SELECTED ARTICLES FROM THE RECENT LITERATURE 2005
9/8/05
Role of leukotrienes in allergic rhinitis
Summary
Background - There has been considerable interest in the possible pathogenic role of cysteinyl-leukotrienes (Cyst LT) in allergic rhinitis (AR) and the effects of Cyst LT receptor antagonists (LTRA) such as montelukast on AR manifestations.
Findings - The relevant literature about this subject was reviewed by Peters-Golden and Henderson of the Univ of Michigan. They summarized evidence that: 1) Cyst LT levels in nasal secretions are increased following nasal allergen challenges in sensitive subjects and during the symptomatic periods during pollinating seasons; 2) Cyst LT installation can induce much of the local inflammatory effects seen during active AR; 3) clinical trials of treatment with LTRA have shown significant but modest beneficial effects in AR. There is additive efficacy when LTRA are used with other classes of agents.
Reference
Ann Allergy Asthma Immunol 2005;94:609-18
Editor's Comments
This review by experienced observers appropriately describes the evidence suggesting Cyst LT participation in AR. Their conclusion that LTRA treatment is of only modest efficacy in AR is in general agreement with most clinical studies. Their statement that LTRA has additive benefit when used with H1 antihistamines is more controversial, with variable findings seen in different studies. My personal impression is that any additive benefit of LTRA treatment given with H1 antihistamines is modest, if at all.
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