Measurement of immunoreactive leukotriene C4 in blood of asthmatic children

The effect of vitamin E on the lipid environment of rat hepatocyte membranes

Tocopherol is one of the known beneficial natural antioxidants ensuring the optimal level of functioning of mammalian organisms. Numerous in vitro and in vivo experiments have shown that the biological role of vitamin E is to prevent the development of pathologies caused by oxidative stress. In particular, the role of enzymatic factors of lipid peroxidation and related inflammation as a result of eicosanoid synthesis was clearly shown. We studied changes in the structural and functional state of hepatocyte membranes in the classical model of E-hypovitaminosis caused by long-term (70 days) insufficient intake of vitamin E in the diet of rats. The test components were determined spectrophotometrically after appropriate chromatographic procedures. The amount of total and individual leukotrienes was determined by ELISA. Prolonged tocopherol deficiency in rats caused a 49.4% decrease in tocopherol, more than 27.0% – in cholesterol. Of the 8 individual phospholipids studied, 6 showed significant changes: a decrease in cardiolipin and phosphatidylserine, and an increase in phosphatidylethanolamine by 3.24 times, an increse in lysophosphatidylcholine by 86.9%, in phospha­tidylcholine by 52.8%, and in sphingomyelin by 30.6%, relative to control. There were changes in the levels of unsaturated fatty acids playing a significant role in the development of functional disorders in cells and affecting the metabolism of ecosanoids derived from arachidonic acid by the 5-lipoxygenase oxidation pathway. Changes in the levels of total and individual cysteinyl leukotrienes in the state of E-hypovitaminosis were revealed. Restoration of vitamin E intake returns most of the studied indicators such as tocopherol, cholesterol, polyunsaturated fatty acids to the control levels and activates the processes of sequential conversion of leukotrienes in the body of rats. The obtained results indicate the potentiating effect of vitamin E on metabolic processes in the body as a whole and in hepatocytes and eicosanoid metabolism. The degree of tocopherol intake allows one to influence the course of inflammatory processes associated with eicosanoids, not only through the impact on precursors, but also on the utilization of metabolites, including leukotrienes.

Leukotriene D4 and eosinophil transendothelial migration, superoxide generation, and degranulation via beta2 integrin

BACKGROUND

Evidence indicates that cysteinyl leukotriene (cysLT) 1 receptor antagonists possess anti-inflammatory properties in asthmatic patients in vivo. Although the exact mechanisms of these actions remain unknown, cysLTs regulate the locomotion and functions of eosinophils. We previously reported that leukotriene D4 augments the expression of eosinophil beta2 integrin and the adhesion of eosinophils to rh intercellular adhesion molecule 1 via beta2 integrin.

OBJECTIVE

To examine whether leukotriene D4 modifies the transendothelial migration (TEM) and effector functions of eosinophils.

METHODS

We evaluated the effects of leukotriene D4 on (1) eosinophil TEM across human umbilical vein endothelial cells, (2) superoxide anion (O2-) generation, and (3) eosinophil-derived neurotoxin release in eosinophils isolated from the blood of healthy individuals.

RESULTS

Leukotriene D4 (0.1-1 microM) significantly induced eosinophil TEM, O2- generation, and eosinophil-derived neurotoxin release. Pranlukast, a cysLT1 receptor antagonist, significantly inhibited all of these parameters, although the inhibitory effect on O2- generation was partial. All of these responses were significantly inhibited by anti-beta2 integrin but not by anti-alpha4 integrin antibodies.

CONCLUSIONS

Leukotriene D4 directly up-regulates the TEM and effector functions of eosinophils mainly via the cysLT1 receptor and beta2 integrin. These effects of leukotriene D4 probably contribute to the manifestation of eosinophil inflammation in asthmatic airways.

Leukotriene activity modulation in asthma

Leukotrienes constitute a class of inflammatory mediators synthesised from arachidonic acid, a product of cell membrane metabolism. Synthesis occurs in the 5-lipoxygenase enzyme pathway, which produces several species of leukotrienes, each with characteristic biological activities. With regard to asthma, the leukotrienes are particularly important because of their ability to directly and potently mediate bronchoconstriction; in addition, they specifically stimulate the secretion of mucus into the airways and the extravasation of fluids and proteins into the airway tissues, both of which contribute to airway obstruction. A number of antileukotriene agents have been developed with the goal of modulating the inflammatory process in various disease states. These agents fall into 2 general classes: leukotriene receptor antagonists and leukotriene synthesis inhibitors. Results of antileukotriene agents in preclinical and clinical trials indicate that antileukotriene agents attenuate the response to challenges with inhaled leukotrienes, cold air, exercise, aspirin and allergen; in addition, they have shown efficacy in clinical asthma and have not been associated with serious adverse effects. Although results to date indicate that these medications are well tolerated and effective in the treatment of asthma, the recent approval by the FDA of 2 antileukotriene agents will give physicians further insight into how patients with asthma respond to them.

gamma-Linolenic acid-containing diet attenuates bleomycin-induced lung fibrosis in hamsters

Although bleomycin (BLM), an antineoplastic drug, is used in the treatment of a variety of tumors, the mechanism(s) that contribute to its induced lung injury and fibrosis are not fully elucidated. Since alterations in the levels of certain fatty acid metabolites have been associated with BLM-induced lung injury, we tested the effects of dietary gamma-linolenic acid (GLA)-containing evening primrose oil on BLM-induced morphological alterations in the hamster lung, the marked elevation of tissue hydroxyproline (a marker for collagen synthesis), and elevated generation of arachidonic acid metabolites (marker of inflammatory mediators). Our data revealed that after 14 d of dietary GLA-containing oil (i) BLM-induced elevation of lung hydroxyproline was suppressed (P < 0.05), (ii) the marked BLM-induced elevation of lung leukotriene B4 (LTB4) (a marker of polymorphanuclear generation of proinflammatory LTB4) was significantly suppressed (P < 0.05). The decrease in LTB4 was accompanied by marked elevations (P < 0.05) of lung prostaglandin E1 (PGE1) and 15-hydroxyeicosatrienoic acid (15-HETrE), both with known antiinflammatory properties. Taken together, data from these studies suggest that dietary GLA-containing oil contributes to tissue elevation of PGE1 and 15-HETrE, which in vivo may attenuate lung inflammation and fibrosis.

Discovery of OT4003, a novel, potent, and orally active cys-LT1 receptor antagonist

The present paper describes the structural modifications leading to the discovery of a new series of quinoline-containing cys-LT1 receptor (LTD4 receptor) antagonists. A structural optimization with respect to the in vitro receptor binding, the in vivo brochoconstriction, and the toxicological effect in the form of peroxisomal proliferation was performed in order to achieve the target compound OT4003. OT4003 ((S)-(+)-E-2-(3-(2-(7- chloroquinolin-2-yl)ethenyl)phenylaminomethyl)-phenoxyl++ +-hexanoic acid) was found to be a potent and selective inhibitor of [3H]LTD4 specific binding to guinea pig lung membranes (IC50 2.4 +/- 1.0 nM), and also a potent, orally active, antagonist of LTD4 induced bronchoconstriction in guinea pigs [ED50 0.14 (ED16 0.1-ED84 0.4) mg/kg; 4 h pretreatment]. The enantiomerically pure OT4003 was prepared using a short convergent synthesis, including an enzymatic resolution step.

Effect of TYB-2285 on lung anaphylaxis in actively sensitized rats

1. We examined the effect of TYB-2285 on the acute phase and the late phase of lung anaphylaxis in rats. 2. TYB-2285 (3-30 mg/kg PO) inhibited antigen-induced bronchoconstriction and TxB2 production during the acute phase of lung anaphylaxis in a dose-dependent manner. 3. Ketotifen fumarate (30 mg/kg p.o.) inhibited bronchoconstriction and TxB2 production less potently than TYB-2285. 4. TYB-2285 (30 mg/kg p.o.) inhibited the accumulation of neutrophils during the late phase of lung anaphylaxis significantly without a significant change in total cells. 5. Hydrocortisone acetate (100 mg/kg p.o.) inhibited the accumulation of total cells as potent as neutrophils.

New insights into the pathogenesis and management of steroid-resistant asthma

A population of difficult-to-control asthmatics exists who, despite high-dose daily GC therapy, continue to display evidence for active disease. This group has been termed steroid resistant since they fail to adequately respond to aggressive courses of high-dose oral and inhaled GC therapy. Persistent immune activation and airway inflammation which to varying degrees is resistant to GC therapy appears to define the immunological abnormality underlying SR asthma. Recent studies utilizing molecular biological techniques have identified both ligand- and DNA-binding defects that could possibly account for steroid resistance at a molecular level. The evaluation of the SR asthmatic must be comprehensive in its scope as several confounding factors can contribute to this symptom complex. Among others, these include poor compliance, improper medication technique, inadequate anti-inflammatory therapy, unrecognized contributing diseases, incorrect diagnoses, environmental factors, and psychosocial disturbances. The management of the SR asthmatic is challenging, and every attempt should be made to maximize conventional therapy in these patients prior to embarking on alternative therapies as all of the alternative anti-inflammatory/immunomodulatory modalities are associated with significant toxicity or cost. Second-generation inhaled GC therapy, methotrexate, cyclosporine, IVIG, and leukotriene antagonists are potential alternative therapies, and although they remain viable options, they have been used in small numbers, and for short periods of time, and fail to result in long-term remissions. Although much insight into the pathogenesis of SR asthma has been gained, several issues remain unresolved. Ongoing airway inflammation is thought to contribute to steroid resistance, but at present, we have no standard method of determining the degree of inflammation. The incorporation of bronchoscopy with transbronchial biopsy has the potential to provide the greatest amount of information regarding the presence or absence of ongoing airway inflammation, but the invasive nature of the procedure precludes its use in pediatric patients and the most severe adult asthmatics. Large multicenter, placebo-controlled studies evaluating the available alternative therapies that incorporate markers of airway inflammation are needed, as are studies that evaluate these therapies over longer periods of time. It is hoped that by better understanding the mechanisms involved and the natural history of the SR asthmatic, specific treatment modalities will be developed for this challenging group of severe asthmatics.

Arachidonic acid metabolites in acute myocardial infarction

Abnormalities of arachidonic acid metabolism are implicated in spasm and thrombosis in coronary arteries. Therefore, arachidonic acid metabolites were examined in patients with acute myocardial infarction (AMI). Plasma levels of thromboxane B2 (TXB2), 6-keto-prostaglandin F1 alpha (6KPGF1 alpha), leukotriene B4 (LTB4), and slow reacting substance of anaphylaxis (SRS-A) composed of leukotriene C4 (LTC4), leukotriene D4 (LTD4) and leukotriene E4 (LTE4), were measured in 19 AMI patients. Plasma levels of TXB2, LTB4, and SRS-A in systemic artery blood were significantly elevated during the acute stage (within twenty-four hours after the onset of chest pain) of AMI (TXB2, 0.36 ng/mL; LTB4, 0.75 ng/mL; and SRS-A [LTC4+LTD4+LTE4], 0.96 ng/mL compared with those of normal controls (TXB2, 0.18 ng/mL; LTB4, 0.44 ng/mL; and SRS-A (LTC4+LTD4+LTE4], 0.31 ng/mL). These values decreased to near-normal control levels by one month after the AMI attack. The findings in this study suggest that abnormalities of arachidonic acid metabolism accompany, and may play a role in the pathogenesis of, AMI.

The effects of chronic sidestream cigarette smoke exposure on eicosanoid production by tracheal epithelium

Environmental exposure to sidestream cigarette smoke (SSCS) has been associated with an increased incidence of pulmonary infection and bronchospasm. Chronic exposure to SSCS could modify the release of bronchoreactive eicosanoids by tracheal epithelium, the site of initial contact by lung with inhaled toxins. To assess this possibility, New Zealand white rabbits were placed in an environmental chamber flushed with 3 L of SSCS, 15 min/day for 20 days. Eighteen hours after the last exposure the animals were sacrificed and the tracheas were explanted. At 7 days, the epithelial cell outgrowths were exposed to media containing endotoxin (10 micrograms/mL) or acrolein (50 microM), an aldehyde commonly found in smoke, or to control media. After a 2-h exposure, media were assayed for eicosanoids by radioimmunoassay. PGE2 was produced in epithelium from normal animals (5.7 +/- 1.3 ng/10(6) cells), and was not significantly different in SSCS-exposed epithelium. When incubated in medium containing acrolein, PGE2 production increased significantly in SSCS-exposed epithelium (14.9 +/- 2.5, p < .05) but not in control groups. Endotoxin also increased PGE2 production in SSCS-exposed cells (12.6 +/- 3.3 ng/10(6), p < .05). Baseline production of 6-keto PGF1 alpha was 10.8 +/- 3.2 ng/10(6) cells in non-SSCS controls and did not change significantly in these cells with the addition of endotoxin or acrolein. In acrolein plus SSCS-exposed cells, 6-keto PGF1 alpha increased, in a dose-dependent manner, to 88.1 +/- 26.1 ng/10(6) (p < .05 compared to all normals, SSCS-exposed controls, and SSCS plus LPS). TxB2 release in control, non-SSCS-exposed cells was 13.3 +/- 2.8 ng/10(6) cells and was significantly increased (P < .05) only in the SSCS plus acrolein group (60.7 +/- 16.2 ng/10(6) cells). The results indicate that even brief, recurrent exposure to SSCS can change the production of cyclooxygenase products, particularly PGE2, 6- keto PGF1 alpha, and TxB2. This may reflect an altered ability of SSCS-exposed tracheal epithelium to respond to environmental (e.g., acrolein) or bacterial (e.g., endotoxin) insults.

Change of plasma leukotriene C4 during myocardial ischemia in humans

Changes in leukotriene C4 levels during different degrees of myocardial ischemia in humans were examined by comparing radioimmunoassay measures of leukotriene C4 plasma levels obtained during transient and prolonged myocardial ischemia. Leukotriene C4 levels in systemic arterial and coronary sinus blood were determined in patients with chronic stable angina before and after myocardial ischemia induced either by exercise (supine bicycle ergometer exercise stress testing; n = 14; age, 52 +/- 8 years) or by coronary occlusion during angioplasty (n = 14; age 53 +/- 7 years). Temporal changes of leukotriene C4 were also followed in arterial and pulmonary artery blood within 24 h after the onset of chest pain (acute phase), and 1 day, 1 week, and 1 month later in 22 patients with acute myocardial infarction (AMI) (12 patients with thrombolytic therapy, age 61 +/- 10 years; 10 patients without thrombolytic therapy, age 60 +/- 11 years). Clinical characteristics, including coronary risk factors and the severity of coronary artery disease, were not significantly different among the groups. Exercise-induced myocardial ischemia and coronary occlusion did not induce any significant leukotriene C4 changes in the chronic stable angina patients, whereas AMI patients had significantly higher plasma leukotriene C4 levels in both arterial and pulmonary artery blood in the acute phase compared with those of chronic stable angina patients (arterial blood, 471 +/- 164 pg/ml and 477 +/- 235 pg/ml vs. 275 +/- 254 pg/ml or 240 +/- 66 pg/ml, p < 0.05; pulmonary artery blood in AMI, 543 +/- 162 pg/ml vs. 234 +/- 125 pg/ml or 225 +/- 64 pg/ml, coronary sinus blood in chronic stable angina, p < 0.05). These results suggest that leukotriene C4 is involved more in prolonged myocardial ischemia than in transient myocardial ischemia, and that leukocyte function might play a significant role in the pathogenesis of patients with AMI.

Anti-leukotriene agents: a new direction in asthma therapy

A role for the leukotrienes in asthma has been postulated for many years. These mediators induce potent bronchoconstriction, stimulate mucous secretion and decrease mucus transport, increase vascular permeability (thereby promoting edema formation), and induce migration of eosinophils into the lung. Recent studies with both leukotriene receptor antagonists and leukotriene synthesis inhibitors have demonstrated that these new agents can be effective in asthma induced by exercise, aspirin, and allergen challenges. Further, in patients with mild-to-moderate asthma, these drugs improve pulmonary function, decrease symptoms, and reduce the need for "rescue" bronchodilators. Anti-leukotrienes thus represent an important step forward in asthma management.

Persistent increase in plasma and urinary leukotrienes after acute asthma

Leukotrienes may mediate bronchoconstriction in asthma. Cysteinyl leukotriene production rises in vivo after allergen challenge, but few reports describe leukotriene concentrations in clinical asthma or in children. Using high performance liquid chromatography/radioimmunoassay, plasma and urinary leukotrienes in asthmatic children (aged 5-10 years) were measured during an acute exacerbation (peak expiratory flow (PEF) < 65%, n = 10) and one month later (PEF 74-169%, n = 9), and in non-atopic normal children (aged 1.3-13.2 years). In the asthmatics, geometric mean (95% confidence interval) plasma leukotriene B4 (LTB4) was 746 pg/ml (398 to 1403) acutely and 1026 pg/ml (662 to 1593) in remission, compared with 369 pg/ml (167 to 728) in the normal children (n = 14). Plasma cysteinyl leukotrienes were low or undetectable, but urinary leukotriene E4 (LTE4) was higher in the asthmatics during an acute episode (210 pmol/mmol creatinine, 101 to 454) and at follow up (179 pmol/mmol, 110 to 293), compared with the normal children (98 pmol/mmol, 81 to 118, n = 41). This persistent increase in plasma LTB4 and urinary LTE4 concentrations one month after a severe asthmatic episode suggests leukotriene production is related to chronic inflammation rather than to acute bronchoconstriction.

Pharmacology of montelukast sodium (Singulair), a potent and selective leukotriene D4 receptor antagonist

Montelukast sodium (Singulair), also known as MK-0476 (1-(((1(R)-(3-(2-(7-chloro-2-quinolinyl)-(E)-ethenyl)phenyl)(3-2-(1- hydroxy-1-methylethyl)phenyl)propyl)thio)methyl)cyclopropane) acetic acid sodium salt, is a potent and selective inhibitor of [3H]leukotriene D4 specific binding in guinea pig lung (Ki 0.18 +/- 0.03 nM), sheep lung (Ki 4 nM), and dimethylsulfoxide-differentiated U937 cell plasma membrane preparations (Ki 0.52 +/- 0.23 nM), but it was essentially inactive versus [3H]leukotriene C4 specific binding in dimethylsulfoxide-differentiated U937 cell membranes (IC50 10 microM) and [3H]leukotriene B4 specific binding in THP-1 cell membranes (IC50 40 microM). Montelukast also inhibited specific binding of [3H]leukotriene D4 to guinea pig lung in the presence of human serum albumin, human plasma, and squirrel monkey plasma with Ki values of 0.21 +/- 0.08, 0.19 +/- 0.02, and 0.26 +/- 0.02 nM, respectively. Functionally, montelukast antagonized contractions of guinea pig trachea induced by leukotriene D4 (pA2 value 9.3; slope 0.8). In contrast, montelukast (16 microM) failed to antagonize contractions of guinea pig trachea induced by leukotriene C4 (45 mM serine-borate), serotonin, acetylcholine, histamine, prostaglandin D2, or U-44069. Intravenous montelukast antagonized bronchoconstriction induced in anesthetized guinea pigs by i.v. leukotriene D4 but did not block bronchoconstriction to arachidonic acid, histamine, serotonin, or acetylcholine. Oral administration of montelukast blocked leukotriene D4 induced bronchoconstriction in conscious squirrel monkeys, ovalbumin-induced bronchoconstriction in conscious sensitized rats (ED50 0.03 +/- 0.001 mg/kg; 4 h pretreatment), and also ascaris-induced early and late phase bronchoconstriction in conscious squirrel monkeys (0.03-0.1 mg/kg; 4 h pretreatment). A continuous i.v. infusion of montelukast (8 micrograms.kg-1.min-1) resulted in a 70% decrease in the peak early response and a 75% reduction of the late response to ascaris aerosol in allergic conscious sheep. Montelukast, a potent and selective leukotriene D4 receptor antagonist with excellent in vivo activity is currently in clinical development for the treatment of asthma and related diseases.

5-lipoxygenase-activating protein stimulates the utilization of arachidonic acid by 5-lipoxygenase

5-Lipoxygenase (5-LO) and its activating protein (FLAP) are both required for cellular leukotriene (LT) synthesis, with 5-LO catalyzing both the synthesis of (5S)-5-hydroperoxy-6,8,11,14-eicosatetraenoic acid (5-HPETE) from arachidonic acid and the subsequent synthesis of LTA4 from 5-HPETE. We have previously expressed both human 5-LO and human FLAP to high levels in Spodoptera frugiperda (Sf9) insect cells, using recombinant baculoviruses. To study the mechanism by which FLAP activates 5-LO, we compared cellular 5-LO activity in Sf9 cells expressing this enzyme to that in Sf9 cells coexpressing FLAP and 5-LO. In this system, FLAP stimulates the utilization of arachidonic acid by 5-LO as a substrate, and increases the efficiency with which 5-LO converts 5-HPETE to LTA4. LT synthesis in cells coexpressing FLAP and 5-LO is inhibited by 3-[1-(p-chlorophenyl)-5-isopropyl-3-tert-butylthio-1H-indol-2-yl]-2,2- dimethyl-propanoic acid (MK-886), an LT biosynthesis inhibitor which specifically binds to FLAP. These studies in Sf9 cells, together with our recent demonstration that FLAP specifically binds arachidonic acid, suggests that FLAP activates 5-LO by acting as an arachidonic acid transfer protein.

Effects of catecholamines on eicosanoid synthesis with special reference to prostanoid/leukotriene ratio

Catecholamines (adrenaline, dopamine, and noradrenaline) stimulate prostanoid synthesis by acting as "cosubstrates." On the other hand, many inhibitors of leukotriene synthesis, such as nordihydroguaiaretic acid and caffeic acid, have a catecholic structure. Catecholamines have opposite effects on prostanoid and leukotriene synthesis in human polymorphonuclear leukocytes and whole blood. Basic phenols (catechol, hydroquinone, and phenol) also increase the prostanoid/leukotriene ratio in polymorphonuclear leukocytes. These actions correlate to their antioxidant capacities and oxidation potentials, and they are not mediated via adrenergic receptors. There is only limited knowledge about the effects of natural catecholamines on the prostanoid/leukotriene ratio in vitro and in vivo. Indirect data suggest that catecholamines could increase prostanoid production in physiological or pathological situations, such as heavy physical exercise, myocardial infarction, and surgical stress. This interaction may also be of clinical importance in asthma, gastric ulcer, and psoriasis, where decreased prostanoid/leukotriene ratios have been reported.

Amniotic fluid embolism and leukotrienes--the role of amniotic fluid surfactant in leukotriene production

Surfactant rich lipid (lipid) was extracted from cell free 10,000 x g pellets of amniotic fluid. White blood cells (WBC) were isolated from human donors. 36 x 10(7) WBC and 5 g rabbit lung were incubated with pretreated lipid or dipalmitoyl lecithin (lecithin). Leukotrienes (LTs) were identified by high performance liquid chromatography (HPLC) and bioassay, and quantified by radioimmunoassay. Peaks of LTC4 and LTD4 on HPLC and guinea-pig ileum contraction could be identified in lipid and lecithin groups, but not in the control group. LTC4 production by lipid and lecithin groups was significantly higher than that by the control group. An involvement of amniotic fluid surfactant in leukotriene production is suggested.

Arachidonate metabolites in bronchoalveolar lavage fluid from horses with and without COPD

Arachidonate metabolites were measured in bronchoalveolar lavage fluid (BALF) from horses with (N = 4) and without (N = 7) chronic obstructive pulmonary disease (COPD). Prostaglandin (PG) D2, leukotriene (LT) B4 and LTC4 were present in highest concentrations in BALF from clinically normal horses. Concentrations of PGE2 and PGF were significantly higher in BALF from horses with COPD than in BALF from normal horses, but no differences were detected in thromboxane B2, 6-keto-PGF1 alpha, PGD2, LTB4 or LTC4.

Bronchodilation with a potent and selective leukotriene D4 (LTD4) receptor antagonist (MK-571) in patients with asthma

The sulfidopeptide leukotrienes LTC4, LTD4, and LTE4 can cause airway smooth muscle contraction and have been implicated in the pathophysiology of asthma. MK-571 is a selective, potent LTD4 receptor antagonist that could attenuate airway obstruction in asthma by inhibiting the actions of sulfidopeptides at the LTD4 receptor site. The objectives of this study were to investigate the potential for MK-571 to cause bronchodilation in asthma patients with existing airway obstruction and to evaluate its effect on the bronchodilation response to an inhaled beta 2-agonist (albuterol). Twelve male patients (ages 19 to 42 yr) with asthma (baseline FEV1 50 to 80% predicted) participated in this placebo-controlled, randomized, two-period, cross-over study. On separate treatment days, each patient received either MK-571 or placebo intravenously for 6 h; inhaled albuterol was administered at the fifth and sixth hour of MK-571/placebo treatment to achieve maximal bronchodilation on that study day. Spirometry (forced expiratory volume in 1 s, FEV1) was monitored at intervals throughout each study period. MK-571 caused clinically significant bronchodilation; the increase in FEV1 above baseline, 20 min after the start of the MK-571 infusion, was 22 +/- 3.9% compared with 1.3 +/- 2.3% for placebo (mean +/- SE, p < 0.01). This degree of bronchodilation was maintained throughout the MK-571 infusion. In addition, bronchodilation from inhaled albuterol appeared additive with MK-571. Finally, baseline airway obstruction correlated with the degree of bronchodilation achieved with MK-571 (r = -0.73; p = 0.007).(ABSTRACT TRUNCATED AT 250 WORDS)

Epithelial strips: an alternative technique for examining arachidonate metabolism in equine tracheal epithelium

We have developed an alternative method for examining equine tracheal epithelial arachidonic acid (AA) metabolism that utilizes strips of pseudostratified columnar epithelium attached to a layer of elastic tissue 80 to 130 microns thick. We compared the responses of this preparation with those of enzymatically dispersed suspensions of tracheal epithelium obtained from the same animal. Strips incubated with [3H]AA incorporated 40.8 +/- 3.6% of added radioactivity and released 2.55 +/- 0.23% of incorporated radioactivity when stimulated with 5 microM A23187. Values for the cell suspension were 59.6 +/- 1.6% and 1.90 +/- 0.08%, respectively. Stimulation with 50 microM histamine or bradykinin resulted in significant release of free [3H]AA only from the strips. High-performance liquid chromatography radioactivity profiles of eicosanoids released following stimulation with 5 microM A23187 demonstrated peaks that coeluted with free AA, prostaglandin (PG) E2, and PGF2 alpha for the strips, and free AA, leukotriene B4, and 5-HETE for the cell suspensions. The absence of PGE2 production by cell suspensions was confirmed by assaying immunoreactive PGE2 in supernatants from unlabeled strips and suspensions stimulated with 5 microM A23187. Epithelial strips produced 10.3 +/- 1.3 ng PGE2/ml supernatant, whereas 5 x 10(6) cells in suspension produced less than 100 pg/ml. Despite the lack of PG production by the cell suspensions, immunocytochemical staining with an anti-PGH synthase antibody demonstrated the presence of PGH synthase in epithelial cells of both preparations. These data indicate that, in contrast to epithelial cell suspensions, epithelial strips synthesize cyclooxygenase metabolites and respond to peptide agonists.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma prostaglandins, leukotrienes and thromboxane in acute high altitude hypoxia

To explore the hypothesis that acute exposure to altitude hypoxia and acute mountain sickness (AMS) are associated with the release of vasoactive eicosanoids, 10 adult subjects were studied at sea-level and after 1-8 days (H1-H8) of exposure to an altitude of 4350 m (Observatoire Vallot). Plasma concentrations of 6 eicosanoids were determined in peripheral venous blood samples by radioimmunoassay after extraction with cooled ethanol and chromatographic separation by HPLC. All subjects experienced symptoms of AMS. Maximal clinical scores were observed at H1 or H2. Symptoms were no longer noted at H8. Hypoxia induced a very large increase in plasma concentration of most eicosanoids; thromboxane B2 (TxB2) and leukotriene B4 (LTB4) were maximum at H1 and H2 (about 5 times the normoxic value); prostaglandins PGE2, 6-keto-PGF1 alpha and PGF2 alpha were maximum at H3 or H4 (about 2.5-5 times of normoxic value). All eicosanoids returned almost to normoxic values by H8. Vasoconstricting mediators were released mostly at the initial phase (H1, H2), vasodilating mediators becoming predominant thereafter (H3, H4). The time pattern of appearance in blood of mediators acting on vascular permeability was strikingly parallel to the clinical score of AMS. In conclusion, exposure to acute hypoxia induced a large increase in plasma concentration of eicosanoids, the variation with time of which is compatible with a hydrostatic-permeability hypothesis of AMS pathophysiology.

The effect of aerosolized SK&F 104353-Z2 on the bronchoconstrictor effect of leukotriene D4 in asthmatics

Leukotriene D4 (LTD4) is a potent bronchoconstrictor and vasoactive mediator that has been implicated in the pathogenesis of bronchial asthma. We have studied the effect of SK&F 104353-Z2, a specific LTD4 antagonist, on LTD4-induced bronchoconstriction in asthmatics. A total of 12 mild asthmatics (mean baseline FEV1 +/- SEM: 85.9% +/- 2.6) received on 2 separate days, double-blind and cross-over, 800 micrograms SK&F 104353-Z2 or placebo via aerosol. After 30 min, doubling concentrations of LTD4 (0.078 to 20.1 microM in the first 4 patients and up 80.4 microM in the other patients) were inhaled with intervals of 30 min. Specific airways conductance (sGaw) and forced expiratory volume in 1 s (FEV1) were measured. On the placebo-day LTD4 inhalation caused a concentration dependent bronchoconstriction. The effect of SK&F 104353-Z2 on baseline sGaw and FEV1 could be evaluated in 10 patients. After inhalation of SK&F 104353-Z2 a small, but significant increase, in sGaw (0.107 +/- 0.013 to 0.132 +/- 0.011 cm H2O-1s-1) and FEV1 (3.39 +/- 0.23 to 3.56 +/- 0.25 liter) was observed. The effect of SK&F 104353-Z2 on the dose-response curve for LTD4 was evaluated in the six patients who inhaled concentrations of LTD4 up to 80 microM. On the active treatment day, the dose-response curve for LTD4 was significantly shifted to the right.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacologic and pharmacokinetic profile of SK&F S-106203, a potent, orally active peptidoleukotriene receptor antagonist, in guinea-pig

In this report the pharmacologic and pharmacokinetic profile of the leukotriene receptor antagonist 3(S)-[(2-carboxyethyl)thio]-3-[2-(8-phenyloctyl)phenyl] propanoic acid (SK&F S-106203) in guinea-pigs is described. In isolated guinea-pig tracheae SK&F S-106203 was a potent, competitive antagonist of leukotriene (LT) D4-induced contractions (pA2 = 7.6). SK&F S-106203 was also a potent antagonist of LTE4-induced contractions (pKB = 7.3), but had little effect on those elicited by LTC4 (pKB = 5.5). SK&F S-106203 (10 microM) had no effect on contractions produced by histamine, carbachol, KCl, U-44069, PGF2 alpha or PGD2. In addition, SK&F S-106203 (10 microM) did not inhibit cyclic nucleotide phosphodiesterase (PDE) activity of several PDE isozymes. In guinea-pig lung membrane preparations, SK&F S-106203 was a potent antagonist of 3H-LTD4 binding with a Ki = 19.4 +/- 2.1 nM (n = 5). The pharmacokinetic profile of SK&F S-106203 was determined in unanesthetized guinea-pigs. Following an i.v. (bolus) dose (25 mg/kg), SK&F S-106203 disappeared from plasma in a biphasic fashion with half-lives of 0.1 h (50% of the area under the plasma concentration-time curve, AUC) and 11 h. The AUC obtained for SK&F S-106203 following i.v. administration was 87.3 +/- 7.5 micrograms-h/ml. Following an oral dose of SK&F S-106203 (100 mg/kg), the maximal plasma concentration (Cmax) and the time Cmax was achieved (Tmax) were 21.62 +/- 2.26 micrograms/ml and 4 +/- 1 h, respectively; the AUC was 279.9 +/- 41.8 micrograms-h/ml. Studies examining the effects of i.v. infusion of SK&F S-106203 revealed that marked inhibition of LTD4-induced bronchospasm was produced with steady-state plasma levels of SK&F S-106203 less than 1 microgram/ml (less than 2 microM). Oral (p.o.) pretreatment with 100 mumol/kg SK&F S-106203 for up to 24 h essentially abolished LTD4-induced bronchospasm; this correlated with sustained plasma concentrations of greater than 2 micrograms/ml. The results indicate that in guinea-pig airways, SK&F S-106203 is a potent and selective LT receptor antagonist that is active via aerosol, oral and i.v. routes of administration. When given orally, SK&F S-106203 is highly bioavailable and has a very long duration of action which correlates with the pharmacokinetic profile of the compound. SK&F S-106203 may be useful therapy in asthma and other disorders in which the LTs are thought to play a prominent pathophysiological role.

Effect of OKY-046 (thromboxane A2 synthetase inhibitor) on exercise-induced asthma

The influence of OKY-046, which is a thromboxane (TxA2) synthetase inhibitor, was studied in patients with exercise-induced asthma (EIA). When OKY-046 was administered to 11 patients with EIA-positive (EIA+) asthma, 7 patients showed an effect of the inhibition of airway contraction. As the mechanism of action, inhibition of TxA2 production and acceleration of PGI2 were considered, since OKY-046 has no bronchodilation action. In other words, the fact that TxA2 was a mediator of EIA had been made clear, but it was also found that it had no association as a mediator of leukotrienes (LTC4 and LTB4) in EIA.

Lecithins enhance leukotriene production from white cells

36 x 10(7) WBC were isolated from 120 ml heparinized venous blood by 5% dextran T-500 sedimentation. 20 mg egg lecithin and 20 mg dipalmitoyl lecithin were respectively pretreated in 2 ml 0.15 M Tris buffer by vibration and sonication. WBC were incubated with the pretreated lecithins for 20 min. Leukotrienes (LTs) were identified by HPLC and bioassay, and quantified with an RIA Kit. Crude incubation medium of both lecithin groups caused guinea pig ileum contractions which were antagonized with FPL55712. Incubation media were partially purified with Bond elut C18. Purified samples of both lecithin groups showed LTC4 and LTD4 peaks on HPLC. LTC4 production (pg/10(7) WBC, M +/- SD) was 194.5 +/- 61.7 (n = 5) in control group, 348.9 +/- 95.4 (n = 6) in dipalmitoyl lecithin group, 543.8 +/- 105.6 (n = 6) in egg lecithin group and 105.62 +/- 63.2 (n = 6) in AA-861 + dipalmitoyl lecithin group. LTC4 production of both lecithin groups was significantly higher than that of control group (P less than 0.01 in dipalmitoyl lecithin group and P less than 0.001 in egg lecithin group). Both egg lecithin and dipalmitoyl lecithin enhanced LT production from WBC. LT production was suppressed in the presence of AA-861. The mechanism of the enhancement in LT production is unclear, but these lecithins are apparently not substrates because dipalmitoyl lecithin contains no arachidonic acid.

Effects of hydrocortisone and aminophylline on plasma leukotriene C4 levels in patients during an asthmatic attack

To study the role of leukotriene C4(LTC4) and the effect of hydrocortisone and aminophylline on plasma LTC4 levels in patients with asthmatic attacks, we measured LTC4 in plasma of 18 asthmatics during a wheezing attack and of 7 normal subjects. Blood samples were obtained before and after treatment with aminophylline and/or hydrocortisone injections. We extracted LTC4 using a Sep-Pak C18 cartridge for the measurement of LTC4 by radioimmunoassay. The plasma levels of immunoreactive LTC4 (i-LTC4) of the normal subjects were 142 +/- 25 pg/ml (n = 7), while those of nonatopic type asthmatic patients with wheezing attacks were 208 +/- 68 pg/ml (n = 15) (p less than 0.01). Before and after treatment with both hydrocortisone succinate (100 mg) and aminophylline (250 mg), 6 asthmatic patients with wheezing attacks had a mean plasma level of i-LTC4 181 +/- 24 and 132 +/- 18 pg/ml (p less than 0.01), respectively. On the other hand, the treatment with aminophylline 250 mg alone increased the i-LTC4 levels from 178 +/- 19 pg/mg to 213 +/- 16 pg/mg (n = 6)(p less than 0.05), while treatment with hydrocortisone succinate 100 mg decreased the i-LTC4 level 0.05 from 284 +/- 99 pg/ml to 249 +/- 85 pg/ml (n = 4)(p less than 0.05). In conclusion, the present study shows that the i-LTC4 level in venous blood of patients with asthmatic attacks is decreased significantly by treatment with hydrocortisone succinate.

Interleukin-2 production of T cells in atopic dermatitis

Patients with atopic dermatitis (AD) were treated with Tranilast, Interleukin-2 (IL-2) (production of T cells in vitro) and blood histamine values, before and after Tranilast therapy, were measured, and the following results were obtained: 1) Compared with healthy controls, the IL-2 producing ability of T cells in patients with AD was increased. 2) After Tranilast therapy, IL-2 production of T cells in AD decreased in quantity to the control level. 3) Skin lesion severities of AD were correlated with the quantity of IL-2 production of T cells. 4) Serum histamine levels were not significantly different between AD patients and healthy controls, before or after Tranilast therapy.

Role of leukotrienes in hydrochloric acid-induced gastric lesions in rats

This study was designed to clarify the role of leukotrienes (LTs) in 0.6 N hydrochloric acid (HCl)-induced gastric lesions. In rats given 1 ml of 0.6 N HCl intragastrically, severe hemorrhagic lesions were observed in the gastric corpus mucosa 15 min, and 1, 3, and 5 hr after HCl administration. In the control rats treated with physiological saline, LTs in gastric mucosa were not observed throughout the experiments. Peptide LT contents (sum of LTC4 and LTD4) after 1 or 3 hr were increased to 13.2 +/- 2.9 ng/g tissue and 6.3 +/- 1.9, respectively, although peptide-LTs were not observed 15 min and 5 hr after HCl administration. Premedication with AA-861, a lipoxygenase inhibitor, decreased dose-dependently peptide LT contents 1 hr after HCl administration. Furthermore, gastric lesions caused by 0.6 N HCl were significantly prevented by 300 mg/kg of AA-861 3 hr after HCl administration, although the dose of AA-861 did not significantly prevent gastric lesions 1 hr after HCl administration. Administration of YM-638, a peptide LT antagonist, showed similar protective effects to AA-861 except inhibition of increase in LT levels after HCl administration. These results suggest that peptide LTs contribute to persistence of gastric lesions, although they might not participate in the onset of 0.6 N HCl-induced gastric lesions.

The generation and metabolism of leukotrienes in the ionophore-stimulated blood of normal and asthmatic subjects

The generation and metabolism of leukotrienes (LTs) B4, C4, D4, and E4 were studied in vitro in the A23187-stimulated whole blood of normal (N) and atopic asthmatic (AA) human subjects. Using a combination of reversed-phase high performance liquid chromatography and radioimmunoassay, we have demonstrated that the blood cells of atopic asthmatic patients have an enhanced ability to release LTB4 and LTC4 when compared to those of normal subjects. The release of LTB4 and LTC4 in response to ionophore is dose- and time-dependent. Half-maximal doses of ionophore caused the generation of high, sustained levels of LTB4, which are significantly higher in the AA blood than in N blood. Incubations of 3H-LTB4 in ionophore-stimulated N and AA blood revealed a slow metabolism to 20-OH-LTB4 and 20-COOH-LTB4. LTC4 is generated in smaller amounts than LTB4, with an early peak after 10 min which is significantly higher (p less than 0.01) in the AA blood compared to the N blood. Subsequent metabolism of LTC4 elicits significantly greater amounts of LTD4, and consistently higher levels of LTE4, in the AA blood. Parallel incubations of 3H-LTC4 in ionophore-stimulated N and AA blood demonstrated rapid metabolism of LTC4 by the glutathione detoxification pathway. The elevated production of LTB4 and LTC4 in AA blood was not accounted for by differences in leukocyte sub-type counts in the two groups, nor by differences in their rates of catabolism. The novel, selective 5-lipoxygenase inhibitor BW A4C [N-(3-phenoxycinnamyl) acetohydroxamic acid] caused dose-dependent inhibition of LTB4 and LTC4 generation and was equipotent in N and AA blood.

Leukotriene C4 in children with atopic asthma. I. Plasma levels in acute asthma

The leukotrienes C4, D4 and E4 are potent biologic mediators, and are thought to play an important role in obstructive airways disease such as asthma. In this study, plasma immunoreactive LTC4 (iLTC4) levels in asthmatic children were measured using radioimmunoassay after Sep-pak extraction in order to determine whether LTC4 is released in vivo during an asthmatic attack. In 10 non-atopic children, the mean +/- SEM of plasma iLTC4 level was 0.031 +/- 0.013 pmol/ml. Significantly higher plasma iLTC4 levels were recognized at all stages in asthmatic children, both in remission (p less than 0.01) and during an attack (p less than 0.01). PaO2 levels during an attack were significantly lower in the high iLTC4 group. In 15 asthmatic children, the plasma iLTC4 levels during an attack (0.134 +/- 0.017 pmol/ml) significantly decreased during recovery (0.078 +/- 0.012 pmol/ml) (p less than 0.05). Plasma iLTC4 levels correlated closely with lung function (p less than 0.01). The high iLTC4 levels in plasma in asthmatic children suggest a role for LTC4 in the pathophysiology of asthma.

Leukotriene C4 in children with atopic asthma. II. Plasma levels in bronchial challenge with specific allergen

Peptide leukotrienes C4, D4 and E4 are considered to be major mediators of hypersensitivity reactions. In this study, immunoreactive leukotriene C4 (iLTC4) in plasma, taken from asthmatic children who had undergone bronchial challenge with a specific allergen, was measured using radioimmunoassay in order to determine whether LTC4 is released in vivo during human allergic reactions. With regard to the bronchial challenge of 10 asthmatic children, plasma iLTC4 levels at the post-challenge stage (0.131 +/- 0.037 pmol/ml) were significantly elevated compared to the pre-challenge stage (0.065 +/- 0.016 pmol/ml) (p less than 0.01). The bronchial response was not directly related to the increased plasma iLTC4 levels, but the strength of the bronchial response did relate to the plasma iLTC4 levels at the pre-challenge (p less than 0.05) and post-challenge (p less than 0.01) states. The pre-challenge levels are relevant to bronchial reactivity, and the post-challenge levels are relevant to bronchoconstriction caused by exposure to allergens. The in vivo release of LTC4 following exposure to a specific allergen suggests that leukotrienes are important in the pathogenesis of asthma.

Leukotrienes. Biology and role in disease

Leukotrienes are a novel group of chemical messengers derived from arachidonic acid. They are produced by several different tissues by processes linked to phospholipid flux in response to specific stimuli. The leukotrienes interact with specific receptors in target cell membranes to initiate a response. Most of these responsive cells are derived from bone marrow, skin, smooth muscle, and vascular endothelium. Leukotrienes are powerful mediators of inflammation and smooth muscle contraction, and there is increasing evidence that they are important factors in immune-mediated disease. Several available effective antiinflammatory drugs may act partially by inhibiting the production of leukotrienes.

Dietary fish oil inhibits bleomycin-induced pulmonary fibrosis in the rat

Intratracheal bleomycin induces pulmonary fibrosis in experimental animals, but the mechanisms involved are poorly understood. Since altered levels of fatty acid metabolites are associated with bleomycin-induced lung injury, we examined the effects of a change in dietary fat on bleomycin-induced fibrosis. Previously we have shown that an essential fatty acid-deficient diet can reduce the severity of bleomycin-induced pulmonary fibrosis. The present study examined the effect of replacement of usual dietary fat with menhaden oil, rich in eicosapentaenoic acid, on the development of pulmonary fibrosis. Weanling rats were raised on a standard laboratory diet or a diet consisting of a fat-free powder to which was added 25% (w/w) of menhaden oil. After 8 weeks of feeding, the animals received either 1.5 units of bleomycin or an equivalent volume of saline intratracheally. In animals receiving the laboratory diet, bleomycin treatment produced a 44% increase in total lung protein content when compared to saline-treated controls (p less than 0.001) and a 77% increase in total lung hydroxyproline content (p less than 0.01). In contrast, bleomycin-treated animals receiving the menhaden oil diet had only small increases, which did not reach statistical significance, in protein and hydroxyproline content in the lung. Bronchoalveolar lavage cellularity did not differ among the treatment groups, but the percentage of lavage macrophages was slightly diminished in bleomycin-treated animals receiving the laboratory diet. Cellular differentials of lavage fluid did not differ significantly between bleomycin- and saline-treated animals receiving the menhaden oil diet. Bleomycin-induced histologic changes, quantitated by morphometric analysis, were significantly reduced with the menhaden oil diet. We conclude that a diet rich in eicosapentaenoic acid can significantly ameliorate bleomycin-induced pulmonary fibrosis, possibly via alterations in eicosanoid metabolism.

Plasma levels of leukotriene C4, B4, slow reacting substance of anaphylaxis in chronological phases of cerebrovascular disease

In this study we report and compare plasma leukotriene (LT) levels in seventeen (17) patients with cerebral infarction, five (5) patients with cerebral hemorrhage and twelve (12) age-matched healthy volunteers. Plasma samples were collected at intervals of 1-7 days, 8-14 days, 15-30 days and 31 days- after cerebrovascular accident. Plasma immunoreactive LTC4, LTB4 and SRS-A (Slow Reacting Substance of Anaphylaxis or total peptido-LT's) levels were measured for each sample. Immunoreactive LTC4 (and SRS-A) levels were elevated in patients with cerebral infarction whilst LTB4 levels were raised in the patients with cerebral hemorrhage. In particular, cerebral infarcted patients exhibited significantly elevated levels in phases 1-7 days and after 15 days when compared with the age-matched healthy volunteers. In patients with cerebral hemorrhage, significant increases in LTB4 were measured in days 1-7 only. These results suggest a clinical relationship between the plasma levels of LT's and cerebrovascular disease.

Arachidonic acid metabolism in cultured alveolar macrophages from normal, atopic, and asthmatic subjects

In order to test the hypothesis that alveolar macrophages (AM) from asthmatics might manifest abnormalities in the amounts, spectrum, or glucocorticoid regulation of eicosanoid synthesis, we compared arachidonic acid (AA) metabolism under resting and ionophore A23187-stimulated conditions in cultured AM obtained by bronchoalveolar lavage from 10 asthmatic, nine atopic, and 10 nonatopic normal subjects. [14C]AA-prelabeled AM constitutively released free [14C]AA and release increased significantly with A23187 incubation. Under resting conditions, unlabeled cells produced small amounts of immunoreactive thromboxane B2 (TxB2), prostaglandin D2 (PGD2), prostaglandin E2 (PGE2), and leukotriene B4 (LTB4). With A23187 stimulation there were significant increases in the synthesis of all immunoreactive metabolites, which were produced in the following relative amounts: LTB4 much greater than TxB2 greater than PGD2 greater than leukotriene C4 greater than PGE2. High performance liquid chromatographic separation of radiolabeled eicosanoids produced by prelabeled cells confirmed the radioimmunoassay results and further indicated the production of relatively large amounts of 5-hydroxyeicosatetraenoic acid and 12-hydroxyheptadecatrienoic acid. Pretreatment (16 h) with 1 microM methylprednisolone inhibited A23187-induced synthesis of immunoreactive cyclooxygenase products to a greater extent than immunoreactive leukotrienes. We identified no significant differences among the three study groups in the quantities or profiles of eicosanoids synthesized either constitutively or with A23187 stimulation, nor in their regulation by methylprednisolone.

A new 5-lipoxygenase selective inhibitor derived from Artocarpus communis strongly inhibits arachidonic acid-induced ear edema

Natural compounds isolated from the Indonesian plant, Artocarpus communis, inhibit 5-lipoxygenase of cultured mastocytoma cells. One of five compounds, AC-5-1, strongly inhibits 5-lipoxygenase with a half-inhibition dose of 5 +/- 0.12 X 10(-8) M. However, prostaglandin synthesizing activity is not inhibited until 10(-5) M. AC-5-1 is a highly selective inhibitor for 5-lipoxygenase. The AC-5-1 at 10(-5) M inhibits 96% of leukotriene C4 synthesis of mouse peritoneal cells facilitated by calcium-ionophore. Arachidonic acid-induced ear edema of mice, an in vivo inflammatory model, involving leukotriene induction, is strongly inhibited by AC-5-1 in a dose-dependent manner. The inhibition is the strongest of any inhibitors of 5-lipoxygenase reported previously. Since the natural compound AC-5-1 can selectively inhibit 5-lipoxygenase and affect in vivo inflammation, it will be interesting to investigate the role of leukotrienes on inflammation and other physiological processes.

Critical considerations in the development of an assay for sulfidopeptide leukotrienes in plasma

A sensitive and specific assay has been developed for measurement of total sulfidopeptide leukotrienes (LT) in plasma. LTC4 and LTD4 in plasma are converted to LTE4 which is then extracted by C18 Sep-Pak binding and elution. Total LTE4 is resolved by reverse phase high performance liquid chromatography (RP-HPLC) and quantitated by radioimmunoassay (RIA). A [3H]LTE4 internal standard is added to the starting plasma sample to allow overall recovery to be calculated and to define the fractions from RP-HPLC to be assayed for LTE4-like immunoreactivity. The correlation between the measured increase in LTE4 concentration after addition of incremental amounts of LTC4 and LTE4 to plasma was 0.989 and 0.978, respectively, with slopes of 1.05 and 1.11. Addition of 51 pg/ml LTE4 to 5 ml plasma was detectable; the measured increase was 48 +/- 12 pg/ml (mean +/- SE, n = 7). The intra-assay coefficient of variation for 341 pg/ml of added LTC4 was 3.2% (n = 6). Sulfidopeptide leukotrienes could not be detected in blood samples taken from 12 normal volunteers in whom the theoretical detection limit, calculated from the sensitivity of the RIA, the overall recovery of LTE4, and the volume of plasma extracted, was 83 +/- 4 pg LTE4/ml plasma (0.19 +/- 0.01 pmol sulfidopeptide leukotriene/ml plasma; mean +/- SE).

Blood leukotriene levels during the acute asthma attack in children

Leukotrienes (LT) have been proposed to be important mediators in the etiology of the acute asthma attack (AAA). We therefore studied blood LT levels in 18 children having AAA. Heparinized blood samples were obtained before and after treatment with epinephrine injections and/or metaproterenol inhalations in the emergency room. The samples were acidified and subjected to Sep-pak chromatography. Reverse phase high performance liquid chromatography (RP-HPLC), ultraviolet (UV) spectroscopy and bioassay on guinea pig ileum were used to identify the LT based on comparison to data produced by standard synthetic LT samples. Radioimmunoassay (RIA) was used to further confirm the presence of LT. LT C, D and E were detected in the plasma of children having AAA. Only LT C levels were significantly elevated over control values. The mean blood LT C level of control patients was 1.6 +/- 1.2 nanograms per milliliter (ng/ml, mean +/- SEM) while that of the asthma patients was 73.8 +/- 18.2 ng/ml prior to treatment. After emergency room treatment the asthma patients had a mean blood LT C level of 22.5 +/- 11.7 ng/ml. Lowered levels of LT C accompanied improved clinical condition of the patients. This finding indicates that the AAA in children is associated with elevated blood levels of LT C.

Effects of dietary fats on bleomycin-induced pulmonary fibrosis

Bleomycin treatment has been used for the experimental induction of pulmonary fibrosis, but the mechanisms involved are poorly understood. Since alterations in the levels of certain fatty acid metabolites have been associated with bleomycin-induced lung injury, we examined the effects of different dietary fats on the development of bleomycin-induced pulmonary fibrosis. Weanling rats were raised on standard laboratory feed or a diet consisting of a fat-free powder to which was added either coconut oil or beef tallow (25% w/w). After 8 weeks of feeding, animals received either 1.5 units bleomycin or an equivalent volume of saline intratracheally. Bleomycin treatment resulted in significant increases in total lung hydroxyproline content in the groups fed the standard lab diet (p less than 0.001) and beef tallow diet (p less than 0.001), but not in the group receiving the coconut oil diet. Furthermore, the lung hydroxyproline content in bleomycin-treated animals was less with the beef tallow diet compared with standard lab feed (p less than 0.05). Bleomycin treatment resulted in an increase in thiobarbituric acid-reactive products, an index of lipid peroxidation, in lungs from animals fed the standard lab diet, but not in the other diet groups. The percentage of diseased lung, as determined by morphometric analysis, was increased in bleomycin-treated animals from all diet groups (p less than 0.05). We conclude that alterations in dietary fats can reduce the severity of pulmonary fibrosis resulting from bleomycin treatment. Possible mechanisms for this effect include alterations in eicosanoid metabolism or changes in immune or effector cell function.

New developments concerning leukotriene antagonists: a review

The numbers and subtypes of leukotriene (LT) receptors have only recently been investigated and more work is needed to evaluate the distribution of receptors on tissues and cells in both normal and pathological states. Classification of the heterogeneity of LT receptors may assist in the discovery of new antiallergy and antiinflammatory drugs much in the same way as the study of different adrenergic receptors has benefited cardiovascular drug discovery. The clinical evaluation of the currently available LT antagonists is awaited with interest; however, their therapeutic role in the treatment of asthma, a primary goal for the majority of these agents, will require painstaking clinical appraisal. They seem unlikely to supplant the currently used bronchodilators but may provide a valuable prophylactic adjunct that may suppress some of the inflammatory events that occur in obstructive lung disease. Whether the LT antagonists modify the hyperreactive state that prevails in asthma is also the subject of much speculation.