title: High levels of urinary leukotriene E4 excretion in steroid treated patients with severe asthma.
abstract: Urinary LTE4 reflects the whole body production of the cysteinyl-leukotrienes (LTC4, LTD4 and LTE4) that are established mediators in asthma. The influence of chronic inhaled and oral glucocorticoid treatment on urinary excretion of leukotriene (LT) E4 was investigated in subjects with asthma. Enzyme immunoassay analysis of LTE4 was performed in spot urine samples collected from 40 patients with severe asthma, 25 patients with mild-moderate asthma and 20 non-asthmatic control subjects. Urinary LTE4 was significantly higher in patients with severe asthma (69.7 +/- 5.5) as compared to mild-moderate asthma (45.7 +/- 3.3 with P < 0.0004) and control (42.5 +/- 2.5 with P < 0.0001). Despite chronic systemic treatment with glucocorticoids, chronically severe asthma had presented with higher levels of LTE4 compared to mild moderate asthma and healthy controls. The findings support previous indications that one important component in asthmatic airway inflammation, the cysteinyl-leukotriene pathway remains relatively unopposed by oral glucocorticoids.
authors.affiliation: Clinique des Maladies Respiratoires, INSERM U454, Hôpital Arnaud de Villeneuve, 371 Av du Doyen Gaston Giraud, 34295 Montpellier 5, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vachier
authors.forename: Maria
authors.initials: M
authors.lastname: Kumlin
authors.forename: Sven Erik
authors.initials: SE
authors.lastname: Dahlén
authors.forename: Jean
authors.initials: J
authors.lastname: Bousquet
authors.forename: Philippe
authors.initials: P
authors.lastname: Godard
authors.forename: Pascal
authors.initials: P
authors.lastname: Chanez
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy / Q000652:urine*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D017999:Leukotriene E4 / Q000652:urine*; D008297:Male; D008875:Middle Aged; D013256:Steroids / Q000008:administration & dosage*
chemical_list: D013256:Steroids; D017999:Leukotriene E4