engleski

EFFECT OF ASTHMA THERAPY ON CEREBROVASCULAR DISEASE AND NEURODEGENERATION

After a short time of clinical experience, COX-2 inhibitors such as Vox and Rofecoxib were removed from the market because they increased the incidence of stroke and acute myocardial infarction. Recent studies have shown that COX 1/COX-2 inhibitors also have very similar side effects. The next step in asthma therapy was the introduction of 5-lipoxygcnasc inhibitors (Zileuton) and Cvsleukotriene antagonists (Zafirlukast, Montelukast, Prankulast). There was a very good drug response within the first 4-13 weeks in mild or moderate asthma patients but side effects such as hypersensitivity reactions, dyspepsia, elevations of liver function tests and increased bleeding tendency were also present (large trials). At this point, we should ask ourselves what should be the alternative and strategic in asthma therapy, which would not affect other systems. Some recent studies have shown that there are some 6% of people in the population who have variant 5-LOX genotype (lacking the common allele) and increase in inflammatory products and intima-media thickness as well. Also, there are a number of studies investigating dietary intake of n-6 (arachidonic acid) and n-3 polyunsaturatcd (eicosapentaenoic acid) fatty acids, and its effect on leukotriene synthesis. Eicosapentaenoic acid is a poor substrate for COX-2 and thc products of eicosapentaenoic acid inflammatory eicosanoids of series 3 and 5 are less inflammatory potent than the products of arachidonic acid inflammatory eicosanoids of series 4. We suggest that asthma patients should substitute n-6 polyunsaturated fatty acids with n-3 polyunsaturated acids in their daily diet in order to decrease eicosanoid series 2 and 4 production and to prevent cardiovascular and cerebrovascular disorders and neurodegeneration.

Cerebrovascular disorders-etiology; Cerebrovascular disorders - complication; Asthma -therapy; Asthma - complicatiopns; Neurodegenerative disease - prevention and control; Neuroprotective agents - adverse effect

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