The role of leukotriene inhibitors in allergic rhinitis and paranasal sinusitis.

Leukotrienes are inflammatory mediators that are known as the slow-reacting substance of anaphylaxis produced by a number of cell types, including mast cells, eosinophils, basophils, macrophages, and monocytes. Synthesis of these meditators in the text result from the cleavage of arachidonic acid in cell membranes, and exert their biologic effects by binding and activating specific adaptors. This occurs in a serious of events that lead to contraction of the human airway smooth muscle, chemotaxis, and increased vascular permeability. These effects have lead to their important role in the diseases of asthma, allergic rhinitis, and possible paranasal sinusitis with the formation of nasal polyps. Since these agents lead to the production of symptoms in patients who are asthmatic, the use of leukotriene enzyme inhibitors, particularly montelukast, zafirlukasts seem appropriate.