title: Lipoxin A4 levels in asthma: relation with disease severity and aspirin sensitivity.
abstract: BACKGROUND
  Lipoxin (LX) A4, an endogenous anti-inflammatory eicosanoid, has been found to be low in patients with severe asthma. However, few studies also suggested more diminished LX A4 levels in aspirin-exacerbated respiratory disease (AERD) when compared with aspirin-tolerant asthma (ATA). It is, therefore, currently not clear whether the asthma severity or the presence of AERD has a primary role in the disturbed LX metabolism.
  
  
  OBJECTIVE
  To detect LX A4 and 15-epi-LX A4 levels in asthma patients with and without AERD of comparable severity.
  
  
  METHODS
  The study groups consisted of 22 subjects with AERD, 22 subjects with ATA and 10 volunteers without asthma and aspirin sensitivity. Whole-blood samples were stimulated with calcium ionophore, A23187 (5 x 10(-5) m) and A23187 (5 x 10(-5) m)+aspirin (10(-4) m). LX A4 and 15-epi-LX A4 levels were analysed by the enzyme immune assay method.
  
  
  RESULTS
  Severe asthma patients in both AERD [0.5 (0.8)] ng/mL and ATA [0.5 (0.45) ng/mL] groups showed diminished generation for LX A4 to stimulation with A23187 in comparison with other severity degrees in their groups (P=0.02 and 0.046, respectively). LX A4 generation in both severe groups was comparable with each other (P>0.05). Although severe cases with AERD showed a diminished capacity to generate 15-epi-LX A4, this did not reach statistical significance.
  
  
  CONCLUSIONS
  This study indicated that diminished LX A4 generation was unique to severe asthma phenotype regardless of comorbid aspirin sensitivity. Clinical Implications Lower LX A4 levels in severe asthma would suggest a possibility for LX analogues as future treatment options in these patients.
authors: Department of Chest Diseases, Division of Allergy, Ankara University School of Medicine, Ankara, Turkey. gulfemcelik@gmail.com
authors: G E
authors: GE
authors: Celik
authors: F O
authors: FO
authors: Erkekol
authors: Z
authors: Z
authors: Misirligil
authors: M
authors: M
authors: Melli
mesh_terms: D000328:Adult; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000150:complications / Q000175:diagnosis*; D004342:Drug Hypersensitivity / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D044045:Lipoxins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D044045:Lipoxins; C040527:lipoxin A4; D001241:Aspirin