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.