Chest
Volume 99, Issue 2, February 1991, Pages 289-291
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Clinical Investigations
Serum Leukotriene B4 Levels in Patients with Obstructive Pulmonary Disease

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Leukotriene B4 has been found to be increased in the serum of cigarette smokers and some patients with bronchial asthma, as well as in the sputum of patients with cystic fibrosis and COPD. Corticosteroids supposedly may block the formation of LTB4. To determine if the effect of CS on airway disease is by reduction in LTB4, we studied serum LTB4 levels in clinically stable patients with asthma or COPD who were treated with or without CS. The LTB4 was extracted from serum and assayed by radioimmunoassay. Serum LTB4 concentrations, expressed as the mean ± SD, were 0.36 ± 0.15 ng/ml in ten normal controls, 0.56 ± 0.18 ng/ml in nine asthmatic subjects, 0.67 ± 0.2 ng/ml in eight asthmatic subjects receiving CS, 0.81 ± 0.19 ng/ml in seven patients with COPD, and 0.97 ± 0.29 ng/ml in eight patients with COPD receiving CS. Serum LTB4 levels in normal controls differed significantly from all groups with COPD or asthma (p<0.01). Levels of LTB4 in asthmatic subjects differed from levels in patients with COPD (p<0.03), and levels in asthmatic subjects receiving CS differed from subjects with COPD receiving CS (p<0.03). Concentrations of LTB4 within either the COPD or the asthmatic groups were not lower in the patients treated with CS. We conclude that serum LTB4 concentrations are higher in COPD than in asthma or normal controls and that administration of CS is not associated with low LTB4 levels. The beneficial effects of CS in obstructive airway disease appear to be mediated by mechanisms other than reduction of LTB4.

Section snippets

MATERIALS AND METHODS

Subjects in this study included persons with no known pulmonary disease, with bronchial asthma, or with COPD, as defined by the American Thoracic Society.19 The study was approved by the Institutional Review Board of the University of Missouri-Columbia School of Medicine, and all subjects gave informed consent. Patients were categorized as treated with CS if they were receiving oral prednisone therapy at the time of blood sampling. As dosages of prednisone varied at different times, an average

RESULTS

The results are summarized in Table 1, Table 2. Our normal population and both subgroups of patients with COPD were similar in age (mean ± SD, 65 ± 19, 60 ± 10, and 66 ± 9 years, respectively). Asthmatic subjects and asthmatic subjects receiving CS (mean ± SD] age of 30 ± 7 and 42 ± 16 years) were significantly younger than normal subjects and all patients with COPD.

The durations of disease and of treatment with bronchodilators were similar in all groups. There were only two current smokers,

DISCUSSION

Leukotriene B4 is a mediator of inflammation and has been associated with efflux of neutrophils into BALF in humans, as well as bronchial hyperreactivity in dogs.23,24

Elevated LTB4 concentrations have been reported in various body fluids in several allergic and inflammatory conditions.10,16,25, 26, 27 Increased serum LTB4 concentrations have been found in asthmatic subjects, smokers, patients with psoriasis, and those with bronchogenic carcinoma.10,12,13 Increased plasma concentrations have

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    Supported in part by the Medical Research Service, Harry S. Truman Memorial Veterans Hospital, and the Department of Medicine, University of Missouri-Columbia School of Medicine.

    Presented in abstract form at the 16th World Congress on Diseases of the Chest and 55th Annual Assembly, American College of Chest Physicians, Boston, Oct 29-Nov 2, 1989.

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