白三烯受体拮抗剂孟鲁司特在皮肤科的应用

Application of montelukast, a leukotriene receptor antagonist, in dermatology

白三烯是强效生物炎症介质，与受体结合参与皮肤过敏性疾病的发生及发展，然而白三烯受体拮抗剂（孟鲁司特），在过敏性皮肤病治疗中的特异性作用机制尚不详。目前有关孟鲁司特的相关研究较多，但结果不一。研究显示，孟鲁司特对儿童轻中度特应性皮炎有效，而对成人中重度特应性皮炎虽无明显疗效，但可改善患者的睡眠和炎性体征。孟鲁司特联合组胺H1受体拮抗剂虽不能减少慢性荨麻疹的发作次数，但可明显改善患者临床症状和生活质量。因孟鲁司特具有良好的耐受性及安全性，因此，对传统治疗方法无效的荨麻疹和特应性皮炎患者皆可尝试使用该药治疗。

Leukotrienes （LTs）, a potent biological mediator, participate in the development of allergic dermatoses by binding to their receptors. Montelukast is a leukotriene receptor antagonist used in the treatment of allergic dermatoses. However, the therapeutic mechanisms of leukotriene receptor antagonists remain unknown. There have been numerous studies on montelukast, but the results are varying and somewhat contradictory. Studies have demonstrated that montelukast is effective for the treatment of mild to moderate atopic dermatitis in children, and can improve the sleep and inflammatory symptoms in adult patients with moderate to severe atopic dermatitis regardless of their poor response. Though the combination of montelukast and H1 receptor antagonists can not reduce the number of urticarial episodes, they markedly improve the clinical symptoms and quality of life in patients with chronic urticaria. On account of the good tolerability and safety, montelukast may be attempted in patients with urticaria and atopic dermatitis unresponsive to conventional therapy.