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Urinary leukotriene E4 in pediatric pulmonary arterial hypertension: a pilot case control study
Hamdy El-Sayed1, Hala Elmarsafawy2, Basma Shouman3
1Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Insights
Urinary leukotriene E4 (LTE4) levels are significantly elevated in children with pulmonary arterial hypertension (PAH). This finding suggests LTE4 plays a role in PAH development, offering a potential biomarker for this serious condition.
Area of Science:
- Pediatric Cardiology
- Pulmonary Hypertension Research
- Inflammatory Mediators
Background:
- Pediatric pulmonary arterial hypertension (PAH) is a severe, life-threatening condition.
- Current targeted therapies for pediatric PAH are limited.
- Understanding the underlying pathogenesis is crucial for developing new treatments.
Purpose of the Study:
- To investigate the role of leukotriene E4 (LTE4), an inflammatory mediator, in the pathogenesis of pediatric pulmonary arterial hypertension (PAH).
- To assess urinary LTE4 levels as a potential diagnostic marker for pediatric PAH.
Main Methods:
- The study included 21 pediatric patients diagnosed with group 1 PAH via cardiac catheterization, many with associated congenital heart disease (PAHCHD).
- A control group of 21 healthy individuals was matched for age and sex.
- Urinary LTE4 levels were quantified using an enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Patients with pediatric PAH exhibited significantly higher urinary LTE4 levels and LTE4/creatinine ratios compared to healthy controls (p < 0.05).
- Urinary LTE4 demonstrated high sensitivity and specificity for predicting PAH, with a cut-off level of 35.4 pg/ml.
- Elevated LTE4 suggests its involvement in the inflammatory processes underlying pediatric PAH.
Conclusions:
- Significantly elevated urinary LTE4 levels in pediatric PAH patients indicate its potential role as an inflammatory mediator in disease pathogenesis.
- LTE4 may serve as a valuable biomarker for the early detection and management of pediatric pulmonary arterial hypertension.
- Further research into LTE4-targeted therapies could offer new treatment avenues for pediatric PAH.
Background:
Pediatric pulmonary arterial hypertension (PAH) is a potentially fatal disease. New targeted therapies based on the underlying pathogenesis are still needed.
Objective:
This study aims to evaluate the role of leukotriene E4, an inflammatory mediator, in developing pediatric pulmonary arterial hypertension (PAH).
Methods And Setting:
The study included 21 patients with PAH who belonged to group 1 of the international pH classification. PAH was diagnosed via cardiac catheterization. Most patients had PAH associated with congenital heart disease (PAHCHD). The control group comprised 21 healthy participants of matched age and sex. Urinary leukotriene E4 (LTE4) levels were assessed using an enzyme-linked immunosorbent assay.
Results:
Urinary LTE4 levels and urinary LTE4 to urinary creatinine ratio were significantly increased among patients compared to healthy controls (p < 0.05). Further, a high combination of sensitivity and specificity was observed for urinary LTE4 with a cut-off level of 35.4pg/ml for predicting PAH.
Conclusion:
The significantly elevated urinary LTE4 levels in pediatric patients with PAH can suggest the role of LTE4 as an inflammatory mediator in the disease pathogenesis.
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