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Physiology · Blood and immunity: leukotrienes
Sample itemA man with asthma has bronchoconstriction that is not relieved by antihistamines but improves with montelukast. Which mediators are being blocked?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Cysteinyl leukotrienes made by the lipoxygenase pathway
Cysteinyl leukotrienes LTC4, LTD4 and LTE4, derived from arachidonic acid by 5-lipoxygenase, were formerly called slow-reacting substance of anaphylaxis. They are powerful bronchoconstrictors and increase vascular permeability, and montelukast blocks their receptor.
Option by option
A. Prostacyclin made by cyclooxygenase
Prostacyclin is a bronchodilator and vasodilator, not a bronchoconstrictor.
B. Histamine acting on H1 receptors
Histamine acts on H1 receptors, but antihistamines did not help here.
C. Cysteinyl leukotrienes made by the lipoxygenase pathway (correct)
Correct. Cysteinyl leukotrienes cause bronchoconstriction, and montelukast antagonises them.
D. Bradykinin acting on endothelial receptors
Bradykinin is not the target of montelukast.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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