[Treatment of ASS-Associated Polyposis (ASSAP) with a cysteinyl leukotriene receptor antagonist - a prospective drug study on its antiinflammatory effects].

Abstract

BACKGROUND:

In a high rate of cases with recurrent polyposis an association with ASS-intolerance is detectable despite missing pulmonary symptoms. New examinations of a disturbed arachidonic acid metabolism lead to the development of new therapeutical options. Treatment with leukotriene-receptor antogonists (LTA) showed primarily good results in therapy of ASS-associated asthma.

METHODS:

18 patients with ASS-intolerance trias - diagnosed by oral provocation - were treated with the LTA Montelukast, after undergoing sinus surgery. Patients underwent a diagnostic pathway of provocation including four groups: recurrent chronic sinusitis, excessive polyposis, polyposis associated with asthma and anaphylactic symptoms after oral ASS-intake. Clinically we examined the following parameters periodically after sinus surgery: nasal and pulmonal symptoms by scoring levels, recurrency of polypoid hyperplasia by endoscopic follow-ups and serum ECP-levels. To evaluate antiinflammatory tissue effects of LTA EG1/EG2 labelled cells and cytokine levels of Interleukin 5 in mucosa samples of the lower turbinate were analysed under LTA-therapy.

RESULTS:

Under therapy with LTA we saw a beneficial effect on nasal and pulmonary symptoms and a significant reduction of recurrent polyposis in endoscopic examinations in relation to the untreated group. Results were proven by a permanent reduction of serum ECP-level. A reduction of the rate of EG2-positive cells according to decreased Interleukin 5 levels in the nasal mucosa unter LTA-treatment assumed antiinflammatory effects on ASS-associated polyposis.

CONCLUSIONS:

We could demonstrate antiinflammatory effects of Leukotriene-Receptor-Antagonists primarily during postoperative treatment of patients with ASS-associated nasal polyps.

• Authors: T Grundmann, M Töpfner
• Journal: Laryngo- rhino- otologie (Laryngorhinootologie) Vol. 80 Issue 10 Pg. 576-82 (Oct 2001) ISSN: 0935-8943 [Print] Germany
• Vernacular Title: Leukotrienrezeptorantagonisten zur Rezidivprophylaxe bei der ASS-assoziierten Polyposis - Erste klinische Ergebnisse zur Wirkung auf entzündliche Gewebeprozesse1.
• PMID: 11602930 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Acetates
• Anti-Asthmatic Agents
• Cyclopropanes
• Leukotriene Antagonists
• Quinolines
• Sulfides
• montelukast
• Aspirin

Topics

• Acetates (therapeutic use)
• Adult
• Anti-Asthmatic Agents (therapeutic use)
• Aspirin (adverse effects)
• Asthma (drug therapy, etiology)
• Cyclopropanes
• Female
• Humans
• Leukotriene Antagonists (therapeutic use)
• Male
• Middle Aged
• Nasal Polyps (drug therapy, etiology)
• Quinolines (therapeutic use)
• Recurrence
• Sulfides