Comparative assessment of leukotriene levels in different forms of rhinitis

Background. Leukotrienes (LT) as the products of the lipoxygenase mechanism of the metabolism of arachidonic acid play a significant role in the development of the inflammatory response in allergic rhinitis (АЙ) and АЙ in combination with chronic rhinosinusitis of bacterial etiology (CRSBE). Objective. Comparative assessment of the role of leukotrienes LT C4, D4, E4 and LT B4 in АЙ and АЙ with CRSBE. Methods. 83 patients with the studied forms of rhinitis aged 18 to 55 years were examined (40 patients with АЙ, 43 patients with АЙ with CRSBE). The control group included 27 apparently healthy individuals. The plasma LT levels were determined by enzyme immunoassay. In order to determine the threshold values of LT C4, D4, E4 and LT B4 levels in АЙ and АЙ with CRSBE, an ROC analysis was performed. Results. The total LT C4, D4, E4 levels are of decisive importance in the development and maintenance of the allergic mechanism of inflammation, while LTB4 predominates in the formation of a purulent-inflammatory process in these forms of rhinitis. In АЙ and АЙ with CRSBE, a high level of total LT C4, D4, E4 (3.60±0.18 ng/ml and 3.25±0.16 ng/ml, respectively) was observed in comparison with the indicators of the control group (0.64±0.12 ng/ml; p<0.05). The LTB4 level was significantly increased only in patients with АЙ with CRSBE, amounting to 14.43±0.57 ng/ml (p<0.05), while in АЙ this indicator did not differ from the values in the control group (1.89±0.19 and 1.52±0.21 ng ml, respectively). The ROC analysis of the LT level showed that the threshold value of the LT C4, D4, E4 was 1.53 ng/ ml between AR patients and healthy ones (test sensitivity 95.0%, specificity 96.3%); 1.47 ng/ml between AR patients with CRSBE and healthy ones (test sensitivity 95.3%, specificity 96.3%). For LTB4, the threshold value was 6.24 ng/ml between AR patients and AR patients with CRSBE (test sensitivity 95.3%, specificity 100.0%); 5.74 ng/ml between AR patients with CRSBE and healthy ones (test sensitivity 97.7%, specificity 100.0%). Conclusion. LT make a significant contribution to the development of an inflammatory response in the nasal mucosa in AR and AR with CRSBE. A significant role of total LT C4, D4, E4 was revealed both in AR and AR with CRSBE. These LT are responsible for the allergic component of the inflammatory response, which is consistent with the literature data. The level of LTB4, which directly supports the infectious component of inflammation in the mucous membrane of the upper respiratory tract, is elevated only in AR with CRSBE.

D4, E4, allergic rhinitis, inflammation, infection, chronic rhinosinusitis, leukotrienes C4, D4, E4, leukotriene B4