Prostaglandin D2 (PGD2) is implicated in various biological functions to mediate inflammatory
response. It is produced from arachidonic acid by the activity of two enzymes, cyclooxygenase
and tissue-specific PGD2 synthase. PGD2 has been shown to play a role in cardiovascular
diseases, arthritis, kidney fibrosis, pulmonary disease, cancer and mastocytosis. 11,15-dioxo-9α-
hydroxy-, 2,3,4,5-tetranorprostan-1,20-dioic acid (tetranor-PGDM), a novel D-ring metabolite of
PGD2 in urine, has been identified as the main endogenous metabolite of PGD2. Levels of
urinary tetranor-PGDM have been shown to directly reflect levels of PGD2 biosynthesis and
mast cells activity. Urinary tetranor-PGDM levels have also been used in identifying cases of
severe food allergies, Duchenne muscular dystrophy, and drug related intolerance in asthma
< 15.4 ng/mg creatinine
Urine tetranor-PGDM is measured by direct ELISA.
Patient should not be on aspirin, indomethacin, or anti-inflammatory medications, if possible, for
at least 48 hours prior to collection of specimen.
24 hours urine collection. Refrigerate during collection and mix well. Transfer 5 – 10 ml urine to
urine transport container and freeze immediately. Rejection criteria include: room temperature,
thawed or refrigerated specimens.
Ship specimens strictly frozen in dry ice.
- Inagaki S, Maeda S, Narita M, et al. Urinary PGDM, a prostaglandin D2 metabolite, is a novel
biomarker for objectively detecting allergic reactions of food allergy. J Allergy Clin Immunol.
- Inagaki S, Maeda S, Narita M, et al. Urinary tetranor-pgdm metabolite from prostaglandin D2, is a new
marker to detect the severity of immediate allergic reactions evoked by the oral food challenge in children
with food allergy. Journal of Allergy and Clinical Immunology. 2017;139(2).
- Morrow JD, Guzzo C, Lazarus G, Oates JA, Roberts LJ 2nd. Improved diagnosis of mastocytosis by
measurement of the major urinary metabolite of prostaglandin D2. J Invest Dermatol. 1995;104(6):937-
- Nagata N, Masuko S, Inoue R, Nakamura T, Aritake K, Murata T. Development of Monoclonal
Antibody-Based EIA for Tetranor-PGDM which Reflects PGD2 Production in the Body. J Immunol Res.
2021;2021:5591115. Published 2021 Apr 26. doi:10.1155/2021/5591115