Asthma is associated with the overproduction of
leukotrienes (LTs), including
LTB4. Patients with severe
asthma can be highly responsive to
5-lipoxygenase (5-LO) inhibition, which blocks production of both the cysteinyl LTs and
LTB4. Production of
LTB4 has traditionally been ascribed to neutrophils, mononuclear phagocytes, and epithelial cells, and acts as a
chemoattractant for inflammatory cells associated with
asthma. The source of
LTB4 is unclear, especially in eosinophilic
asthma. We speculated that the benefit of 5-LO inhibition could be mediated in part by inhibition of eosinophil-derived
LTB4.
LTB4 concentrations were assayed in BAL fluid from patients with severe
asthma characterized by isolated neutrophilic, eosinophilic, and paucigranulocytic
inflammation. Expression of
LTA4 hydrolase (LTA4H) by airway eosinophils was determined by immunohistochemistry (IHC). Subsequently, peripheral blood eosinophils were activated and secreted
LTB4 was quantified by
enzyme immunoassay. Blood eosinophil LTA4H expression was determined by flow cytometry, qPCR, and IHC.
LTB4 concentrations were elevated in BAL fluid from patients with severe
asthma, including those with isolated eosinophilic
inflammation, and these eosinophils displayed LTA4H via IHC. LTA4H expression by blood eosinophils was confirmed by flow cytometry, IHC, and qPCR. Robust
LTB4 production by blood eosinophils was observed in response to some, but not all, stimuli. We demonstrated that eosinophils express LTA4H transcripts and
protein, and can be stimulated to secrete
LTB4. We speculate that in many patients with
asthma, eosinophil-derived
LTB4 is increased, and this may contribute to the efficacy of 5-LO inhibition.