CORRELATION AMONG URINARY EOSINOPHIL PROTEIN-X, LEUKOTRIENE E-4, AND 11-DEHYDROTHROMBOXANE B-2 IN PATIENTS WITH SPONTANEOUS ASTHMATIC ATTACK

Various kinds of cells and their mediators are thought to be involved in the pathogenesis of bronchial asthma. However, changes in each medi ator or relationship among mediators during an asthmatic attack have n ot been well documented. In this study, to clarify whether eosinophil protein X (EPX) is a marker which is distinct from leukotriene E-4 (LT E4), or 11-dehydrothromboxane B-2 (11DTXB(2)), we measured the urinary excretion of EPX, LTE4, and 11DTXB(2) in 14 asthmatics who were admit ted to the hospital with either an acute asthmatic attack or status as thmaticus. These patients included eight atopic and six nonatopic type s of bronchial asthma, with a median age of 34.0 years. Urinary excret ion of EPX was significantly high on admission with the asthmatic atta ck, and returned to control levels 175 [122 -384] mu g/day when the pa tients were in the improved state (1036-317 mu g/day, P < 0.01). Simil ar findings were observed in LTE4 (155-59 ng/day, P < 0.01) and 11DTXB (2) (991-442 ng/day, P<0.01). No significant differences in values wer e observed between atopic and non-atopic types of asthma in all three substances. When the individual data during the attack state were anal ysed, a significant correlation was observed between changes (%) in ur inary EPX and those in urinary LTE4, but no such relationship was obse rved between changes (%) in urinary EPX and those in urinary 11DTXB2. These results suggest that measuring urinary EPX levels may be a usefu l marker for the understanding and management of the disease.