Dictionary of Allergies .. Atopic dermatitis(AD) and leukotrienes

Leukotrienes are potent proinflammatory mediators derived from of arachidonic acid through the 5- lipoxygenase pathway. There are many controversies about the role of leukotrienes in the pathogenesis of atopic dermatitis(AD). Guzik et al demonstrated that release of peptidylo leukotrienes from inflammatory  cells might play a role in the exacerbation of AD in contrast to pollinosis. The source of leukotrienes cannot indicated, but a strong correlation between urinary peptidoleukotriene levels and clinical status is strongly suggestive  and should be further  investigated[1].

Experimental data suggest a role for cysteinyl leukotrienes in the pathogenesis of atopic dermatitis and there is a rationale for the use of pharmacological agents to antagonize their effects in the treatment of atopic dermatitis[2]. It has been demonstrated that there is a modest, but significant, alleviation of atopic dermatitis with the use of the leukotriene antagonist montelukast used in an adjunctive manner over a 4-week period. Montelukast may be used as an alternative steroid sparing medication for severe atopic dermatitis, especially in patients with associated asthma and rhinitis[3].

References

1. Guzik T et al . Urinary leukotriene levels in adult patients with atopic dermatitis-relation to clinical status and IgE levels. The annual Meeting of the European academy of allergology and clinical Immunology Brussels, Belgium July 3-7, 1999. allergy, suppl. 52:54:25, 1999.

2. Angelova-Fischer I, Tsankov N. Successful treatment of severe atopic dermatitis with cysteinyl leukotriene receptor antagonist montelukast. Acta Dermatovenerol Alp Panonica Adriat. 2005 Sep;14(3):115-9.

3. Yanase DJ, David-Bajar K. The leukotriene antagonist montelukast as a therapeutic agent for atopic dermatitis. J Am Acad Dermatol. 2001 Jan;44(1):89-93