The efficacy of leukotriene receptor antagonist on fraction of exhaled nitric oxide (FeNO) levels in asthmatics with sinusitis *
Recently, the crosstalk between bronchial asthma and rhino-sinusitis has been gaining attention. Regard to the upper and lower inflammation, comorbid ratio between bronchial asthma and allergic rhinitis or sinusitis is estimated about 30% each other, that is very important for the asthma therapy strategy. The present study retrospectively examined the effect of leukotriene receptor antagonist (LTRA) on fractional exhaled nitric oxide (FeNO) of an eosinophilic inflammation marker in asthmatic patients with/without rhino-sinusitis. Forty seven patients who had already been treated by inhaled corticosteroid (ICS) for more than 6 months were divided into 4 groups consisting of those with/without rhinitis and/or sinusitis. Additional comparisons were made with FeNO, lung function (FEV%predicted and PEF%predicted) and symptom score (asthma control test: ACT) and ICS dosage before and after LTRA introduction. The mean ACT score and FEV%predicted were not different among the 4 groups. The mean value of PEF%predicted was lower in the asthmatics with sinusitis than those without sinusitis or those with rhinitis only (p=0.003 and 0.007). The level of FeNO tend to higher in the patients with sinusitis but there was no significant differences (p=0.13). FeNO was suppressed in the group who had sinusitis without/with rhinitis by LTRA treatment (p=0.04 and 0.02, respectively). LTRA inhibited the eosinophilic inflammation of the lower airway even in the patients who were treated by ICS. That may lead us to suggest that LTRA can suppress both the upper and lower airway inflammation which is not inhibited by ICS. (Accepted on June 27, 2012)
