Micheletto C, Visconti M, Trevisan F, Tognella S, Bertacco S, Dal Negro R W
Lung Dept., Bussolengo Gen. Hospital, Verona, Italy.
Eur Ann Allergy Clin Immunol. 2010 Jun;42(3):120-4.
Several comorbid conditions may contribute to worsening asthma symptoms, including nasal polyps (NPs). Cysteinyl leukotrienes (Cys-LTs) play a crucial role in asthma pathophysiology, and specific receptors for CysLTs are reported as upregulated in nasal polyp tissues. The aim of the present study was to assess the prevalence of nasal polyps in severe vs. mild and moderate asthma, and to compare the corresponding levels of urinary Leukotriene E4 (LTE4).
A cohort of 386 asthma patients were studied: n=166 with mild, n=146 with moderate and n=74 severe asthma. All patients performed a nasal endoscopy and urine were collected in the morning for the quantitative LTE4 immunoenzimatic assay (Cayman Chemical, MI, USA). Intolerance to ASA was also assessed by means of a nasal provocation test with L-ASA.
The prevalence of NPs was the following: 8 cases (4.8%) in mild; 14 (9.6%) in moderate, and 33 (44.6%) in severe asthma. Mean urinary LTE4 levels were increasing according to the disease severity. ASA-intolerance was assessed in 1 patient in mild asthma (0.6%), 14 in moderate asthma (9.6%) and 28 in severe asthma (37.8%).
Nasal polyps represent a comorbid which is highly frequent in severe asthma. Both their prevalence and the corresponding mean LTE4 levels in urine proved in strict, direct relationship with asthma severity. In severe asthma, nasal polyps represent a condition which is associated with the highest excretion of urinary LTE4 and ASA intolerance.
几种合并症可能导致哮喘症状恶化，包括鼻息肉（NP）。半胱氨酰白三烯（Cys-LTs）在哮喘病理生理过程中起关键作用，据报道CysLTs的特异性受体在鼻息肉组织中上调。本研究的目的是评估重度哮喘与轻度和中度哮喘中鼻息肉的患病率，并比较相应的尿白三烯E4（LTE4）水平。
对386例哮喘患者进行了研究：166例轻度哮喘患者，146例中度哮喘患者，74例重度哮喘患者。所有患者均接受了鼻内镜检查，并于早晨收集尿液用于定量LTE4免疫酶测定（美国密歇根州开曼化学公司）。还通过L-ASA鼻激发试验评估对阿司匹林（ASA）的不耐受情况。
鼻息肉的患病率如下：轻度哮喘患者中8例（4.8%）；中度哮喘患者中14例（9.6%），重度哮喘患者中33例（44.6%）。尿LTE4平均水平随疾病严重程度增加。在轻度哮喘患者中有1例（0.6%）、中度哮喘患者中有14例（9.6%）、重度哮喘患者中有28例（37.8%）评估为对ASA不耐受。
鼻息肉是重度哮喘中常见的一种合并症。其患病率和相应的尿平均LTE4水平均与哮喘严重程度呈严格的直接关系。在重度哮喘中，鼻息肉与尿LTE4排泄最高和对ASA不耐受相关。
