Abstract
Exhaled breath condensate (EBC) has been increasingly used as a new and non-invasive method to study airway inflammation. In this study we have compared the concentrations of lipid mediators in EBCwith concentrations in bronchoalveolar lavage fluid (BALF).We included 37 patients undergoing bronchoscopy (12 sarcoidosis, 12 COPD, 6 lung cancer, 5 chronic cough, 1 Wegener’s granulomatosis, 1 sclerodermia). Patients were not allowed to have exacerbation or any change in concomitant medication for at least 4 weeks prior to the study. In all patients, EBC was collected immediately prior to the bronchoscopy.The levels of cys-LTs, LTB4, 8-isoprostane were significantly higher in BALF compared to EBC (p < 0.0001, p < 0.001, p < 0.0001 for cys-LTs, LTB4, 8-isoprostane respectively). Moreover, there was a strong positive correlation between both leukotriene B4and 8-isoprostane in BALF and EBC (r= 0.53 andr= 0.79, p < 0.01, respectively) in patients with sarcoidosis and COPD but there was no correlation between eicosanoids BALF and EBC in patients with chronic cough and lung cancer.This is the first study to compare EBC and BALF in different lung diseases which demonstrated significant correlations between the levels of eicosanoids in BALF and EBCin patientswith COPD and sarcoidosis. EBC may be useful inmeasuring inflammation in several inflammatory lung diseases.
Highlights
Exhaled air contains a large variety of substances, many of which may be markers of local physiological and pathophysiological states in the airways [1]
Levels of all mediators except PGE2 (p > 0.05) were significantly higher in bronchoalveolar lavage fluid (BALF) compared to Exhaled breath condensate (EBC) (p < 0.0001, p < 0.001, p < 0.0001 for cys-LTs, LTB4, 8-isoprostane respectively)
The volume of BALF was significantly lower in lung cancer and chronic obstructive pulmonary disease (COPD) patients (p < 0.01 vs sarcoidosis) while the EBC volume was the highest in the healthy control and sarcoidosis group and differed significantly from the volume obtained in lung cancer (p < 0.001) and COPD patients (p < 0.001). (Table 1) Amylase was undetectable in most of samples both EBC and BALF and it was present in 5 of the patients (EBC and BALF) in very low concetrations (4.3 ± 2 units/ml in EBC and 8.5 ± 5 units/ml in BALF)
Summary
Exhaled air contains a large variety of substances, many of which may be markers of local physiological and pathophysiological states in the airways [1]. Exhaled breath condensate (EBC) has been increasingly used as a new and non-invasive method to study airway inflammation [2,3,4,5]. EBC has the advantage of being non-invasive and directly samples mediators from the respiratory tract, giving a more direct approach to measuring inflammatory mediators in lung diseases. EBC contains large number of mediators and their concentrations differ from those found in healthy subjects in several airway diseases, including asthma [2,3, 5], chronic obstructive pulmonary disease (COPD) [4], cystic fibrosis (CF) [6,7] and bronchiectasis [8]. A research tool at present, EBC may become useful in the diagnosis of patients with various pulmonary diseases in clinical practice.
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