| Bronchial asthma is a chronic inflammatory disease of airway. Many inflammatory cells as well as cytokines and mediators released from themselves, take part in the process. Recently, studies have proved that cysteinyl-leukotrienes (CysLTs) can not only recruit the inflammatory cells to the airway, increase blood vessel permeability and mucus excretion , but also induce airway smooth muscle contract .promote airway construction cells' proliferation. Thereby, CysLTs contribute to airway inflammation and remodeling process . They are the most important inflammatory mediators in the asthma. Urinary leukotriene E4(LTE4) is the major metabolite of the total CysLTs in vivo, and excretes at a stable ratio of 4%-7% . Therefore , LTE4 can be detected to evaluate the total CysLTs production in vivo .In order to study the effect of the CysLTs on the pathogenesis of the children bronchial asthma , the investigation detected the urinary LTE4 level in 28 asthma children not only in their acute attack stage but also on their stable stage . The results 晈ere compared with that of the healthy control children .At the same time, the forced expiratory volume in first second (FEV1) and the peripheral eosinophil count (EC) of the asthma children were measured. Then, in order to assess the clinical significance of the detection of the urinary LTE4 in the children with bronchial asthma , the correlation between the results and the concentration of urinary LTE4 was analysed .The result indicated that the concentration of urinary LTE4 was significantly higher in children with asthma than that in the controls [geometric mean (95% confidence interval): acute attack stage 196.67 pg/mg-cr (177.48-217.93); stable stage 171.03pg/mg-cr (153.23-190.90); controls 76.38pg/mg-cr (66.67-87.50), P both <0.01]. Urinary LTE4 in acute attack stage is significant higher than that in thestable stage (P<0.01). The FEV1 in the stable stage is higher than that in the acuteattack stage , the difference is significant .(per cent of expectation ,55.85%±16.70% versus 88.08%± 14.71%, P<0.01). The EC in the stable stage was notable higher than that in the acute attack stage[(11 1.07±97.80) X 106/L versus (209.29±222.34) X 106/L, P<0.05]. At the acute attack stage , there is a negative correlation between urinary LTE4 and FEV1 (r=-0.615, P<0.01). There is no relation between the urinary LTE4 and EC ,as well as FEV1 and EC (correlation coefficient, probability, r=0.163,PX).05 and r=0.024, P>0.05, respectively). After treatment, urinary LTE4 and FEV1 were negative correlate (r=-0.382, P<0.05) , but the decrease value of urinary LTE4 and the increase value of the FEV1 have no correlation (r=-0.249, P>0.05) .Therefore ,it can be concluded that CysLTs indeed take part in the attack process of the bronchial asthma . The urinary LTE4 is increased both in the acute attack stage and the stable stage ,it is close associated with the pathogenesis of the children bronchial asthma. Furthermore , CysLTs probably contributes to pathophysiological processes of the asthma, ie ,airway chronic inflammation continuous existence. Moreover, urinary LTE4 of the asthma children had an incomplete negative correlation with FEV1, had no correlation with EC .It indicated that they have different prediction significance.Thus , dynamic detecting the urinary LTE4 content in asthma children, will be most useful in the asthma inflammation detection. It will be helpful in the clinical diagnosis and provide new treatment ways . In the theory, we can believe that the anti-CysLTs-drugs will produce an imP<0rtant effect on asthma prevention and treatment, but it wait for a further study to define the anti-CysLTs-drugs treatment P<0sition , long-term effect and cooperation or replacement effect with glucocorticosteriod. |
PDF Full Text Request