title: Differences in urinary leukotriene E4 levels and distribution of eosinophils between chronic rhinosinusitis patients with aspirin-intolerant and -tolerant asthma.
abstract: OBJECTIVE
  Urinary leukotriene E4 (U-LTE4) concentrations are significantly elevated in patients with aspirin-intolerant asthma (AIA). However, the relationship between the clinicopathogenetic features of eosinophilic rhinosinusitis and U-LTE4 concentration remains unknown. Here we examined the relationship between U-LTE4 level and eosinophil in chronic rhinosinusitis.
  
  
  METHODS
  We measured the U-LTE4 concentrations and eosinophil counts in ethmoidal and maxillary sinuses and peripheral blood in 30 asthmatic patients (including 15 AIA patients).
  
  
  RESULTS
  Eosinophil counts in ethmoidal sinuses and peripheral blood were markedly higher in asthmatic patients than in controls. Although there were no significant differences between eosinophil counts in maxillary and ethmoidal sinuses for ATA group, eosinophil counts were higher in ethmoidal sinus compared to that in maxillary sinus in the AIA group (P<.05). Eosinophil counts were higher in the maxillary than in ethmoidal sinuses for control patients (P<.05). Despite low correlation between eosinophil counts in peripheral blood and eosinophil counts in maxillary sinus (rs=0.4323, P<.001), moderate correlation was observed between eosinophil counts in peripheral blood and eosinophil counts in ethmoidal sinus (rs=0.5249, P<.0001). Basal U-LTE4 concentrations were higher in AIA patients than in those with aspirin-tolerant asthma. Despite low correlation between eosinophil counts and U-LTE4 concentration in maxillary sinus (rs=0.3849, P<.01), moderate correlation was observed between eosinophil counts and U-LTE4 concentrations in ethmoidal sinus (rs=0.4736, P<.001).
  
  
  CONCLUSIONS
  We describe the differences in U-LTE4 and other parameters in AIA compared to ATA, and correlation among parameters. We demonstrate that eosinophil-dominant inflammation starts in ethmoidal sinus clinicopathogenetically in CRS with asthma. U-LTE4 concentration was not exclusively associated with eosinophil counts in ethmoidal sinus. Eosinophils in ethmoidal sinus may be a major production site for CysLTs, particularly in AIA. CRS with AIA is assumed to be characterized by leukotriene-eosinophil cross-interaction in ethmoidal sinus.
authors.affiliation: The Department of Otorhinolaryngology, Head and Neck Surgery of Kitasato University Hospital, Kanagawa, Japan. Electronic address: ytomoko@med.kitasato-u.ac.jp.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: The Department of Otorhinolaryngology of National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Toyota
authors.initials: T
authors.lastname: Ishii
authors.affiliation: The Department of Otorhinolaryngology of National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: The Clinical Research Center, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan; The Third Department of Internal Medicine, Kagoshima University School of Medicine, Kagoshima, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Higashi
authors.affiliation: The Clinical Research Center, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Taniguchi
authors.affiliation: The Department of Otorhinolaryngology, Head and Neck Surgery of Kitasato University Hospital, Kanagawa, Japan.
authors.forename: Makito
authors.initials: M
authors.lastname: Okamoto
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications / Q000276:immunology / Q000652:urine; D055963:Asthma, Aspirin-Induced / Q000150:complications / Q000276:immunology* / Q000652:urine; D016022:Case-Control Studies; D002908:Chronic Disease; D004802:Eosinophilia / Q000150:complications / Q000276:immunology*; D004804:Eosinophils / Q000166:cytology*; D005005:Ethmoid Sinus / Q000166:cytology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D017999:Leukotriene E4 / Q000652:urine*; D008297:Male; D008443:Maxillary Sinus / Q000166:cytology*; D008875:Middle Aged; D012220:Rhinitis / Q000150:complications / Q000276:immunology* / Q000652:urine; D012852:Sinusitis / Q000150:complications / Q000276:immunology* / Q000652:urine; D055815:Young Adult
chemical_list: D017999:Leukotriene E4
keywords: Aspirin-intolerant asthma; Chronic rhinosinusitis with nasal polyposis; Eosinophilic rhinosinusitis; Ethmoid sinus; Urinary leukotriene E4