Increased synthesis of peptidoleukotrienes may occur in a variety of inflammatory diseases. To test this theory, hospitalized patients with a variety of diseases were studied and urine
LTE4 quantitated as an index of total body peptidoleukotriene synthesis. 10 patients with ARDS, 7 of which had additional organ involvement, and 5 patients suffering from severe
burn injuries were studied. Patients with uncomplicated ARDS excreted approximately 6-fold higher amounts of
LTE4 in urine compared to healthy subjects. When ARDS was complicated by
multiple organ failure (MOF), urine
LTE4 levels were 2- to 150-fold higher than in healthy volunteers. Patients with severe
burn injuries had peak urine
LTE4 levels which were approximately 20-fold higher than in healthy volunteers. As additional controls, patients with
cardiac arrhythmias (absence of inflammatory disease) and patients with uncomplicated
pneumonia (localized
inflammation) showed normal or mildly elevated urinary
LTE4 levels. The urinary
LTE4 levels in ARDS patients did not correlate with serum
creatinine,
bilirubin, or LDH levels, or with the WBC, nor did renal or
liver failure by itself predict extremely elevated urinary
LTE4 levels. In conclusion, patients with ARDS or ARDS/MOF and patients with severe
injuries and
sepsis syndrome excrete higher levels of urinary
LTE4 than patients healthy volunteers or patients with limited inflammatory disease. In certain situations, urinary
LTE4 levels may be useful as a marker of the degree of
inflammation.