Role for cysteinyl leukotriene receptor antagonist therapy in asthma and their potential role in allergic rhinitis based on the concept of "one linked airway disease"

Objective: This review focuses on the shared pathophysiology of asthma and allergic rhinitis. The similarities illustrate the "one linked airway disea se" concept, a unifying theory of these upper and lower airway inflammatory disorders. Since leukotrienes are mediators in both conditions, studies ha ve been performed to assess the potential therapeutic role of cysteinyl leu kotriene antagonists. The purpose of this paper is to provide an overview o f the accumulating data concerning these agents in treating asthma and alle rgic rhinitis. Data Sources: Relevant publications obtained from a literature review. Study Selection: Relevant publications on the topics of leukotrienes, leuko triene receptor antagonists, asthma, and allergic rhinitis were critically evaluated. Results and Conclusions: Studies to date have documented the efficacy of cy steinyl leukotriene receptor antagonists for asthma. The pathophysiology of allergic rhinitis and its similarities to asthma suggest that these agents could play a significant therapeutic role in managing this upper airway di sorder. Because the leukotriene antagonists are oral agents, they may be va luable in treating not only either condition but also both at the same time when they coexist. They appear to be beneficial when prescribed as the ini tial medicine and when used in conjunction with other therapies.