Preventing Influenza Viral Pneumonia With Asthma Drugs

The leukotriene receptor antagonists (LTRAs) Accolate (zafirlukast) and Singulair (montelukast sodium) prevented the development of fatal influenza pneumonia in mice with influenza infection in new research from the University of Virginia.

“Our results—if they can be translated to the human—raise the possibility that, during epidemic or pandemic influenza infections, we can prevent the development of lethal influenza pneumonia in patients by administering LTRA drugs,” said senior author Thomas J Braciale, MD, PhD, University of Virginia (Charlottesville, VA) (doi:10.1371/journal.ppat.1006140).
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Researchers discovered that the early administration of the two asthma drugs could actually ward off the infection of alveolar cells.

“These drugs prevent the uptake of influenza virus by terminal airway alveolar epithelial cells and infection of these cells, which are involved in oxygen exchange in the lungs,” he said. He also noted that LTRA agents have minimal side effects.

“Influenza viral pneumonia is caused by the direct infection of alveolar epithelial cells, which subsequently causes extensive alveolar inflammation and injury,” the authors write. “Clinically this pathology manifests as diffuse alveolar damage leading to acute respiratory distress syndrome.”

According to Dr Braciale, the findings are novel and unexpected.

“If our retrospective data analysis and a required prospective clinical trial indicate that taking an LTRA reduces the incidence of severe influenza infection, then pharmacists would play an important role in determining the conditions under which LTRAs can be administered to patients for influenza prophylaxis,” he noted.

In terms of upcoming research, Dr Braciale told Pharmacy Learning Network that the group is currently conducting a retrospective study of human health care databases to determine whether “individuals taking LTRAs for the treatment of asthma or allergic rhinitis are less likely to wind up hospitalized in the intensive care unit with severe lower respiratory tract influence infections than are influenza-infected individuals not taking these drugs.”

This research was published in PLOS Pathogens and was supported by grants from the National Institutes of Health and the National Institute of General Medicine Sciences.

-Meredith Edwards White