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Urinary leukotriene E₄ in preschool children with acute clinical viral wheeze

Leicester Children's Asthma Centre, Institute for Lung Health, University of Leicester, Leicester, UK

CORRESPONDENCE: J. Grigg, Senior Lecturer in Paediatric Respiratory Medicine, Leicester Children's Asthma Centre, Institute for Lung Health, University of Leicester, Leicester, LE2 7LX, UK. Fax: 44 1162523282. E-mail: jg33@le.ac.uk

Keywords: children, immunoglobulin E, preschool, urinary leukotriene E₄, viral wheeze

Received: March 15, 2002
Accepted August 2, 2002

A. Oommen was funded by grant AM2/01/008 from the National Health Service National Research and Development Programme on Asthma Management. J. Grigg was funded by the Henry Smith's Charity and Medisearch.

Cysteinyl leukotrienes (cystLTs) are important mediators of wheeze in atopic asthma, but the role of cystLTs in the pathogenesis of preschool viral wheeze (PVW) is unclear. Therefore, evidence for increased production of cystLTs in PVW was sought.

Urinary leukotriene E₄ (uLTE₄) and serum total immunoglobulin (Ig)E were measured in children (1–5 yrs) with PVW during an acute attack (n=44) and in the convalescent phase (n=19), and compared with normal controls (n=15). The effect of atopic sensitisation was assessed in a separate group of atopic controls (n=6) in whom only uLTE₄ was measured.

The levels of uLTE₄ were similar in normal and atopic controls and increased in acute PVW (median (interquartile range) 165 (101–285) versus 125 (82–163) ng·mM creatinine^–1). Stratification by IgE showed that whereas uLTE₄ was increased in 23 children with acute PVW and IgE >95th percentile (median 211 (118–312) ng·mM creatinine^–1), uLTE₄ was not increased in the 21 children with acute PVW and IgE 95th percentile. In the convalescent phase, uLTE₄ fell in the subgroup with high IgE but not in the subgroup with low IgE.

It is concluded that increased cysteinyl leukotriene production during acute preschool viral wheeze is associated with high serum immunoglobulin E.

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