Study of urinary leukotriene E4 levels and total serum IgE levels in children with acute exacerbations of asthma

Background: Cysteinyl leukotrienes are important in asthma pathogenesis. Leukotriene (LT) E4, which is the most stable cysteinyl LT, is excreted in the urine and its concentration is raised in acute exacerbation of asthma. Estimation of urinary levels of LTE4 can thus assess changes in total body cysteinyl LT production.

Objectives: To assess the variation of urinary LTE4 levelsin children with asthma during acute exacerbations of varying severity and to see its correlation with the serum IgE levels.

Method: This was a prospective analytical study in which 60 children aged between 3 and 18 years with acute asthma exacerbation formed the study group;  24 age and sex matched children without asthma formed the control group.  The urinary leukotriene E4 levels and serum IgE levels were estimated in both groups.

Results: The difference in urinary leukotriene E4 levels between the acute asthma group (288.35pg/mg) and control group (85.71pg/mg) was statistically significant. Among the study group, urinary LTE4 levels in mild, moderate, and severe exacerbations of asthma showed a significant difference (p<0.0001). Serum IgE levels in the acute asthma group (541.21 IU/mL) and control group (132.15 IU/mL) showed a statistically significant difference (p<0.0001) and it was more in the severe group (p<0.0001). A linear correlation was present between urinary leukotriene E4 levels and serum IgE levels among children with acute asthma exacerbation.

Conclusions: In acute exacerbations of asthma, urinary LTE4 and total serum IgE levels were significantly elevated and there was a significant positive correlation between the two.  

Sri Lanka Journal of Child Health, 2022; 51(1): 52-57