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Exhaled eicosanoids following oral aspirin challenge in asthmatic patients.

AbstractBACKGROUND:
Biochemical analysis of expiratory breath condensate is an emerging non-invasive technique for assessment of airway inflammation.
OBJECTIVE:
We wondered whether application of expiratory breath condensate could facilitate diagnosis of aspirin-intolerant asthma and reproduce eicosanoids mediators' abnormalities described in this disease.
METHODS:
We measured prostaglandins (PGs) E(2), F(2 alpha), 9 alpha 11 beta F(2) and iso-F(2) by gas-chromatography/mass-spectrometry and cysteinyl leukotrienes (cys-LTs) by radioimmunoassay in breath condensates of asthmatic patients undergoing oral aspirin challenge. Fourteen patients with aspirin-induced asthma and 20 aspirin-tolerating asthmatics, most of them on chronic inhaled corticotherapy, were studied and compared with 10 healthy subjects. Additionally, plasma 9 alpha 11 beta PGF(2), the metabolite of PGD(2) and urinary leukotriene (LT) E(4) were measured before and following the challenge.
RESULTS:
At baseline, PG did not differ between the groups, except for lower 9 alpha 11 beta PGF(2) in aspirin-intolerant asthma. Their concentrations were not changed by the challenge. Breath condensate cys-LTs were similar in the groups studied at base, and after aspirin challenge increased only in aspirin-intolerant patients. Elevated baseline urinary LTE(4) and its further increase following aspirin challenge was highly diagnostic for aspirin-intolerant asthma. The discriminatory value of cys-LTs increase in breath condensates was lower (72.8%) than either basal (99%) or post-challenge increase (94%) of urinary LTE(4).
CONCLUSIONS:
In asthmatic patients on chronic corticotherapy measurement of urinary LTE(4) excretion rather than cys-LTs in breath condensate is of greater value for diagnosis of aspirin hypersensitivity.
AuthorsM Sanak, B Kiełbasa, G Bochenek, A Szczeklik
JournalClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (Clin Exp Allergy) Vol. 34 Issue 12 Pg. 1899-904 (Dec 2004) ISSN: 0954-7894 [Print] England
PMID15663565 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Biomarkers
  • Eicosanoids
  • Leukotriene E4
  • Dinoprost
  • Dinoprostone
  • Aspirin
Topics
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
  • Area Under Curve
  • Aspirin (adverse effects)
  • Asthma (chemically induced, diagnosis)
  • Biomarkers (analysis, blood, urine)
  • Breath Tests
  • Case-Control Studies
  • Dinoprost (analysis, blood)
  • Dinoprostone (analysis)
  • Eicosanoids (analysis)
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Leukotriene E4 (urine)
  • Lung (drug effects, metabolism)
  • Male
  • Middle Aged
  • ROC Curve

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