Urinary Leukotriene E4 as a Biomarker in NSAID-Exacerbated Respiratory Disease (N-ERD): a Systematic Review and Meta-analysis.

Autor: Marquette M; Department of Respiratory Medicine, Norwich University Hospital, NorfolkNorwich, UK. m.marquette@uea.ac.uk.; Norwich Medical School, University of East Anglia, Norwich, UK. m.marquette@uea.ac.uk., Tailor BV; Norwich Medical School, University of East Anglia, Norwich, UK., Calder PC; School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK., Curtis PJ; Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK., Loke Y; Norwich Medical School, University of East Anglia, Norwich, UK., Wilson AM; Department of Respiratory Medicine, Norwich University Hospital, NorfolkNorwich, UK.; Norwich Medical School, University of East Anglia, Norwich, UK.
Jazyk: angličtina
Zdroj: Current allergy and asthma reports [Curr Allergy Asthma Rep] 2022 Dec; Vol. 22 (12), pp. 209-229. Date of Electronic Publication: 2022 Nov 14.
DOI: 10.1007/s11882-022-01049-8
Abstrakt: Purpose of Review: Non-steroidal exacerbated respiratory disease (N-ERD) currently requires aspirin challenge testing for diagnosis. Urinary leukotriene E4 (uLTE 4 ) has been extensively investigated as potential biomarker in N-ERD. We aimed to assess the usefulness of uLTE 4 as a biomarker in the diagnosis of N-ERD.
Recent Findings: N-ERD, formerly known as aspirin-intolerant asthma (AIA), is characterised by increased leukotriene production. uLTE 4 indicates cysteinyl leukotriene production, and a potential biomarker in N-ERD. Although several studies and have examined the relationship between uLTE 4 and N-ERD, the usefulness of uLTE 4 as a biomarker in a clinical setting remains unclear.
Findings: Our literature search identified 38 unique eligible studies, 35 were included in the meta-analysis. Meta-analysis was performed (i.e. pooled standardised mean difference (SMD) with 95% confidence intervals (95% CI)) and risk of bias assessed (implementing Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy (Cochrane DTA)). Data from 3376 subjects was analysed (1354 N-ERD, 1420 ATA, and 602 HC). uLTE 4 was higher in N-ERD vs ATA (n = 35, SMD 0.80; 95% CI 0.72-0.89). uLTE4 increased following aspirin challenge in N-ERD (n = 12, SMD 0.56; 95% CI 0.26-0.85) but not ATA (n = 8, SMD 0.12; CI - 0.08-0.33). This systematic review and meta-analysis showed that uLTE 4 is higher in N-ERD than ATA or HC. Likewise, people with N-ERD have greater increases in uLTE 4 following aspirin challenge. However, due to the varied uLTE 4 measurement and result reporting practice, clinical utility of these findings is limited. Future studies should be standardised to increase clinical significance and interpretability of the results.
(© 2022. Crown.)
Databáze: MEDLINE
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