SUMMARYIn patients with cystic fibrosis (CF), high intrapulmonary concentrations of the neutrophil chemotaxin leukotriene B4 (LTB4) are associated with specific reduction of LTB4-induced chemotaxis of circulating neutrophils. The chemotactic abnormality is partially corrected by dietary supplementation with eicosapentaenoic acid (EPA). LTB4-induced neutrophil chemotaxis is mediated by specific, high-afiinity, cell surface LTB4 receptors. The hypotheses that neutrophil LTB4 receptors~are down-regulated in CF, and that EPA normalizes receptor expression, were tested by measuring the number (i?n,ax) and affinity {K^) of LTB4 receptors on neutrophils from eight CF patients before and after EPA (6 weeks of 2-7g/day), and from nine normal individuals. High-aifinity receptor R^^,^ was depressed in CF patients (0-6 + 0-2 x 10''/cell (mean + s.d.) versus 1-8 + 0-7 X 10''/cell in normals), but corrected to normal (20 ± 1-9 x lO^/cell) after EPA. Highaffinity receptor K^ was depressed in CF patients (0-4 ± 0-3 nM versus 1 -4 + 0-5 nM in normals), and also corrected to normal with EPA (14 ± 1 2nM). Low-affinity receptors were depressed, but did not change significantly with EPA. These results indicate that neutrophil responses in chronic inflammatory lung disease can be infiuenced directly by LTB4 receptor modulation, and that this effect of EPA predominates over alterations in neutrophil signal transduction in situations of chronic exposure to LTB4.