Functional Tissue Diagnostics, Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany.
J Physiol Pharmacol. 2011 Aug;62(4):469-72.
Clinical symptoms of patients with mastocytosis may include skin reactions, but also gastrointestinal symptoms with hyperacidity and dysmotility (e.g. ulcer, diarrhea, pain). They are mostly caused by mediators derived from activated mast cells. In order to investigate the impact of leukotrienes on the clinical symptoms excretion of leukotriene B4 (LTB4) and leukotrienes C4-D4-E4 (cysteinyl-leukotrienes) into urine was studied in 9 patients with indolent systemic mastocytosis divided into a group with high and low intensity of symptoms and in 11 healthy volunteers. Leukotriene excretion was determined by ELISA and correlated with methylhistamine excretion. Patients with systemic mastocytosis with high and low intense symptoms showed significantly higher urinary excretion of cysteinyl-leukotrienes than controls. There was a positive correlation of cysteinyl-leukotriene excretion and urinary methylhistamine excretion. LTB4 excretion was also significantly increased in patients with systemic mastocytosis compared to healthy volunteers. No correlation of urinary LTB4 excretion with urinary methylhistamine was observed. The present study demonstrates that urinary excretion of LTB4 and cysteinyl-leukotrienes LTC4-D4-E4 is clearly enhanced in indolent systemic mastocytosis Hence, determination of leukotriene excretion into urine can be used as a tool in the diagnostic and in the therapeutic monitoring of systemic mastocytosis.
肥大细胞增多症患者的临床症状可能包括皮肤反应，也可能包括胃酸过多和运动障碍的胃肠道症状（如溃疡、腹泻、疼痛）。这些症状主要是由活化的肥大细胞衍生的介质引起的。为了研究白三烯对临床症状的影响，我们研究了 9 例惰性系统性肥大细胞增多症患者（分为症状强度高和低的两组）和 11 名健康志愿者尿液中白三烯 B4（LTB4）和白三烯 C4-D4-E4（半胱氨酰白三烯）的排泄情况。通过 ELISA 测定白三烯排泄，并与甲基组氨酸排泄相关。症状强度高和低的系统性肥大细胞增多症患者的尿半胱氨酰白三烯排泄明显高于对照组。半胱氨酰白三烯排泄与尿甲基组氨酸排泄呈正相关。与健康志愿者相比，系统性肥大细胞增多症患者的 LTB4 排泄也明显增加。未观察到尿 LTB4 排泄与尿甲基组氨酸之间存在相关性。本研究表明，惰性系统性肥大细胞增多症患者的 LTB4 和半胱氨酰白三烯 LTC4-D4-E4 的尿排泄明显增加。因此，尿白三烯排泄的测定可作为系统性肥大细胞增多症诊断和治疗监测的工具。
