Urinary levels of leukotriene E4 in acute asthmatic children

Abstract

Background and Aims: Increased production of cysteinyl leukotrienes (CysLTs) within the airways causes acute asthma. Leukotriene E4 (LTE4) is a potent constricting mediator and is excreted in urine. This study hypothesized that urinary LTE4 (uLTE4) levels would be increased in acute asthma in Egyptian children. The study measured uLTE4 in children with acute asthma and compared them to a matched healthy control group. Material and Methods: The study included 40 acute Egyptian asthmatic children and 40 age-and sex-matched controls. All candidates were subjected to a complete clinical study (thorough history and physical examination); with emphasis on severity of asthma attack according to Global Initiative for Asthma Guidelines. Measurement of urinary creatinine was performed for all study candidates. Measurement of uLTE4 (pg/mg creatinine) was performed using commercial ELISA kit. Results: Levels of uLTE4 were significantly higher in cases compared to controls (305.48 ± 34 pg/mg creatinine versus 175.55 ± 79 pg/mg creatinine respectively, 95% CI (17.7; 242.1), p=0.024).Levels of uLTE4 were significantly higher in cases with moderate and severe attacks in comparison to those with mild attacks. There was a significant positive correlation between severity of the attack and uLTE4 levels (Spearman's rho = 0.446, p=0.004). Conclusion: Levels of uLTE4 are significantly elevated during acute asthma episodes in children. The significant direct correlation between severity of these attacks and uLTE4 levels make uLTE4 a possible marker for monitoring acute asthma exacerbations in children.