Brockmann P E, Castro-Rodriguez J A, Holmgren N L, Cerda J, María Contreras A, Moya A, Bertrand P J
Department of Pediatrics, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Allergol Immunopathol (Madr). 2012 May-Jun;40(3):181-6. doi: 10.1016/j.aller.2011.03.012. Epub 2011 Jun 23.
Leukotrienes are among the most important mediators associated with inflammatory responses in patients with exercise induced asthma (EIA). The aim of this study was to investigate the impact of exercise on the urinary leukotriene profile. Hence, we compared post exercise changes of urinary leukotriene E4 (LTE4) concentration between children with EIA and healthy controls.
Ten children with EIA and 15 controls were enrolled. Both groups underwent a standardised exercise challenge test (ECT). LTE4 concentration was measured in urine samples obtained pre and post ECT, using enzyme immunoassay and adjusted by urinary creatinine concentrations.
Median (minimum-maximum) pre ECT concentration of LTE4 was 17.82 (7.58-90.23 pg/ml) in EIA and 17.24 (4.64-64.02 pg/ml) in controls, p=0.86. LTE4 concentration post ECT were 23.37 (4.02-93.00 pg/ml) in EIA and 11.74 (0.13-25.09 pg/ml) in controls, p=0.02. Changes of LTE4 concentration post ECT were 2.54 (-31.98 to 43.31 pg/ml) in cases and -13.53 (-46.00 to 11.02 pg/ml) in controls, p=0.03. There was no significant correlation between basal predicted FEV(1) [%] and changes in LTE4 concentration in cases (i.e., r(s)=0.14) nor controls (i.e., r(s)=0.12). There was a tendency towards more pronounced changes in LTE4 concentration post ECT in children with moderate/mild persistent asthma compared to those with mild but intermittent asthma.
Children with EIA had significantly higher changes of urinary LTE4 concentrations post ECT compared to healthy controls. Urinary measurement of LTE4 may be an interesting and non-invasive option to assess control of EIA in children.
白三烯是运动诱发哮喘（EIA）患者炎症反应中最重要的介质之一。本研究的目的是调查运动对尿白三烯谱的影响。因此，我们比较了EIA患儿与健康对照者运动后尿白三烯E4（LTE4）浓度的变化。
招募了10名EIA患儿和15名对照者。两组均接受标准化运动激发试验（ECT）。使用酶免疫测定法测量ECT前后采集的尿液样本中LTE4的浓度，并通过尿肌酐浓度进行校正。
EIA组ECT前LTE4浓度中位数（最小值 - 最大值）为17.82（7.58 - 90.23 pg/ml），对照组为17.24（4.64 - 64.02 pg/ml），p = 0.86。EIA组ECT后LTE4浓度为23.37（4.02 - 93.00 pg/ml），对照组为11.74（0.13 - 25.09 pg/ml），p = 0.02。ECT后LTE4浓度变化在病例组为2.54（-31.98至43.31 pg/ml），对照组为-13.53（-46.00至11.02 pg/ml），p = 0.03。病例组基础预计FEV(1)[%]与LTE4浓度变化之间无显著相关性（即，r(s)=0.14），对照组也无显著相关性（即，r(s)=0.12）。与轻度但间歇性哮喘患儿相比，中度/轻度持续性哮喘患儿ECT后LTE4浓度变化更明显。
与健康对照者相比，EIA患儿ECT后尿LTE4浓度变化显著更高。尿LTE4测定可能是评估儿童EIA控制情况的一种有趣且非侵入性的选择。
