It has been shown that the leukotriens play a role in the pathobiologic process of allergic
asthma and
wheezing due to
infection. Their specific role in other respiratory disorders or in other diseases is not yet fully understood. A recent consensus has elaborated the guidelines for the treatment of
asthma in the paediatric age. According to these guidelines, the
leukotriene-antagonists are recommended as a possible alternative to inhaled
corticosteroids in the long-term treatment of mild persistent
asthma. The association of antileukotrienes with the usual classical
therapy led to a great improvement in the treatment of the most severe forms of the disease. Moreover, a growing number of disorders such as
allergic rhinitis,
chronic urticaria,
atopic dermatitis and nasal polyposis seem to benefit from the use of these new drugs. In
allergic rhinitis, the most common allergic disorder, the
leukotrienes seem to be, together with
histamine, important mediators of both the early and late stage of the
allergic reaction. They seem to be responsible for the vasodilation and therefore for the
nasal obstruction. There is a production of
leukotrienes also in
chronic urticaria, which is more frequent in adults, and in
atopic dermatitis, which usually has its onset in the paediatric age. This paper summarizes the results of several clinical trials evaluating the therapeutical efficacy and safety of the
leukotriene-antagonists. Despite the promising results, further studies are however necessary on a greater number of patients before recommending the use of this type of
drug in this kind of disorders.