{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T22:10:06Z","timestamp":1775513406988,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Urine leukotriene E4 (uLTE4) is a biomarker of leukotriene synthesis and is elevated in patients with aspirin\u2010exacerbated respiratory disease (AERD). It can also be useful to help delineate aspirin\u2010tolerant chronic rhinosinusitis with nasal polyposis (CRSwNP) patients from AERD patients. The purpose of this study is to determine if uLTE4 biomarker levels are associated with objective and subjective markers of disease severity in patients with CRSwNP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of CRSwNP patients who underwent uLTE4 testing was completed to determine the association of uLTE4 levels to markers of disease severity. uLTE4 levels, as well as presenting subjective (Sinonasal Outcome Test 22 [SNOT22] scores, asthma control test [ACT] scores) and objective data (Lund\u2010Mackay CT score, spirometry and lab values) were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 157 CRSwNP patients who met inclusion criteria, uLTE4 levels were associated with history of asthma (<jats:italic>P<\/jats:italic>&lt;\u2009.001), aspirin sensitivity (<jats:italic>P<\/jats:italic>&lt;\u2009.001), worse Lund\u2010Mackay CT scores (<jats:italic>P<\/jats:italic>=\u2009.002) and other objective markers of disease severity including serum IgE (<jats:italic>P<\/jats:italic>=\u2009.05), presenting blood eosinophil level (<jats:italic>P<\/jats:italic>&lt;\u2009.001), and the highest recorded eosinophil level (<jats:italic>P<\/jats:italic>&lt;\u2009.001). In subgroup analysis, associations of uLTE4 to disease markers had stronger correlations in the aspirin sensitive CRSwNP group (<jats:italic>R<\/jats:italic>range 0.31\u20130.52) than the aspirin tolerant CRSwNP group (<jats:italic>R<\/jats:italic>range \u22120.30\u20130.24). uLTE4 levels were not associated with subjective symptom scores (SNOT22 and ACT scores).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated uLTE4 biomarker levels are associated with worsened objective markers of disease severity in CRSwNP patients but not patient\u2010reported symptom measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3<jats:italic>Laryngoscope<\/jats:italic>, 131:961\u2013966, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29137","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T16:56:40Z","timestamp":1601571400000},"page":"961-966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Elevated Urine Leukotriene<scp>E4<\/scp>Is Associated With Worse Objective Markers in Nasal Polyposis Patients"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3745-2727","authenticated-orcid":false,"given":"Garret","family":"Choby","sequence":"first","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin K.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0359","authenticated-orcid":false,"given":"Jason","family":"Barnes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Hagan","sequence":"additional","affiliation":[{"name":"Division of Allergic Diseases, Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janalee K.","family":"Stokken","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Endoscopic Skull Base Surgery Mayo Clinic Rochester Minnesota 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