CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Exhaled leukotrienes and prostaglandins in COPD

P Montuschi¹, S A Kharitonov², G Ciabattoni³ and P J Barnes²

¹ Department of Pharmacology, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
² Department of Thoracic Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, London, UK
³ Department of Drug Sciences, G d’Annunzio University, Chieti, Italy

Correspondence to:
Correspondence to:
Professor P Montuschi, Department of Pharmacology, School of Medicine, Catholic University of the Sacred Heart, L.go F. Vito, 1-00168 Rome, Italy;
pmontuschi{at}rm.unicatt.it

Background: The role of eicosanoids, including leukotrienes (LTs) and prostaglandins (PGs), in chronic obstructive pulmonary disease (COPD) is uncertain. The aim of this study was to investigate whether eicosanoids are measurable in exhaled breath condensate (EBC), a non-invasive method of collecting airway secretions, in patients with stable mild to moderate COPD, and to show possible differences in their concentrations compared with control subjects.

Methods: LTB₄, LTE₄, PGE₂, PGD₂-methoxime, PGF₂, and thromboxane B₂ (TxB₂) were measured in EBC in 15 healthy ex-smokers, 20 steroid naïve patients with COPD who were ex-smokers, and in 25 patients with COPD who were ex-smokers and who were treated with inhaled corticosteroids. The study was of cross sectional design and all subjects were matched for age and smoking habit.

Results: LTB₄ and PGE₂ concentrations were increased in steroid naïve (LTB₄: median 100.6 (range 73.5–145.0) pg/ml, p<0.001; PGE₂: 98.0 (range 57.0–128.4) pg/ml, p<0.001) and steroid treated patients with COPD (LTB₄: 99.0 (range 57.9–170.5) pg/ml, p<0.001; PGE₂: 93.6 (range 52.8–157.0) pg/ml, p<0.001) compared with control subjects (LTB₄: 38.1 (range 31.2–53.6) pg/ml; PGE₂: 44.3 (range 30.2–52.1) pg/ml). Both groups of patients had similar concentrations of exhaled LTB₄ (p=0.43) and PGE₂ (p=0.59). When measurable, LTE₄ and PGD₂-methoxime concentrations were similar in COPD patients and controls, whereas PGF₂ concentrations were increased in the former. TxB₂-LI was undetectable in any of the subjects.

Conclusions: There is a selective increase in exhaled LTB₄ and PGE₂ in patients with COPD which may be relatively resistant to inhaled corticosteroid therapy.

Keywords: leukotrienes; prostaglandins; exhaled breath condensate; chronic obstructive pulmonary disease

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