Urinary leukotriene E4 in pediatric pulmonary arterial hypertension: a pilot case control study

Pediatric pulmonary arterial hypertension (PAH) is a potentially fatal disease. New targeted therapies based on the underlying pathogenesis are still needed.

This study aims to evaluate the role of leukotriene E4, an inflammatory mediator, in developing pediatric pulmonary arterial hypertension (PAH).

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.

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.

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.