Abstract
Although eicosanoids are involved in lung carcinogenesis they were poorly investigated in exhaled breath condensate (EBC) and bronchoalveolar lavage fluid (BALf) in patients with primary lung cancer. In this study 17 patients with diagnosed non-small cell lung cancer, 10 healthy smokers and 12 healthy nonsmokers were included. The levels of cys-LTs, 8-isoprostane, LTB4 and PGE2 were measured before any treatment in the EBC of all patients and in BALf of patients with lung cancer by enzyme linked immunosorbent assay. 8-isoprostane, LTB4, cys-LTs and PGE2 were detectable in the EBC and BALf. There were no significant differences between healthy smokers and nonsmokers in concentrations of all measured mediators. Compared with both healthy controls, patients with diagnosed lung cancer displayed higher concentrations of cys-LTs (p< 0.05) and LTB4 (p< 0.05) in EBC. In patients with lung cancer, the mean concentrations of all measured mediators were significantly higher in BALf compared with EBC and there was a significant, positive correlation between concentration of cys-LTs, LTB4and 8-isoprostane in BALf and their concentrations in the EBC (r= 0.64,p< 0.05,r= 0.59,p< 0.05,r= 0.53,p< 0.05 respectively). Since cys-LT, LTB4 and 8-isoprostane concentrations in EBC from patients with lung cancer reflect their concentrations in BALf, they may serve as a possible non-invasive method to monitor the disease and to assess the effectiveness of therapy.
Highlights
One problem with the monitoring of patients with non-small cell lung cancer (NSCLC) is the lack of specific markers that could reflect disease severity and progression
The aim of this study was to assess the levels of cys-LTs, PGE2, LTB4 and 8-isoprostane in the exhaled breath condensate (EBC) of patients with primary lung cancer and to compare with those detected in the bronchoalveolar lavage fluid (BALf) of patients diagnosed with NSCLC and those detected in EBC of healthy control
As we have demonstrated previously, the levels of PGE2 and cys-LTs were higher in EBC of patients with lung cancer when we compared with patients with noneoplasmatic diseases (COPD, chronic cough, sarcoidosis) and levels of LTB4 were higher than those observed in patients with chronic cough and sarcoidosis [27]
Summary
One problem with the monitoring of patients with non-small cell lung cancer (NSCLC) is the lack of specific markers that could reflect disease severity and progression. Classifications, which describe the extent of cancer spread and grading systems,are complicated and not always effective in monitoring a patient’s recovery. The method offered a new insight into the pathology of airways inflammation [1,3,4,5] in lung cancer the usefulness of EBC was poorly investigated. Since in the lung cancer microenvironment, cyclooxygenase-2 (COX-2) and 5-lipooxygenase (5-LOX) are over-expressed [6,7] and oxidative stress is increased [8], we hypothesized that the end products of enzymatic (prostaglandin E2: PGE2, leukotriene B4: LTB4 and cysteinyl leukotrienes: cys-LTs) and nonenzymatic (8-isoprostane) metabolism of arachidonic acid could be detectable in EBC collected from patients with lung cancer
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