title: Evaluation of eicosanoids in nasal lavage as biomarkers of inflammation in patients with allergic rhinitis.
abstract: BACKGROUND
  Cysteinyl leukotrienes (cys-LTs), 8-isoprostane and prostaglandin E2 (PGE2) constitute fundamental mediators in allergic inflammation; therefore we wanted to determine the utility of PGE2, 8-isoprostane and cys-LT levels in nasal lavage as biomarkers of allergic inflammation.
  
  
  METHODS
  Twenty-one patients with allergic rhinitis (AR) were included on the basis of a positive history of AR symptoms and positive results of skin prick tests to grass pollen allergens. The main exclusion criteria were: uncontrolled asthma, nasal polyps, respiratory infection, tuberculosis, neoplastic and autoimmune diseases, current smoking and immunotherapy. Both outside the pollen season and at the height of the pollen season, total nasal symptom score (TNS-4) was evaluated and the levels of cys-LTs, 8-isoprostane and PGE2 were measured in nasal lavage fluid (NALF).
  
  
  RESULTS
  Natural allergen stimulation resulted in a significant increase of TNS-4 (p < 0.001) and nasal eosinophilia (p < 0.001). The concentration of PGE2 dominated in the NALF outside the pollen season and decreased significantly at the height of natural exposure (p < 0.01). In contrast, lower baseline concentrations of cys-LTs and 8-isoprostane increased significantly upon allergen stimulation (p < 0.05). There was a significant correlation between mean concentration of PGE2 and eosinophil number in NALF (r = 0.67, p = 0.0439).
  
  
  CONCLUSIONS
  The NALF concentrations of cys-LTs and 8-isoprostane change simultaneously with TNS-4 and nasal eosinophilia. However, due to the lack of any significant correlation, their utility as markers of allergic rhinitis should be warily considered. The decrease of PGE2 concentration in NALF which correlated with nasal eosinophilia may participate in escalation of allergic inflammation and needs further evaluation.
authors.affiliation: Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Ciebiada
authors.affiliation: Department of Pneumonology and Allergy, Medical University of Lodz, Lodz, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Górski
authors.affiliation: Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Antczak
keywords: allergic rhinitis; biomarkers; eicosanoids; leukotrienes; nasal lavage; prostaglandins