Exhaled leukotrienes and prostaglandins in COPD

Background: The role of eicosanoids, including leukotrienes (LTs) and prostaglandins (PGs), in chronic obstructive pulmonary disease (COPD) is uncertain. The aim of this study was to investigate whether eicosanoids are measurable in exhaled breath condensate (EBC), a non-invasive method of collecting airway secretions, in patients with stable mild to moderate COPD, and to show possible differences in their concentrations compared with control subjects. Methods: LTB4, LTE4, PGE(2), PGD(2)-methoxime, PGF(2alpha), and thromboxane B-2 (TxB(2)) were measured in EBC in 15 healthy ex-smokers, 20 steroid naive patients with COPD who were ex-smokers, and in 25 patients with COPD who were ex-smokers and who were treated with inhaled corticosteroids. The study was of cross sectional design and all subjects were matched for age and smoking habit. Results: LTB4 and PGE(2) concentrations were increased in steroid naive (LTB4: median 100.6 (range 73.5-145.0) pg/ml, p<0.001; PGE(2): 98.0 (range 57.0-128.4) pg/ml, p<0.001) and steroid treated patients with COPD (LTB4: 99.0 (range 57.9-170.5) pg/ml, p<0.001; PGE(2): 93.6 (range 52.8-157.0) pg/ml, p<0.001) compared with control subjects (LTB4: 38.1 (range 31.2-53.6) pg/ml; PGE(2): 44.3 (range 30.2-52.1) pg/ml). Both groups of patients had similar concentrations of exhaled LTB4 (p=0.43) and PGE(2) (p=0.59). When measurable, LTE4 and PGD(2)-methoxime concentrations were similar in COPD patients and controls, whereas PGF(2alpha) concentrations were increased in the former. TxB(2)-LI was undetectable in any of the subjects. Conclusions: There is a selective increase in exhaled LTB4 and PGE(2) in patients with COPD which may be relatively resistant to inhaled corticosteroid therapy.