Enhanced production of leukotrienes by peripheral leukocytes and specific IgE antibodies in patients with chronic obstructive pulmonary disease

Background: How leukotrienes (LTs) and IgE-mediated allergy reflect clinical features in patients with chronic obstructive pulmonary disease (COPD) remains unclear. Objective: Our goal was to determine whether LTB4 and LTC4 would correlate with airway obstruction and whether IgE-mediated allergy would influence the generation of LTs and bronchial hyperresponsiveness in patients with COPD. Methods: We measured the pulmonary function, methacholine bronchial hyperresponsiveness, and generation of LTB4 and LTC4 from peripheral leukocytes stimulated with calcium ionophore A23187 in relation to the presence of specific IgE antibodies against inhalant allergens. Results: The leukocytes of patients with COPD generated significantly more LTB4 (with allergy, P < .001; without allergy, P < .001) and LTC4 (with allergy, P < .001; without allergy, P < .01) than the leukocytes of the control subjects. LTC4 production was significantly higher in the allergic COPD subjects than in the nonallergic COPD patients (P < .01), but the amount of LTB4 generated was not significantly different. FEV1 significantly correlated with the level of both LTB4 (with allergy, r = –0.556, P = .0375; without allergy, r = –0.731, P = .0046) and LTC4 (with allergy, r = –0.764, P = .0043; without allergy, r = –0.526, P = .0414) generation in COPD. The log10 of the minimum dose of methacholine was significantly higher in COPD patients without allergy than in those with allergy (P < .05). Conclusion: Enhanced LT generation from peripheral leukocytes is observed in patients with COPD, and the presence of specific IgE antibodies against inhalant allergens enhances LTC4 generation, bronchial hyperresponsiveness, and the relationship between LTC4 generation and airway obstruction. (J Allergy Clin Immunol 2001;107:492-8.)