12‐hydroxy‐eicosatetraenoic acid (12‐HETE): a biomarker of Churg‐Strauss syndrome
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SummaryBackgroundChurg‐Strauss syndrome (CSS) shares similarities with asthma and hypereosinophilic syndrome (HES). Eicosanoids – important inflammatory and signaling molecules – are present in exhaled breath condensate (EBC) and broncho‐alveolar lavage fluid (BALF).ObjectivesTo assess eicosanoid profile both in EBC and BALF of CSS subjects searching for a pattern characteristic of this syndrome.MethodsEBCs from 23 CSS patients, 30 asthmatics, 12 HES patients and 54 healthy controls (HC) were assessed quantitatively for 19 eicosanoids by a high‐performance liquid chromatography ‐ tandem mass spectrometry (HPLC‐MS/MS). In addition, in 21 of 23 CSS subjects and in nine asthmatics, eicosanoids were determined in BALF.ResultsEBC from CSS patients showed markedly elevated levels of 12‐HETE as compared with other studied groups. BALF was characterized by a significant elevation of 12‐HETE and its metabolite 12‐tetranor HETE in CSS as compared with asthma. Clinical activity of CSS correlated with 12‐HETE and its metabolites levels in BALF, but not in EBC.Conclusion and Clinical RelevanceCSS is clearly distinguished from bronchial asthma, and HES by a marked increase in 12‐HETE concentration in both EBC and BALF. This points to a possible new pathogenic mechanism in CSS and may help in future in establishing the diagnosis of CSS.
