[Montelukast: new therapeutic option in patients with nasal polyps associated to respiratory allergic disease].
BACKGROUND
The physiopathogenic mechanism of nasal polyposis is unknown. Chemical mediators found in nasal polyposis are: histamine, serotonin, leukotrienes (LTC4, LTD4, LTE4, LTB4), norepinephrine and possibly prostaglandin D2. Leukotrienes that mediate bronchoconstriction as well as chemical mediators of inflammation are observed in the nasal disease associated to polyposis.


OBJECTIVE
Antileukotrienes might play a significant role in controlling polyposis and symptoms due to sinonasal disease. They represent an alternative to conventional treatments with oral steroids as well as to operations in the long-term control.


OBJECTIVE
This study is a one year investigation that evaluates the important role of leukotriene receptor antagonists on nasal polyposis, with or without association to any allergic disease. Likewise, it compares its use with the conventional therapy used in the above mentioned disease.


METHODS
We included 30 patients, 12 men (40%) and 18 women (60%), with ages between 16-45 years old. The mean age was of 20.7 years. Systematic assessments were made at the beginning of the study, as well as in the third, sixth, ninth, and twelfth month. Objective assessments, computed axial tomography of paranasal sinuses, allergological tests, nasal and bronchial symptoms evaluation, and interleukines, eosinophils, and immunoglobulin determinations were made.


RESULTS
There was an improvement of nasal symptoms in the patients of group 1 (montelukast plus beclomethasone). They included the respiratory ones (p < 0.05), the nasal washing cells (p < 0.05), and the peak flow (p < 0.05) at the third, sixth, and twelfth months, respectively. There was no significant difference with the improvement obtained in the patients of group 3 (surgery-montelukast-beclomethasone) (p < 0.05). There was no significant change in group 2 regarding the baseline in the studied variables (p > 0.05).
Almeida Arvizu
V
V
Servicio de alergia, Centro Médico Nacional Siglo XXI, CP, México, DF. almeida@allergist.net
Guidos Fogelbach
G
G
Sánchez Sánchez
B
B
Vásquez Nava
F
F
Matta Campos
J
J
López Medina
L
L
Rivera Pérez
J
J
Mejía Covarrubias
F
F
Montero Mora
P
P
D000085:Acetates / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000150:complications*; D001507:Beclomethasone / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003521:Cyclopropanes; D016207:Cytokines / Q000097:blood; D004359:Drug Therapy, Combination; D004724:Endoscopy; D004804:Eosinophils; D004809:Ephedrine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007378:Interleukins / Q000097:blood; D007958:Leukocyte Count; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D015289:Leukotrienes / Q000378:metabolism; D017336:Loratadine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D011804:Quinolines / Q000627:therapeutic use*; D013440:Sulfides
D000085:Acetates; D003521:Cyclopropanes; D016207:Cytokines; D007378:Interleukins; D020024:Leukotriene Antagonists; D015289:Leukotrienes; D011804:Quinolines; D013440:Sulfides; D017336:Loratadine; D004809:Ephedrine; D001507:Beclomethasone; C093875:montelukast