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Clinical features of asthmatic patients with increased urinary leukotriene E4 excretion (hyperleukotrienuria): Involvement of chronic hyperplastic rhinosinusitis with nasal polyposis.
J Allergy Clin Immunol. 2004 Feb; 113(2):277-83.JA

Abstract

BACKGROUND

The urinary leukotriene E4 (U-LTE4) concentration is significantly increased in patients with aspirin-intolerant asthma (AIA). However, the relationship between the clinicopathogenetic factors of asthma and the U-LTE4 concentration remains undetermined.

OBJECTIVE

We sought to examine the clinical features of asthmatic patients with increased excretion levels of U-LTE4 (hyperleukotrienuria).

METHODS

We measured the U-LTE4 concentrations in 137 asthmatic patients (including 64 patients with AIA) who were in clinically stable condition. A U-LTE4 concentration of 150 pg/mg creatinine or greater (mean U-LTE4 + 3 SDs of normal healthy control subjects) was indicative of hyperleukotrienuria.

RESULTS

The basal concentration of U-LTE4 was significantly higher in the patients with AIA than in those with aspirin-tolerant asthma (ATA; median, 227.2 vs 90.3 pg/mg creatinine; P <.01). Compared with normal leukotrienuria in the patients with AIA, hyperleukotrienuria in the patients with AIA was associated with older age and decrease in pulmonary function. On the other hand, compared with normal leukotrienuria in the patients with ATA, hyperleukotrienuria in the patients with ATA was associated with severe asthma and chronic hyperplastic rhinosinusitis with nasal polyposis (CHRS/NP), which are well-known symptoms of the aspirin triad, as well as hypereosinophilia and anosmia. The patients with ATA with CHRS/NP excreted U-LTE4 at significantly high concentrations. There were significant decreases in the U-LTE4 concentrations before and after the sinus surgery in both the AIA and ATA groups (P <.05).

CONCLUSION

Cysteinyl leukotrienes are not strictly associated with aspirin intolerance itself but rather with clinical features, such as CHRS/NP, that are similar to those seen in AIA. CHRS/NP might be involved in cysteinyl leukotriene overproduction in asthmatic patients.

Authors+Show Affiliations

Clinical Research Center, National Sagamihara Hospital, Kanagawa, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14767442

Citation

Higashi, Noritaka, et al. "Clinical Features of Asthmatic Patients With Increased Urinary Leukotriene E4 Excretion (hyperleukotrienuria): Involvement of Chronic Hyperplastic Rhinosinusitis With Nasal Polyposis." The Journal of Allergy and Clinical Immunology, vol. 113, no. 2, 2004, pp. 277-83.
Higashi N, Taniguchi M, Mita H, et al. Clinical features of asthmatic patients with increased urinary leukotriene E4 excretion (hyperleukotrienuria): Involvement of chronic hyperplastic rhinosinusitis with nasal polyposis. J Allergy Clin Immunol. 2004;113(2):277-83.
Higashi, N., Taniguchi, M., Mita, H., Kawagishi, Y., Ishii, T., Higashi, A., Osame, M., & Akiyama, K. (2004). Clinical features of asthmatic patients with increased urinary leukotriene E4 excretion (hyperleukotrienuria): Involvement of chronic hyperplastic rhinosinusitis with nasal polyposis. The Journal of Allergy and Clinical Immunology, 113(2), 277-83.
Higashi N, et al. Clinical Features of Asthmatic Patients With Increased Urinary Leukotriene E4 Excretion (hyperleukotrienuria): Involvement of Chronic Hyperplastic Rhinosinusitis With Nasal Polyposis. J Allergy Clin Immunol. 2004;113(2):277-83. PubMed PMID: 14767442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical features of asthmatic patients with increased urinary leukotriene E4 excretion (hyperleukotrienuria): Involvement of chronic hyperplastic rhinosinusitis with nasal polyposis. AU - Higashi,Noritaka, AU - Taniguchi,Masami, AU - Mita,Haruhisa, AU - Kawagishi,Yukio, AU - Ishii,Toyota, AU - Higashi,Ai, AU - Osame,Mitsuhiro, AU - Akiyama,Kazuo, PY - 2004/2/10/pubmed PY - 2004/3/18/medline PY - 2004/2/10/entrez SP - 277 EP - 83 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 113 IS - 2 N2 - BACKGROUND: The urinary leukotriene E4 (U-LTE4) concentration is significantly increased in patients with aspirin-intolerant asthma (AIA). However, the relationship between the clinicopathogenetic factors of asthma and the U-LTE4 concentration remains undetermined. OBJECTIVE: We sought to examine the clinical features of asthmatic patients with increased excretion levels of U-LTE4 (hyperleukotrienuria). METHODS: We measured the U-LTE4 concentrations in 137 asthmatic patients (including 64 patients with AIA) who were in clinically stable condition. A U-LTE4 concentration of 150 pg/mg creatinine or greater (mean U-LTE4 + 3 SDs of normal healthy control subjects) was indicative of hyperleukotrienuria. RESULTS: The basal concentration of U-LTE4 was significantly higher in the patients with AIA than in those with aspirin-tolerant asthma (ATA; median, 227.2 vs 90.3 pg/mg creatinine; P <.01). Compared with normal leukotrienuria in the patients with AIA, hyperleukotrienuria in the patients with AIA was associated with older age and decrease in pulmonary function. On the other hand, compared with normal leukotrienuria in the patients with ATA, hyperleukotrienuria in the patients with ATA was associated with severe asthma and chronic hyperplastic rhinosinusitis with nasal polyposis (CHRS/NP), which are well-known symptoms of the aspirin triad, as well as hypereosinophilia and anosmia. The patients with ATA with CHRS/NP excreted U-LTE4 at significantly high concentrations. There were significant decreases in the U-LTE4 concentrations before and after the sinus surgery in both the AIA and ATA groups (P <.05). CONCLUSION: Cysteinyl leukotrienes are not strictly associated with aspirin intolerance itself but rather with clinical features, such as CHRS/NP, that are similar to those seen in AIA. CHRS/NP might be involved in cysteinyl leukotriene overproduction in asthmatic patients. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/14767442/Clinical_features_of_asthmatic_patients_with_increased_urinary_leukotriene_E4_excretion__hyperleukotrienuria_:_Involvement_of_chronic_hyperplastic_rhinosinusitis_with_nasal_polyposis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091674903026162 DB - PRIME DP - Unbound Medicine ER -