Urinary leukotriene E4 as a biomarker in NSAID-exacerbated respiratory disease (N-ERD): a systematic review and meta-analysis.
Urinary leukotriene E4 as a biomarker in NSAID-exacerbated respiratory disease (N-ERD): a systematic review and meta-analysis.
Purpose of Review
Non-steroidal exacerbated respiratory disease (N-ERD) currently requires aspirin challenge testing for diagnosis. Urinary leukotriene E4 (uLTE4) has been extensively investigated as potential biomarker in N-ERD. We aimed to assess the usefulness of uLTE4 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. uLTE4 indicates cysteinyl leukotriene production, and a potential biomarker in N-ERD. Although several studies and have examined the relationship between uLTE4 and N-ERD, the usefulness of uLTE4 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). uLTE4 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 uLTE4 is higher in N-ERD than ATA or HC. Likewise, people with N-ERD have greater increases in uLTE4 following aspirin challenge. However, due to the varied uLTE4 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.
Aspirin-intolerance, Asthma, N-ERD, Non-steroidal anti-inflammatory respiratory disease, Samter’s, Urinary leukotrienes E4
209-229
Marquette, Malcolm
6e3c8656-c4b3-4c2b-af2a-0d5f0672040f
Tailor, Bhavesh V
f941f62e-26e9-48fd-b66e-391226a4ba2b
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Curtis, Peter J
a7c08f12-2f0b-4989-be94-295a63634b8f
Loke, Yoon
4680878f-db19-48b5-8b14-d5afdaf0c260
Wilson, Andrew M
638cc989-1223-4662-a823-a9d050b06fc5
14 November 2022
Marquette, Malcolm
6e3c8656-c4b3-4c2b-af2a-0d5f0672040f
Tailor, Bhavesh V
f941f62e-26e9-48fd-b66e-391226a4ba2b
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Curtis, Peter J
a7c08f12-2f0b-4989-be94-295a63634b8f
Loke, Yoon
4680878f-db19-48b5-8b14-d5afdaf0c260
Wilson, Andrew M
638cc989-1223-4662-a823-a9d050b06fc5
Marquette, Malcolm, Tailor, Bhavesh V, Calder, Philip, Curtis, Peter J, Loke, Yoon and Wilson, Andrew M
(2022)
Urinary leukotriene E4 as a biomarker in NSAID-exacerbated respiratory disease (N-ERD): a systematic review and meta-analysis.
Current Allergy and Asthma Reports, 22 (12), .
(doi:10.1007/s11882-022-01049-8).
Abstract
Purpose of Review
Non-steroidal exacerbated respiratory disease (N-ERD) currently requires aspirin challenge testing for diagnosis. Urinary leukotriene E4 (uLTE4) has been extensively investigated as potential biomarker in N-ERD. We aimed to assess the usefulness of uLTE4 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. uLTE4 indicates cysteinyl leukotriene production, and a potential biomarker in N-ERD. Although several studies and have examined the relationship between uLTE4 and N-ERD, the usefulness of uLTE4 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). uLTE4 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 uLTE4 is higher in N-ERD than ATA or HC. Likewise, people with N-ERD have greater increases in uLTE4 following aspirin challenge. However, due to the varied uLTE4 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.
Text
SR uLTE4 manuscript_MMUEA2022_Rev_Ref
- Accepted Manuscript
Text
s11882-022-01049-8
- Version of Record
More information
Accepted/In Press date: 18 October 2022
Published date: 14 November 2022
Additional Information:
Funding Information:
This work was funded by Asthma UK Centre of Applied Research (AUKCAR).
Publisher Copyright:
© 2022, Crown.
Keywords:
Aspirin-intolerance, Asthma, N-ERD, Non-steroidal anti-inflammatory respiratory disease, Samter’s, Urinary leukotrienes E4
Identifiers
Local EPrints ID: 471664
URI: http://eprints.soton.ac.uk/id/eprint/471664
ISSN: 1529-7322
PURE UUID: 81472162-04ed-4ad8-9704-02263e844164
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Date deposited: 16 Nov 2022 17:31
Last modified: 17 Mar 2024 02:42
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Contributors
Author:
Malcolm Marquette
Author:
Bhavesh V Tailor
Author:
Peter J Curtis
Author:
Yoon Loke
Author:
Andrew M Wilson
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