Thromboxane and
leukotrienes have been implicated in
inflammation. However, the production level of these
eicosanoids in patients with
rheumatoid arthritis is still unclarified. In the present study, endogenous synthesis of
thromboxane and cysteinyl
leukotrienes in patients was investigated. The production of
eicosanoids in patients is assessed by measuring stable urinary metabolites,11-dehydro
thromboxane B2 and
leukotriene E4, using gas chromatography/selected ion monitoring and liquid chromatography/tandem mass spectrometry. The level of urinary
thromboxane in patients was significantly higher than that in healthy volunteers (P < 0.05). Furthermore, we investigated the effects of administered drugs on the production of these
eicosanoids. The urinary
thromboxane level of the untreated group (1630 +/- 613 pg/mg
creatinine) was much higher than that of healthy volunteers (342 +/- 263 pg/mg
creatinine). The level in the group receiving
NSAID alone was similar to that in healthy volunteers, and the group receiving
steroid alone showed slightly lower
thromboxane levels than the untreated group. On the other hand, the
leukotriene E4 level in patients (280 +/- 360 pg/mg
creatinine) was also significantly higher than that in healthy volunteers (59 +/- 54 pg/mg
creatinine, P < 0.05). In particular, the group receiving
methotrexate (904 +/- 685 pg/mg
creatinine) had higher
leukotriene levels than not only healthy volunteers but also other medicated groups. These findings demonstrated that endogenous
thromboxane and
leukotriene production in patients with
rheumatoid arthritis are enhanced, and the effects of medication on the production of these
eicosanoids differed in
thromboxane and
leukotriene E4.