Abstract
ObjectivesLeukotrienes play a central pathophysiological role in allergic asthma. The aim of this study was to investigate the utility of measuring urinary leukotriene E4 (LTE4) levels in the diagnosis of atopic diseases in early childhood.MethodsChildren aged 0 through 4 years from a birth cohort in the Prediction of Allergies in Taiwanese Children (PATCH) study were enrolled. Urinary LTE4 levels were measured and its association between total serum IgE levels, allergen-specific IgE sensitization and atopic diseases were assessed.ResultsA total of 182 children were regular followed up at clinics for a four-year follow-up period. Urinary LTE4 levels appeared to be elevated in children with total serum IgE levels exceeding 100 kU/L, allergen-specific IgE sensitization after 2 years of age. Elevation of urinary LTE4 levels (≥500 pg/mg of creatinine) significantly discriminated high serum total IgE levels (≥100 kU/L) at age 2 (P = 0.027). A higher level of total serum IgE or urinary LTE4 was significantly associated with the risk of developing allergic rhinitis and asthma at age 3. A significantly higher urinary LTE4 level was found in children with a combination of IgE sensitization and asthma at age 4.ConclusionsUrinary LTE4 levels appear to be highly associated with IgE sensitization and its related allergic airway diseases after age 2. The measurement of urinary LTE4 (≥500 pg/mg of creatinine) could not only be a non-invasive method for atopic predisposition but also potentially provide a strategy for the diagnosis and management of asthma in preschool children.
Highlights
Allergic diseases are among the most common chronic diseases throughout the world and the prevalence of atopic diseases in childhood has significantly been increasing in the past few decades [1, 2]
immunoglobulin E (IgE) sensitization was predictive in asthma, the utility of measuring total serum IgE or allergen-specific IgE for purpose of diagnosis and management is variable
The prevalence of allergic respiratory diseases increases with increasing age and a rapid upward trend is observed after 2 year of age [21]
Summary
Allergic diseases are among the most common chronic diseases throughout the world and the prevalence of atopic diseases in childhood has significantly been increasing in the past few decades [1, 2]. The diagnosis of atopic diseases, especially asthma, is difficult in preschool children. The physician’s diagnosis of asthma in children under the age of five is mainly based on clinical evaluation. Several studies have shown an association between prevalence of asthma and total serum immunoglobulin E (IgE) levels [3, 4]. Allergen-specific IgE antibodies provide useful serological information in the differential diagnosis on IgEmediated atopic diseases in young children with allergy-like symptoms [5]. IgE sensitization was predictive in asthma, the utility of measuring total serum IgE or allergen-specific IgE for purpose of diagnosis and management is variable. It is important to recognize that a conjunction of IgE sensitization with other biomarkers may be helpful in the diagnosis and management of early-life asthma
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