Acetylsalicylic acid-triggered 15-HETE generation by peripheral leukocytes for identifying ASA sensitivity.
BACKGROUND
Exposure to acetylsalicylic acid (ASA) may exacerbate respiratory or skin diseases or induce anaphylactoid reactions in apparently healthy individuals. We wanted to evaluate the clinical and diagnostic utility of measuring ASA-induced 15-hydroxyeicosatetraenoic acid (15-HETE) generation.


METHODS
We performed a prospective single-blind study with 26 subjects undergoing clinical evaluation and/or ASA provocation testing. We also included 12 control subjects. Peripheral blood leukocytes were incubated with 500 μM ASA and 15-HETE release was measured by competitive ELISA.


RESULTS
We found that 18 subjects were ASA-tolerant and 8 were ASA-intolerant. The mean increase in 15-HETE in intolerant subjects was 34% and this was comparable to the mean increase of 30% observed in ASA-tolerant subjects. A similar mean increase was also observed in control subjects. The ROC calculation showed that the optimal diagnostic threshold would be an increase of greater than 33%. However, the sensitivity of this increase was only 63% and the specificity was 50%.


CONCLUSIONS
Our data suggest that further studies are needed before the ASA-induced 15-HETE test can be used in clinical practice.
University Clinic of Respiratory and Allergic Diseases Colnik, Colnik, Slovenia. peter.korosec@klinika-golnik.si
Peter
P
Korosec
Ursa
U
Tisler
Nissera
N
Bajrovic
Mira
M
Silar
Ales
A
Mrhar
Mitja
M
Kosnik
D001241:Aspirin / Q000009:adverse effects* / Q000494:pharmacology; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006893:Hydroxyeicosatetraenoic Acids / Q000009:adverse effects* / Q000096:biosynthesis; D007962:Leukocytes / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
D006893:Hydroxyeicosatetraenoic Acids; C025984:15-hydroxy-5,8,11,13-eicosatetraenoic acid; D001241:Aspirin