Valerie Jaroenpuntaruk, Sarah M Jenkins, Carin Y Smith, Alexei Gonzalez-Estrada, Lyda Cuervo-Pardo, Miguel A Park, Elina Jerschow, Rohit Divekar, Avni Y Joshi, Thanai Pongdee, Dayne H Voelker, Joseph H Butterfield, Sergio E Chiarella
{"title":"尿肥大细胞介质的性别差异：诊断特应性和肥大细胞疾病的意义。","authors":"Valerie Jaroenpuntaruk, Sarah M Jenkins, Carin Y Smith, Alexei Gonzalez-Estrada, Lyda Cuervo-Pardo, Miguel A Park, Elina Jerschow, Rohit Divekar, Avni Y Joshi, Thanai Pongdee, Dayne H Voelker, Joseph H Butterfield, Sergio E Chiarella","doi":"10.1016/j.anai.2025.05.028","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Urinary mast cell mediators aid in diagnosing atopic and mast cell disorders, yet sex differences in these mediators remain unreported despite known sex-specific variations in eicosanoid pathways.</p><p><strong>Objective: </strong>To characterize sex differences in urinary mast cell mediators 2,3-dinor-11β-prostaglandin F2α (2,3-BPG), N-methylhistamine (NMH), and leukotriene E4 (LTE4).</p><p><strong>Methods: </strong>This retrospective chart review of 4,033 patients of all ages at Mayo Clinic from June 1, 2019, to May 31, 2024, included demographic and clinical data. Urine mast cell mediators 2,3-BPG, NMH, and LTE4 were quantified using liquid chromatography-tandem mass spectrometry and normalized to creatinine (Cr) levels. Statistical analyses were performed using R.</p><p><strong>Results: </strong>Among patients tested for urinary mast cell mediators, 78.8% were female. Compared to females, males were older at testing (mean 48.0 vs 40.1 years), more likely to report ever smoking (33.5% vs 22.7%), had higher BMI (mean 28.6 vs 27.7), more often had an atopic condition (82.6% vs 71.0%) or comorbidity (46.1% vs 30.3%), and had higher median LTE4 levels (102.5 vs 90.0 pg/mg Cr) (P < 0.001 for all). Males also more commonly had elevated 2,3-BPG (8.0% vs 3.7%) and eosinophil counts (17.0% vs 5.9%) and higher median tryptase levels (5.1 vs 4.3 pg/mL) (P < 0.001 for all). Multivariable analysis revealed a sex-by-atopy interaction for LTE4, with higher levels in atopic males (M/F ratio 1.15, [95% CI: 1.07-1.25], P < 0.001) and lower levels in non-atopic females (M/F ratio 0.86, [95% CI: 0.76-0.97], P = 0.02).</p><p><strong>Conclusion: </strong>Sex differences in testing rates and urinary mediator levels highlight the need to consider sex in optimizing the diagnostic utility of these mediators.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sex Differences in Urinary Mast Cell Mediators: Implications for Diagnosing Atopic and Mast Cell Disorders.\",\"authors\":\"Valerie Jaroenpuntaruk, Sarah M Jenkins, Carin Y Smith, Alexei Gonzalez-Estrada, Lyda Cuervo-Pardo, Miguel A Park, Elina Jerschow, Rohit Divekar, Avni Y Joshi, Thanai Pongdee, Dayne H Voelker, Joseph H Butterfield, Sergio E Chiarella\",\"doi\":\"10.1016/j.anai.2025.05.028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Urinary mast cell mediators aid in diagnosing atopic and mast cell disorders, yet sex differences in these mediators remain unreported despite known sex-specific variations in eicosanoid pathways.</p><p><strong>Objective: </strong>To characterize sex differences in urinary mast cell mediators 2,3-dinor-11β-prostaglandin F2α (2,3-BPG), N-methylhistamine (NMH), and leukotriene E4 (LTE4).</p><p><strong>Methods: </strong>This retrospective chart review of 4,033 patients of all ages at Mayo Clinic from June 1, 2019, to May 31, 2024, included demographic and clinical data. Urine mast cell mediators 2,3-BPG, NMH, and LTE4 were quantified using liquid chromatography-tandem mass spectrometry and normalized to creatinine (Cr) levels. Statistical analyses were performed using R.</p><p><strong>Results: </strong>Among patients tested for urinary mast cell mediators, 78.8% were female. Compared to females, males were older at testing (mean 48.0 vs 40.1 years), more likely to report ever smoking (33.5% vs 22.7%), had higher BMI (mean 28.6 vs 27.7), more often had an atopic condition (82.6% vs 71.0%) or comorbidity (46.1% vs 30.3%), and had higher median LTE4 levels (102.5 vs 90.0 pg/mg Cr) (P < 0.001 for all). Males also more commonly had elevated 2,3-BPG (8.0% vs 3.7%) and eosinophil counts (17.0% vs 5.9%) and higher median tryptase levels (5.1 vs 4.3 pg/mL) (P < 0.001 for all). Multivariable analysis revealed a sex-by-atopy interaction for LTE4, with higher levels in atopic males (M/F ratio 1.15, [95% CI: 1.07-1.25], P < 0.001) and lower levels in non-atopic females (M/F ratio 0.86, [95% CI: 0.76-0.97], P = 0.02).</p><p><strong>Conclusion: </strong>Sex differences in testing rates and urinary mediator levels highlight the need to consider sex in optimizing the diagnostic utility of these mediators.</p>\",\"PeriodicalId\":50773,\"journal\":{\"name\":\"Annals of Allergy Asthma & Immunology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.8000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Allergy Asthma & Immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.anai.2025.05.028\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Allergy Asthma & Immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.anai.2025.05.028","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：尿肥大细胞介质有助于诊断特应性和肥大细胞疾病，然而，尽管已知二十烷类途径存在性别特异性差异，但这些介质的性别差异仍未报道。目的：探讨尿肥大细胞介质2,3-dino -11β-前列腺素F2α (2,3- bpg)、n -甲基组胺（NMH）和白三烯E4 （LTE4）的性别差异。方法：回顾性分析了2019年6月1日至2024年5月31日在梅奥诊所（Mayo Clinic）就诊的4033名不同年龄的患者，包括人口统计学和临床数据。采用液相色谱-串联质谱法对尿肥大细胞介质2,3- bpg， NMH和LTE4进行定量，并将其归一化为肌酐（Cr）水平。结果：接受尿肥大细胞介质检测的患者中，78.8%为女性。与女性相比，男性在检测时年龄较大（平均48.0岁vs 40.1岁），更有可能报告曾经吸烟（33.5% vs 22.7%）， BMI较高（平均28.6 vs 27.7），更常患有特应性疾病（82.6% vs 71.0%）或共病（46.1% vs 30.3%），并且LTE4中位水平较高（102.5 vs 90.0 pg/mg Cr）（所有P < 0.001）。男性也更常见2,3- bpg （8.0% vs 3.7%）和嗜酸性粒细胞计数（17.0% vs 5.9%）升高，中位胰蛋白酶水平（5.1 vs 4.3 pg/mL）较高（所有P < 0.001）。多变量分析显示LTE4存在性别-特应性相互作用，特应性男性中LTE4水平较高（M/F比1.15,[95% CI: 1.07-1.25], P < 0.001），非特应性女性中LTE4水平较低（M/F比0.86,[95% CI: 0.76-0.97], P = 0.02）。结论：检测率和尿介质水平的性别差异突出了在优化这些介质的诊断效用时考虑性别的必要性。
Sex Differences in Urinary Mast Cell Mediators: Implications for Diagnosing Atopic and Mast Cell Disorders.
Background: Urinary mast cell mediators aid in diagnosing atopic and mast cell disorders, yet sex differences in these mediators remain unreported despite known sex-specific variations in eicosanoid pathways.
Objective: To characterize sex differences in urinary mast cell mediators 2,3-dinor-11β-prostaglandin F2α (2,3-BPG), N-methylhistamine (NMH), and leukotriene E4 (LTE4).
Methods: This retrospective chart review of 4,033 patients of all ages at Mayo Clinic from June 1, 2019, to May 31, 2024, included demographic and clinical data. Urine mast cell mediators 2,3-BPG, NMH, and LTE4 were quantified using liquid chromatography-tandem mass spectrometry and normalized to creatinine (Cr) levels. Statistical analyses were performed using R.
Results: Among patients tested for urinary mast cell mediators, 78.8% were female. Compared to females, males were older at testing (mean 48.0 vs 40.1 years), more likely to report ever smoking (33.5% vs 22.7%), had higher BMI (mean 28.6 vs 27.7), more often had an atopic condition (82.6% vs 71.0%) or comorbidity (46.1% vs 30.3%), and had higher median LTE4 levels (102.5 vs 90.0 pg/mg Cr) (P < 0.001 for all). Males also more commonly had elevated 2,3-BPG (8.0% vs 3.7%) and eosinophil counts (17.0% vs 5.9%) and higher median tryptase levels (5.1 vs 4.3 pg/mL) (P < 0.001 for all). Multivariable analysis revealed a sex-by-atopy interaction for LTE4, with higher levels in atopic males (M/F ratio 1.15, [95% CI: 1.07-1.25], P < 0.001) and lower levels in non-atopic females (M/F ratio 0.86, [95% CI: 0.76-0.97], P = 0.02).
Conclusion: Sex differences in testing rates and urinary mediator levels highlight the need to consider sex in optimizing the diagnostic utility of these mediators.
期刊介绍：
Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.
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