Urinary leukotriene levels are increased during exacerbation of atopic eczema/dermatitis syndrome. Relation to clinical status.
BACKGROUND
Leukotrienes are potent mediators of allergic inflammation and their role in the pathogenesis of allergic disorders, particularly asthma, is well established. Their importance in the pathogenesis of atopic eczema/dermatitis syndrome (AEDS) is still unclear. We aimed to compare urinary cysteinyl leukotriene (Cys-LT) levels during exacerbation and remission of AEDS in relation to clinical status, IgE levels, and eosinophil counts.


METHODS
Urinary Cys-LTs were measured by direct enzyme immunoassay in 17 adult patients with AEDS and in 17 healthy controls in whom atopy had been excluded. Cys-LTs were compared during exacerbation and remission of AEDS in relation to the clinical status measured by SCORAD. Total IgE levels were measured by enzyme-linked immunoassay (ELISA).


RESULTS
Mean clinical score during the exacerbation was 64.3 +/- 3.1 and during remission 22.4 +/- 4 (P < 0.01). Cys-LTs levels were significantly higher during the exacerbation of AEDS than in the control group (230.9 +/- 20.8 vs 123.2 +/- 9.9 pg/mg creatinine; P < 0.005). During the remission, the difference between AEDS patients and the control group was not significant (96.3 +/- 8.7 vs 123.2 +/- 9.9 pg/mg creatinine; P = 0.8). During AEDS exacerbation Cys-LTs levels were significantly correlated with the clinical status (rS = 0.73, P < 0.01) and with eosinophil counts (r = 0.86; P < 0.01) but not with the duration of the disease, age of patients, or IgE levels.


CONCLUSIONS
Our results point to enhanced biosynthesis of Cys-LTs during the AEDS exacerbations. Inflammatory cells, e.g. eosinophils are the most probable source of Cys-LTs. A strong correlation between Cys-LT levels and clinical status may in part explain preliminary clinical observations of efficacy of leukotriene antagonists in alleviating symptoms of AEDS.
Adamek-Guzik
T
T
Department of Internal and Agricultural Medicine, J Dietl Hospital, Cracow, Poland.
Guzik
T J
TJ
Czerniawska-Mysik
G
G
Korpanty
G
G
Mastalerz
L
L
Radwan
J
J
Szczeklik
A
A
D000293:Adolescent; D000328:Adult; D003545:Cysteine / Q000652:urine*; D003872:Dermatitis / Q000503:physiopathology / Q000652:urine*; D004485:Eczema / Q000503:physiopathology / Q000652:urine*; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000503:physiopathology / Q000652:urine*; D007073:Immunoglobulin E / Q000032:analysis; D007958:Leukocyte Count; D015289:Leukotrienes / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012720:Severity of Illness Index; D013577:Syndrome
D015289:Leukotrienes; C112381:cysteinyl-leukotriene; D007073:Immunoglobulin E; D003545:Cysteine