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Bradykinin and Tachykinin-induced Leukotriene Release in Airway Virus Infections

We would like to thank Dr. Crimi and colleagues for their very interesting comments on the possible mechanisms of cys-LT release during viral infections. Montelukast has been shown to be efficacious in a number of pulmonary diseases such as asthma, allergic rhinitis, exercise-induced bronchoconstriction, viral-induced asthma, and respiratory syncytial virus–induced wheezing. Given the variety of lung disorders that involve leukotrienes and the complex nature of the inflammatory process, it is reasonable to speculate that leukotriene generation and release could be stimulated by a variety of cytokines that interact and amplify each other.

We did not collect data on bradykinin or tachykinin generation in our 2- to 5-year-old patients, so we cannot comment specifically on their role in viral-induced asthma. However, there is increasing evidence provided by Crimi and coworkers as well as others (1–3) that kinins may play a significant part in the pathophysiology of inflammatory lung disease through release of cys-LTs. The proinflammatory effects of kinins may contribute to the enhanced inflammatory reaction to a respiratory virus in susceptible children. Undoubtedly, the interaction of kinins and leukotrienes is an important part of the larger picture of inflammation of asthmatic airways and warrants further investigation.

Hans Bisgaard

Copenhagen University Hospital, Gentofte, Copenhagen, Denmark

FOOTNOTES

Conflict of Interest Statement: H.B. has, within the last 3 years, received honoraria for lectures and attendance at Pediatric Advisory Boards for Aerocrine, Altana, AstraZeneca, GlaxoSmithKline (GSK), and Merck, and holds no stock options in the pharmaceutical industry in the respiratory field, and owns world patents for an inhaler device but receives no royalty, and the COPSAC clinical research unit has, in the last 3 years, received research grants from the following industry partners in increasing order: Aerocrine, Merck, GSK, and AstraZeneca.

REFERENCES

1. Turner DJ, Guota K, Yang XX, Martin JG. Bradykinin-induced airway constriction in guinea-pigs: role of leukotriene D4. Pulm Pharmacol Ther 2000;13:181–188.[Medline]
2. Crimi N, Pagano C, Palermo F, Mastruzzo C, Prosperini G, Pistorio MP, Vancheri C. Inhibitory effect of a leukotriene receptor antagonist (montelukast) on neurokinin A-induced bronchoconstriction. J Allergy Clin Immunol 2003;111:833–839.[Medline]
3. Crimi N, Mastruzzo C, Pagano C, Lisitano N, Palermo F, Vancheri C. Montelukast protects against bradykinin-induced bronchospasm. J Allergy Clin Immunol 2005;115:870–872.[Medline]

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