Increases in Urinary 9α,11β-Prostaglandin F₂ Indicate Mast Cell Activation in Wine-Induced Asthma

Abstract

Background: Wine-induced asthmatic symptoms may be caused by sulphite additives. Prostaglandin (PG)D₂ and cysteinyl leukotrienes (cysLT) are important mediators of asthmatic responses. To determine whether the sulphite additives in wine alter the production of PGD₂ and cysLT, asthmatic patients with compelling histories of wine sensitivity were challenged with high- and low-sulphite wines; the urinary metabolites of PGD₂ and cysLT were measured before and after challenge. Methods: Eight self-reporting wine-sensitive asthmatic patients completed double-blind challenges with high- and low-sulphite wines on separate days. Urine samples were collected before and after consumption of 150 ml of wine. Urinary concentrations of 9α,11β-PGF₂ and leukotriene (LT)E₄ were measured by enzyme immunoassay. Results: Urinary 9α,11β-PGF₂ concentrations increased in all subjects following challenge with high-sulphite wine, and the median concentration increased 1.6-fold (p < 0.01). Urinary 9α,11β-PGF₂ also increased 1.5-fold after low-sulphite wine challenge, although this did not reach statistical significance (p = 0.08). The median difference in 9α,11β-PGF₂ concentration after high-sulphite wine challenge was not significantly different compared with that after low-sulphite wine challenge. Median urinary LTE₄ concentrations did not change significantly after either wine challenge. Conclusions: Increased urinary 9α,11β-PGF₂ concentrations following wine challenge suggest mast cell activation as a possible mechanism for wine-induced asthma, although this did not appear to be related to the sulphite additives in wine. Urinary 9α,11β-PGF₂ may warrant further assessment as a potential biomarker of reactivity to wine in asthmatic subjects.

Prostaglandin E2 and cysteinyl leukotriene concentrations in sputum: association with asthma severity and eosinophilic inflammation

“…Urinary LTE 4 concentrations were significantly higher in patients with eosinophilic airway inflammation; however, there were no differences in the urinary concentrations of the PGD 2 metabolite, 9a,11b-PGF 2 , among the different subject groups. This is in keeping with observations that baseline plasma and urinary levels of 9a,11b-PGF 2 were not different in asthmatic and control subjects [8,34], whereas this metabolite may be a specific marker of mast cell activation by allergens and other triggers [34][35][36][37]. Sputum 8-isoprostane concentrations also did not differ significantly among the different subject groups, although the levels were somewhat elevated in patients with moderate asthma and those with eosinophilic airway inflammation.…”

Alcohol-induced Respiratory Symptoms Are Common in Patients With Aspirin Exacerbated Respiratory Disease

“…18 Sulfite hypersensitivity also exists in some asthmatics 19, 20 and although one-third of our respondents with AERD reported that red wine was the alcohol type causing the most forceful respiratory reactions, most patients found that all alcohols incited reactions, even those with little to no sulfites. Additionally, studies comparing broncho constriction induced by wine with high vs. low sulfite content have not found any difference between the two, 21–23 suggesting that alcohol itself, and not an additive, is the culprit for these reactions. Sensitivity to alcohol is common in Asian populations due to a polymorphism in acetaldehyde dehydrogenase, and patients classically present with facial flushing and occasionally respiratory symptoms.…”

Wine and Health: A Review

“…Adverse reactions to wine (facial flushing, asthma, and oral allergic swelling and burning) in some cases has been determined to have been caused by a sensitivity to the venom of Hymenoptera insects (wasps, bees, ants), which may contaminate wines during vinification (Armentia 2008). A recent study in asthmatic patients with wine sensitivity reported mast cell activation as a possible mechanism for wine-induced asthma, which did not correlate with wine sulfite levels (Misso et al 2009). …”