Establishing Urinary Leukotriene E4 as a Diagnostic Biomarker for Chronic Rhinosinusitis with Comorbid Asthma and Atopy
Objective: While urinary leukotriene E (uLTE ) is a validated biomarker for the cysteinyl leukotriene pathway, which is central to the pathophysiology of asthma, atopy, and chronic rhinosinusitis (CRS), the contributions of comorbid asthma and atopy to uLTE levels in various CRS subtypes have not been previously characterized. We sought to (1) identify reference values for uLTE in subjects with and without CRS and (2) determine how the presence of comorbid atopy and asthma affects uLTE levels in CRS. Setting: Tertiary referral medical center. Subjects and Methods: A prospective case-control study was conducted to compare uLTE levels between patients with CRS and healthy controls. Urinary LTE levels were measured by enzyme immunoassay and were adjusted for urinary creatinine concentrations (pg/mg Cr). Patients with CRS were stratified by the clinical comorbidities to determine normative uLTE values for patients with CRS with and without comorbid asthma or atopy. Results: A total of 153 patients (mean age, 47.3; 47.1% female) were included in the study. Patients with CRS demonstrated significantly higher concentrations of uLTE than healthy controls (1652 vs 1065 pg/mg Cr, P =.032). Within the group of patients with CRS, comorbid asthma also individually correlated with elevated uLTE levels (1597 pg/mg Cr, P =.0098). Patients with CRS who did not have comorbid allergy and asthma, in contrast, did not have statistically higher uLTE levels than healthy controls (1142 pg/mg Cr, P =.61). Conclusion: Urinary LTE serves as a noninvasive measure of the inflammatory state in CRS. Comorbid asthma and atopy contribute to elevated uLTE levels in CRS. 4 4 4 4 4 4 4 4 4 4 4 4 4
Otolaryngology - Head and Neck Surgery (United States)
Digital Object Identifier (DOI)
Santarelli, Griffin D.; Lam, Kent K.; and Han, Joseph K., "Establishing Urinary Leukotriene E4 as a Diagnostic Biomarker for Chronic Rhinosinusitis with Comorbid Asthma and Atopy" (2019). Neurology Articles. 593.