Increases in urinary 9α,11β-prostaglandin F₂ indicate mast cell activation in wine-induced asthma

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)E ₄ 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.