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Leukotriene receptor cysLT1 in intestinal epithelial cells and va...

Posted at 1:30 PM on Jun 03, 2008 by concernedcitizen, #31069
Leukotriene receptor cysLT1 in intestinal epithelial cells and variation in montelukast blood levels between individuals. We know many things about this topic: 1. Montelukast enters the blood stream through the intestines 2. the cysLT1 (receptor that Singulair blocks) exists in intestinal epithelial cells 3. montelukast will bind with high affinity to the ideal gene type cysLT1 receptor 4. after montelukast enters into the blood stream is it 99% bound to plasma proteins (that point is hypothesized to be the reason that montelukast does not inhibit CYP2C8 in vivo but it does in vitro if it is true that in vivo it does not inhibit CYP2C8) 5. there is variation between individuals on how much montelukast makes it into the blood stream Well, did anybody out there in science land think of trying to find out how much montelukast binds to the cysLT1 receptors in intestinal epithelial cells? They got all interested in transport proteins but where are the studies about the cysLT1 receptors in intestinal epithelial. And, what is the effect of montelukast if it binds to intestinal cysLT1receptors? Now, concernedcitizen believes that if montelukast binds to intestinal epithelial cysLT1receptors that could be a BIG problem because those receptors have a different function than in respiratory tissue. In the one place, we gotta' breathe. In the other place, we gotta' digest food properly. We have all of these children who have stomach pain. Does anybody want to find out why? This drug belongs in the science HALL OF SHAME. Somebody please call Arnold Diaz. I am quite discussed today. Oncogene. 2006 Oct 26;25(50):6660-5. Epub 2006 May 22. Links Endogenous production of leukotriene D4 mediates autocrine survival and proliferation via CysLT1 receptor signalling in intestinal epithelial cells.Paruchuri S, Mezhybovska M, Juhas M, Sjölander A. Cell and Experimental Pathology, Department of Laboratory Medicine, Lund University, Malmö University Hospital, Malmö, Sweden. The cysteinyl leukotriene1 (CysLT1) receptor (CysLT1R) enhances survival and proliferation of intestinal cells via distinct pathways. Here, we have demonstrated that there is significant endogenous production of CysLTs from both non-tumour- and tumour-derived intestinal epithelial cells. Treatment of two non-tumour cell lines, Int 407 and IEC-6, with CysLT1R antagonists led to shrinkage and detachment of cells, confirmed as apoptotic cell death, and a dose-dependent reduction in proliferation. However, in the tumour intestinal cell lines Caco-2, SW480, HCT-116 and HT-29, treatment with CysLT1R antagonists significantly reduced proliferation, but had no effect on apoptosis. A unique characteristic of intestinal cancer cells is the presence of nuclear CysLT1Rs, which are inaccessible to receptor antagonists. In these cells, inhibition of the endogenous production of CysLTs indirectly, by 5-lipoxygenase inhibition, impaired CysLT1R signalling throughout the cell, and resulted in apoptosis of the tumour cells. These data reveal the existence of constitutive CysLT1R signalling that mediates both survival and proliferation in intestinal cells. Importantly, we propose that tumour-derived intestinal cells are resistant to CysLT1R antagonist-induced apoptosis, a phenomena that could be explained by nuclear CysLT1R signalling. PMID: 16715140 [PubMed - indexed for MEDLINE] CLINICAL TRIAL - transport proteins and montelukast http://clinicaltrials.gov/ct2/show/record/NCT00513760
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Reply 2 months ago on Jun 03, 2008 by concernedcitizen, #8869

If montelukast is effective for duodenal eosinophilia (meaning it does bind with intestinal cysLT1 receptors), then what happens in normal people if it binds those receptors? Talk about confusing!

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1: J Pediatr Gastroenterol Nutr. 2004 Mar;38(3):343-51. Links
Clinical efficacy and pharmacokinetics of montelukast in dyspeptic children with duodenal eosinophilia.Friesen CA, Kearns GL, Andre L, Neustrom M, Roberts CC, Abdel-Rahman SM.
Section of Gastroenterology, The Children's Mercy Hospital and Clinics, Kansas City, Missouri 64108, USA. cfriesen@cmh.edu

BACKGROUND: Montelukast, a competitive cysteinyl leucotriene-1 receptor antagonist, reduces airway eosinophilia in asthmatics. We evaluated the effect of this drug in children with eosinophilic duodenitis, defined histologically as duodenal mucosa with peak eosinophil count of more than 10 eosinophils/hpf. METHODS: Forty children and adolescents (6-18 yr) with dyspepsia and duodenal eosinophilia were enrolled in a double blind, randomized, placebo-controlled, cross-over study of monteleukast therapy. Subjects were randomized to receive either 10 mg montelukast or an identical placebo once daily and were evaluated on day 14 for symptomatic and biochemical responses. Subjects were also randomized to one of two blood sampling schemes to evaluate montelukast pharmacokinetics. RESULTS: Using a post treatment global pain assessment, a positive clinical response was observed in 62.1% of patients receiving montelukast compared with 32.4% on placebo (p < 0.02). Pain assessment score deteriorated in 45% of montelukast responders (5/11) after cross-over to placebo and improved in 62% (8/13) of placebo non-responders on cross-over to montelukast. In patients with peak duodenal eosinophil counts between 20-29/hpf (n=19), a positive pain assessment response was observed in 84% of patients receiving montelukast compared to 42% receiving placebo (p < 0.01). Response rate did not differ by age, gender or histologic findings at baseline. Pharmacokinetic analysis yielded parameter estimates for absorption rate constant (Ka), apparent volume of distribution (Vd/F) and elimination rate constant (Kel) of 0.42 h, 0.19 L/kg and 0.26 h, respectively. The relative extent of systemic drug exposure was comparable to that observed in previous pediatric investigations with similar weight-adjusted montelukast doses. Neither dose nor calculated drug exposure were associated with the level of post treatment pain assessment or the change in biochemical markers. CONCLUSIONS: These data suggest a beneficial role for montelukast in the treatment of pediatric patients with dyspepsia associated with duodenal eosinophilia.

PMID: 15076638

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Reply 2 months ago on Jun 03, 2008 by concernedcitizen, #8887

Very interesting the genetics of intestinal transport proteins vs. the genetics of the leukotriene receptor CysLT1.

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