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Increased Leukotrienes in Exhaled Breath Condensate in Childhood Asthma

Department of Thoracic Medicine and Department of Pediatric Respiratory Care, Imperial College School of Medicine, National Heart and Lung Institute, London, United Kingdom

Correspondence and requests for reprints should be addressed to Peter J. Barnes, M.D., Department of Thoracic Medicine, Imperial College School of Medicine, National Heart and Lung Institute, Dovehouse Street, London SW3 6LY, UK. E-mail: p.j.barnes{at}ic.ac.uk

Cysteinyl leukotrienes (cys-LTs; LTC₄, LTD₄, and LTE₄) are generated predominantly by mast cells and eosinophils and induce airway smooth muscle contraction, microvascular leakage, and mucous hypersecretion whereas leukotriene B₄ (LTB₄) is a potent chemoattractant of neutrophils. We measured cys-LTs and LTB₄ in exhaled breath condensate from children aged 7–14 years including healthy nonatopic children (n = 11) and children with mild intermittent asthma (steroid naive, n = 11), mild persistent asthma (low-dose inhaled steroid treatment, n = 13), or moderate to severe persistent asthma (high-dose inhaled steroid treatment, n = 13). Exhaled LTB₄ levels were increased in patients with mild and moderate to severe persistent asthma compared with patients with mild intermittent asthma (126.0 ± 8.8 and 131.9 ± 7.1 versus 52.7 ± 3.8 pg/ml, p < 0.001 and p < 0.0001) and normal subjects (126.0 ± 8.8 and 131.9 ± 7.1 versus 47.9 ± 4.1 pg/ml, p < 0.0001). Elevated exhaled cys-LT levels were found in patients with mild and moderate to severe persistent asthma compared with normal subjects (27.9 ± 2.8 and 31.5 ± 4.5 versus 18.5 ± 0.5 pg/ml, p < 0.01 and p < 0.05). There was an inverse correlation between exhaled cys-LTs and LTB₄ in patients with mild persistent asthma. We conclude that exhaled cys-LTs and LTB₄ may be noninvasive markers of airway inflammation in pediatric asthma.

Key Words: asthma • children • cysteinyl leukotrienes • exhaled breath condensate • leukotriene B₄

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