[Antileukotrienes in the therapy of bronchial asthma]. / Gli antileucotrienici nella terapia dell'asma bronchiale.

Cysteinyl-leukotrienes (Cys-LTs) are mediators released in bronchial asthma and are both direct bronchoconstriction and proinflammatory substances that mediated several steps in the pathophysiology of chronic asthma, including inflammatory cells recruitment, vascular leakage, and possibly airway remodelling. Available evidence from clinical trials and real-word experience derived from managing patients with asthma justifies a broader role for antileukotriene drugs (anti-LTs) in asthma management than that recommended in the National Asthma Education and Prevention Program and National Institute of Health treatment guidelines. Anti-LTs seem to be effective alternatives to inhaled corticosteroids (ICS) either as monotherapy or as adjunctive therapy that reduces the need for higher doses of ICS in patients with mild-to-moderate persistent asthma. This class of drugs may be used as adjunctive therapy for all levels of disease severity because they are effective in combination with ICS during long-term maintenance therapy. The anti-LTs seem especially effective in preventing aspirin-induced asthma providing an additional advantage of reducing nasal congestion in patients with both asthma and rhinitis and in the treatment of exercise induced-asthma. This class of drugs have several features that are likely to promote adherence to treatment and are generally well tolerated. The available clinical data suggest that anti-LTs should be considered as a therapeutic option or as additive therapy in patients with mild to severe asthma.

Association between serum leptin levels and 24-hour blood pressure in obese women.

OBJECTIVE: To assess the relationship between serum leptin and 24-hour blood pressure (BP) in obese women, according to body fat distribution. RESEARCH METHODS AND PROCEDURES: A cross-sectional study was carried out in a population of 70 nondiabetic, normotensive, obese women (40 with android and 30 with gynoid type of obesity) and 20 nonobese healthy women as a control group. All subjects underwent 24-hour ambulatory BP monitoring. Blood samples were collected for serum leptin and plasma insulin measurements. Total cholesterol and high-density lipoprotein cholesterol were also measured. RESULTS: Serum leptin levels were significantly higher in obese subjects than in controls, and they were more elevated in android obese women than in gynoid ones. Leptin levels were positively related to body mass index (BMI), insulin, and waist and hip circumferences in the android group. Among gynoid subjects, leptin levels showed positive associations with BMI and insulin. In women with android obesity, strong positive correlations (p < 0.001) were found between leptin levels and 24-hour systolic BP (SBP), daytime SBP, nighttime SBP, 24-hour diastolic BP (DBP), and daytime DBP. Multiple regression analyses, including age, insulin and leptin concentrations, BMI, and waist and hip circumferences on 24-hour and daytime SBP and DBP, showed that only leptin levels contributed to the variability of BP. CONCLUSIONS: Our study shows that serum leptin levels are directly related to 24-hour BP levels in normotensive women with android fat distribution, independently of BMI.