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Abstract
Allergic rhinitis is an IgE mediated hypersensitivity of the mucous membranes of the nasal airway, eyes, Eustachian tubes, middle ears, sinuses and pharynx, precipitated by exposure to certain allergens, which may be inhalant, digestant, contactant, drugs, infections or endogenous., it affects nearly 15 to 20%of the population, so it is the most common allergic disorder, It can be classified as seasonal, perennial, or episodic.
The pathophysiologic processes involved in AR have been divided into early-phase and late-phase responses. In early –phase response: when allergens deposit on the nasal mucosa of the now-sensitized individual, they are recognized by the IgE receptors on the mast cells. cross linking of the IgE receptors and immediate release of performed and newly synthesized mediators responsible for the stimulation of nerves, mucus glands, and blood vessels. In late- phase response several hours after the initial allergen exposure and characterized primarily by nasal congestion.
Treatment of allergic rhinitis includes avoidance of allergen, pharmacological therapy include anti histamines , Sympathomimetic agents, Anticholenergics, Mast cell stabilizer, Corticosteroids either local or systemic, Anti IgE antibodies , immuno-therapy and surgical treatment if needed.
Leukotrienes are generated by the action of 5-lipoxygenase on arachidonic acid. They are released in both the early and late phase responses in allergic rhinitis, LTs induce increases in nasal mucosal blood flow, and nasal airway resistance.
Leukotriens inhibitors have recently been approved for the treatment of allergic rhinitis as they selectively block the cysteinyl leukotriene receptors and have been shown to effectively reduce airway eosinophilic inflammation, eosinophil chemotaxis, and peripheral blood eosinophil counts The purpose of this meta-analysis study was to answer the following question:
Is Leukotriens inhibitors have a role in control allergic rhinitis symptoms or not?
In our meta-analysis study, 10 studies fulfilled the inclusion criteria 4 of them their data analysed by software revman 5 these studies were done on 4655 patients, and the result was towards the using anti leukotrien drugs in control of allergic rhinitis symptoms, as the difference was significant.
Also form other studies (6 studies ) neither included nor excluded as their data would not be applied to the revman 5 software, done on 2102 patients , 2 studies of them were done on 890 patents and was found that there is no role of anti leukotriens in controlling allergic rhinitis symptoms , but 4 studies done on 1312 patients found that anti leukotrien drugs have a beneficial role in control of allergic rhinitis symptoms and improvement of quality of life parameters also well tolerated by the patients.
At the end, our conclusion from the results of our meta analysis study and our research that, there is strong evidence that anti leukotrien drugs have a good control of allergic rhinitis symptoms, either day or night symptoms, improvement of quality of life parameters, and well tolerated.