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The following is a summary of “Metabolomic endophenotypes based on oxo-eicosatetraenoic acids in patients with aspirin-exacerbated respiratory disease,” published in the May 2025 issue of Journal of Allergy and Clinical Immunology by Szatkowski et al. 

In patients with aspirin-exacerbated respiratory disease (AERD), arachidonic acid (AA) metabolism was characterized by an imbalance between proinflammatory and anti-inflammatory eicosanoids.  

Researchers conducted a retrospective study to identify metabolomic clusters based on plasma and urinary levels of 15-oxo-eicosatetraenoic acid (15-oxo-ETE), 5-oxo-eicosatetraenoic acid (5-oxo-ETE), and other lipoxygenase AA metabolites in a pulmonology setting. 

They performed hierarchical cluster analysis on 78 patients with AERD and 63 with aspirin-tolerant asthma (ATA) using 23 variables. These included demographic, clinical, biochemical, and treatment data, sinus computed tomography findings, and plasma and urinary levels of selected eicosanoids. Eicosanoid measurements were conducted using high-performance liquid chromatography and tandem mass spectrometry.  

The results showed 2 distinct clusters in each group. In AERD clusters, the Lund-Mackay (LM) score and urinary leukotriene E₄ (LTE₄) were significantly elevated, while urinary 15-oxo-ETE was lower compared to ATA clusters. Patients of Cluster 1_AERD and cluster 1_ATAATA were older, had higher body mass index (BMI), more severe asthma, poorer asthma control, and increased plasma levels of 15-hydroxyeicosatetraenoic acid, 15-oxo-ETE, and 5-hydroxyeicosatetraenoic acid. Individuals with AERD showed more advanced sinus abnormalities and higher urinary 15-oxo-ETE and LTE₄ levels than those with ATA.  

Investigators concluded that higher plasma and lower urinary levels of 15-oxo-ETE were linked to more severe asthma and poorer asthma control in patients with AERD of older age and higher BMI. 

Source: jacionline.org/article/S0091-6749(25)00606-2/fulltext