Cysteinyl leukotrienes implicated in nocturnal asthma


NEW YORK (Reuters Health) – Leukotriene (LT) E4 appears to play a part in the pathogenesis of nocturnal asthma, according to investigators from Sapporo Medical University in Japan.

In fact, researcher Dr. Hiroshi Tanaka told Reuters Health, that "clinicians should be aware of the possibility of the contribution of leukotrienes to nocturnal exacerbation in mild and moderate asthmatic patients." This, he added, forms a basis for "the usefulness of leukotriene antagonists in nocturnal asthma."

Dr. Tanaka and colleagues repeatedly examined urinary LTE4 and thromboxane A2 levels in 9 nocturnal asthmatics, 9 non-nocturnal asthmatics and 5 controls. The findings appeared in the December issue of Chest.

In nocturnal asthmatics and controls, LTE4 concentrations from 3 to 6 am were significantly higher than from 3 to 6 pm. This was not the case in non-nocturnal asthmatics. However, mean LTE4 levels were significantly higher in the asthmatic groups than in controls. Furthermore, nocturnal asthmatics also showed a "small" peak in LTE4 levels from 6 to 9 pm.

Thromboxane A2 levels in all groups were significantly higher from 3 to 6 am than from 3 to 6 pm. Mean levels were also higher in both groups of asthmatics than in controls.

Given the similarity in thromboxane findings in the two asthmatic groups and the difference in leukotriene levels, particularly the circadian rhythm seen in nocturnal asthmatics, the researchers conclude that LTE4, rather than thromboxane A2, "might contribute to the nocturnal worsening of asthma."

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