and airway mucus hypersecretion in patients with acute exacerbation of bronchiectasis. Methods Eighty-four inpatients with acute exacerbation of bronchiectasis were randomly divided into a control group and an experiment group, with 42 cases in each group. The control group received conventional therapy and the experiment group took orally montelukast 10 mg before sleep every day based on conventional therapy for two weeks. At admission and 15 days after admission, the amount in 24 hours, dry/wet weight ratio and viscosity of sputum were observed while the levels of neutrophil elastase (NE) and mucin MUC5ac in sputum were determined by ELISA. The pulmonary ventilation function, airway resistance and blood gas analysis were also measured. Results The sputum amount in 24 hours, dry/wet weight ratio and viscosity of sputum, NE and MUC5ac of sputum, pulmonary ventilation function, blood gas analysis and airway resistance were declined or improved remarkably after treatment compared with before treatment in two groups (P<0.05). Meanwhile, the sputum amount in 24 hours [(5.62±1.83) g vs. (7.53±2.32) g], NE [(3.85±0.97) μg/ml vs. (4.54±1.03) μg/ml], MUC5ac [(0.65±0.21) μg/ml vs. (0.82± 0.29) μg/ml] and the airway resistance [(119.16±11.76)% vs. (128.37±12.08)%] were declined remarkably in the experiment group compare with the control group after treatment (all P<0.05). The viscosity of sputum between the two groups after treatment showed no significant difference. Conclusion In patients with acute exacerbation of bronchiectasis, montelukast can reduce amount of sputum and airway resistance, reduce expression of mucin MUC5ac through down-regulation of NE, thus inhibit airway mucus hypersecretion.

Citation： NIE Xiaohong, XU Zhiqiang, ZHANG Yi, LAI Xiaorong. Effect of leukotriene receptor antagonist on airway mucus hypersecretion in patients with acute exacerbation of bronchiectasis. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(4): 375-378. doi: 10.7507/1671-6205.201702005 Copy

1.	慢性氣道炎癥性疾病氣道黏液高分泌管理中國專家共識編寫組. 慢性氣道炎癥性疾病氣道黏液高分泌管理中國專家共識. 中華結核和呼吸雜志, 2015, 38(10): 723-729.
2.	成人支氣管擴張癥診治專家共識編寫組. 成人支氣管擴張癥診治專家共識. 中華結核和呼吸雜志, 2012, 35(7): 485-492.
3.	萬志輝, 范慧, 胡克, 等. 長期吸入沙美特羅/氟替卡松聯合小劑量紅霉素口服治療支氣管擴張癥的療效觀察. 中國呼吸與危重監護雜志, 2012, 11(4): 371-374.
4.	Haworth CS, Bilton D, Elborn JS. Long-term macrolide maintenance therapy in non-CF bronchiectasis: evidence and questions. Respir Med, 2014, 108(10): 1397-1408.
5.	鐘慧, 洪建國. 半胱氨酰白三烯受體拮抗劑孟魯司特的研究進展. 中華哮喘雜志(電子版), 2011, 5(5): 362-366.
6.	鐘貞, 鄧玥, 張婷. 慢性氣道炎癥黏液高分泌的治療藥物研究進展. 重慶醫學, 2014,43(13):1644-1646.
7.	Rvan A, Smith A, Moore P, et al. Expression and characterization of a novel recombinant version of the secreted human mucin MUC5AC in airway cell lines. Biochemistry, 2015, 54(4): 1089-1099.
8.	Moulton BC, Barker AF. Pathogenesis of bronchiectasis. Clin Chest Med, 2012, 33(2): 211-217.
9.	Main E, Grillo L, Rand S.Airway clearance strategies in cystic fibrosis and non-cystic fibrosis bronchiectasis. Semin Respir Crit Care Med.2015,36(2): 251-266.
10.	李曉云, 劉雙. 支氣管擴張病因的研究進展. 心肺血管病雜志, 2014, 33(1): 124-126.
11.	倪圣, 丁建中. 氣道黏液高分泌機制研究進展. 長江大學學報(自科版), 2013, 10(9): 97-101.
12.	Gehrig S, Duerr J, Weitnauer M, et al. Lack of neutrophil elastase reduces inflammation, mucus hypersecretion, and emphysema, but notmucus obstruction, in mice with cystic fibrosis-like lung disease. Am J Respir Crit Care Med, 2014, 189(9): 1082-1092.
13.	吳其標, 曹世宏. 中性粒細胞彈性蛋白酶在支氣管擴張癥發病中的作用及治療對策. 國外醫學內科學分冊, 2004, 31(12): 519-521.
14.	陶和平, 涂小金, 李順文, 等. 黏液高分泌對慢性阻塞性肺疾病轉歸的預測價值. 中國現代醫生, 2015, 53(33): 32-34, 38.
15.	嚴能兵, 羅鴻. 白三烯的研究進展與臨床意義. 國際檢驗醫學雜志, 2014, 35(6): 721-723.
16.	Coffey MJ, Torretti B, Mancuso P. Adipokines and cysteinyl leukotrienes in the pathogenesis of asthma. J Allergy(Cairo), 2015, 2015(94): 1-9.
17.	周敏, 陳輝龍, 程勝, 等. 孟魯司特對哮喘小鼠肺組織黏蛋白 MUC5ac 表達的影響. 醫藥導報, 2013, 32 (1): 5-8.
18.	鄧俊, 楊艷, 梁宇佳, 等. 孟魯司特對哮喘大鼠氣道炎癥的調控作用及其機制. 山東醫藥, 2016, 56 (24): 34-36.
19.	Tenero L, Piazza M, Sandri M, et al. Effect of montelukast on markers of airway remodeling in children with asthma. Allergy Asthma Proc, 2016, 37(5): 77-83.
20.	陳凡, 焦琳, 吳莎, 等. 孟魯司特聯合抗生素治療支氣管擴張癥的臨床觀察. 臨床肺科雜志, 2015, 20(9): 1703-1706.

1. 慢性氣道炎癥性疾病氣道黏液高分泌管理中國專家共識編寫組. 慢性氣道炎癥性疾病氣道黏液高分泌管理中國專家共識. 中華結核和呼吸雜志, 2015, 38(10): 723-729.
2. 成人支氣管擴張癥診治專家共識編寫組. 成人支氣管擴張癥診治專家共識. 中華結核和呼吸雜志, 2012, 35(7): 485-492.
3. 萬志輝, 范慧, 胡克, 等. 長期吸入沙美特羅/氟替卡松聯合小劑量紅霉素口服治療支氣管擴張癥的療效觀察. 中國呼吸與危重監護雜志, 2012, 11(4): 371-374.
4. Haworth CS, Bilton D, Elborn JS. Long-term macrolide maintenance therapy in non-CF bronchiectasis: evidence and questions. Respir Med, 2014, 108(10): 1397-1408.
5. 鐘慧, 洪建國. 半胱氨酰白三烯受體拮抗劑孟魯司特的研究進展. 中華哮喘雜志(電子版), 2011, 5(5): 362-366.
6. 鐘貞, 鄧玥, 張婷. 慢性氣道炎癥黏液高分泌的治療藥物研究進展. 重慶醫學, 2014,43(13):1644-1646.
7. Rvan A, Smith A, Moore P, et al. Expression and characterization of a novel recombinant version of the secreted human mucin MUC5AC in airway cell lines. Biochemistry, 2015, 54(4): 1089-1099.
8. Moulton BC, Barker AF. Pathogenesis of bronchiectasis. Clin Chest Med, 2012, 33(2): 211-217.
9. Main E, Grillo L, Rand S.Airway clearance strategies in cystic fibrosis and non-cystic fibrosis bronchiectasis. Semin Respir Crit Care Med.2015,36(2): 251-266.
10. 李曉云, 劉雙. 支氣管擴張病因的研究進展. 心肺血管病雜志, 2014, 33(1): 124-126.
11. 倪圣, 丁建中. 氣道黏液高分泌機制研究進展. 長江大學學報(自科版), 2013, 10(9): 97-101.
12. Gehrig S, Duerr J, Weitnauer M, et al. Lack of neutrophil elastase reduces inflammation, mucus hypersecretion, and emphysema, but notmucus obstruction, in mice with cystic fibrosis-like lung disease. Am J Respir Crit Care Med, 2014, 189(9): 1082-1092.
13. 吳其標, 曹世宏. 中性粒細胞彈性蛋白酶在支氣管擴張癥發病中的作用及治療對策. 國外醫學內科學分冊, 2004, 31(12): 519-521.
14. 陶和平, 涂小金, 李順文, 等. 黏液高分泌對慢性阻塞性肺疾病轉歸的預測價值. 中國現代醫生, 2015, 53(33): 32-34, 38.
15. 嚴能兵, 羅鴻. 白三烯的研究進展與臨床意義. 國際檢驗醫學雜志, 2014, 35(6): 721-723.
16. Coffey MJ, Torretti B, Mancuso P. Adipokines and cysteinyl leukotrienes in the pathogenesis of asthma. J Allergy(Cairo), 2015, 2015(94): 1-9.
17. 周敏, 陳輝龍, 程勝, 等. 孟魯司特對哮喘小鼠肺組織黏蛋白 MUC5ac 表達的影響. 醫藥導報, 2013, 32 (1): 5-8.
18. 鄧俊, 楊艷, 梁宇佳, 等. 孟魯司特對哮喘大鼠氣道炎癥的調控作用及其機制. 山東醫藥, 2016, 56 (24): 34-36.
19. Tenero L, Piazza M, Sandri M, et al. Effect of montelukast on markers of airway remodeling in children with asthma. Allergy Asthma Proc, 2016, 37(5): 77-83.
20. 陳凡, 焦琳, 吳莎, 等. 孟魯司特聯合抗生素治療支氣管擴張癥的臨床觀察. 臨床肺科雜志, 2015, 20(9): 1703-1706.

Chinese Journal of Respiratory and Critical Care Medicine

Effect of leukotriene receptor antagonist on airway mucus hypersecretion in patients with acute exacerbation of bronchiectasis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content