Urinary leukotriene E4 as a biomarker in NSAID-exacerbated respiratory disease (N-ERD): A systematic review and meta-analysis

Marquette, Malcolm, Tailor, Bhavesh V. ORCID: https://orcid.org/0000-0001-7534-5183, Calder, Philip C., Curtis, Peter J. ORCID: https://orcid.org/0000-0001-5211-047X, 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). 209–229. ISSN 1529-7322

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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

Item Type:	Article
Uncontrolled Keywords:	aspirin-intolerance,asthma,n-erd,non-steroidal anti-inflammatory respiratory disease,samter’s,urinary leukotrienes e4,immunology and allergy,immunology,pulmonary and respiratory medicine ,/dk/atira/pure/subjectarea/asjc/2700/2723
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Related URLs:	http://www.scopus.com/inward/record.url?... https://link.springer.com/10.1007/s11882...
Depositing User:	LivePure Connector
Date Deposited:	16 Nov 2022 14:30
Last Modified:	13 Nov 2023 17:53
URI:	https://ueaeprints.uea.ac.uk/id/eprint/89891
DOI:	10.1007/s11882-022-01049-8

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