Exhaled Breath Condensate Analysis Research Articles

Inflammatory markers in exhaled breath condensate in bronchial asthma

Chronic respiratory diseases are among the most common non- infection diseases. In particular, it is bronchial asthma (BA), characterized by bronchial hyperreactivity and varying degrees of airway obstruction that is the cause of morbidity and mortality. The methods available for the information about the presence of inflammation in the airways, such as bronchoscopy and bronchial biopsy to be obtained have currently been invasive and difficult in everyday clinical practice, especially for children and seriously ill patients. In this regard, recently there has been an increase in the development of non-invasive methods for diagnosing the respiratory system, being comfortable and painless for trial subjects, especially children, also providing the inflammatory process control in the lungs, the severity assessment and monitoring the treatment process. The exhaled breath condensate (EBC) is of great attention, which is a source of various biomolecules, including nitric oxide (NO), leukotrienes, 8-isoprostane, prostaglandins, etc., being locally or systemically associated with disease processes in the body. Of particular interest is the presence of cytokines in EBC, namely the specific proteins produced by various cells of the body that play a key role in inflammatory processes in AD and provide cell communication (cytokine network). Thereby, it becomes possible for the severity and control level of childhood bronchial asthma using only the EBC analysis to be assessed. In addition, the non-invasiveness of this method allows it to be reused for monitoring lung diseases of even the smallest patients, including infants. Thus, the field of metabolite analysis in EBC has been developing and, in the near future, the given method is likely to be the most common for diagnosing the respiratory system diseases in both children and adults.

Metabolomics profiling of human exhaled breath condensate by SPME/GC × GC-ToFMS: Exploratory study on the use of face masks at the level of lipid peroxidation volatile markers

Metabolomics encompasses the acquisition of large-scale datasets from a single sample to identify and/or elucidate physiological or pathological mechanisms, or even to assess environmental exposure, being sample preparation and instrumental analysis two fundamental steps in the construction of a metabolomics workflow. The study of the human exhaled breath condensate (EBC) has gained tremendous interest recently owing to the advances in analytical techniques. Thus, this study aims to develop a methodology for EBC metabolites profiling based on headspace solid phase microextraction (SPME) combined with comprehensive two-dimensional gas chromatography (GC × GC). Metabolite’s extraction efficiency was improved by the optimization of four SPME parameters using a real EBC matrix: fibre coating, sample pH and volume, and extraction temperature. EBC analysis was performed according to the optimized parameters, using aliquots of 500 μL of EBC, at its physiological pH, with the DVB/CAR/PDMS fibre coating, at 40.0 ± 0.1 °C, being able to detect analytes at pg/mL, with acceptable reproducibility. EBC volatile composition was provided, with around 400 chemical features detected, in which 130 were putatively identified as belonging to hydrocarbons, aldehydes, alcohols, ketones, esters, monoterpenic and sesquiterpenic compounds, ethers, norisoprenoids and furans, revealing therefore its high complexity. This research represents the most detailed study on the volatile composition of EBC and allows the assessment of a broad range of endogenous and exogenous metabolites, with further relevance on clinical or environmental exposure studies. To test the applicability of this methodology, an exploratory study was carried out to assess the impact of the use of surgical facemasks on young researcher’s lipid peroxidation volatile markers during a normal working day in a laboratory. In young healthy adults (age ≤ 32), the use of surgical facemasks seems not significantly affect the levels of the volatile markers of lipid peroxidation (aliphatic alkanes and aldehydes), neither the O2 saturation level - SpO2. This methodology shows promise as a convenient way to follow specific physiological or pathological conditions based on EBC metabolome and may be paired as part of an aggregate analytical structure.

Carbon Dots Detect Water-to-Ice Phase Transition and Act as Alcohol Sensors via Fluorescence Turn-Off/On Mechanism.

Highly fluorescent carbon nanoparticles called carbon dots (CDs) have been the focus of intense research due to their simple chemical synthesis, nontoxic nature, and broad application potential including optoelectronics, photocatalysis, biomedicine, and energy-related technologies. Although a detailed elucidation of the mechanism of their photoluminescence (PL) remains an unmet challenge, the CDs exhibit robust, reproducible, and environment-sensitive PL signals, enabling us to monitor selected chemical phenomena including phase transitions or detection of ultralow concentrations of molecular species in solution. Herein, we report the PL turn-off/on behavior of aqueous CDs allowing the reversible monitoring of the water-ice phase transition. The bright PL attributable to molecular fluorophores present on the CD surface was quenched by changing the liquid aqueous environment to solid phase (ice). Based on light-induced electron paramagnetic resonance (LEPR) measurements and density functional theory (DFT) calculations, the proposed kinetic model assuming the presence of charge-separated trap states rationalized the observed sensitivity of PL lifetimes to the environment. Importantly, the PL quenching induced by freezing could be suppressed by adding a small amount of alcohols. This was attributed to a high tendency of alcohol to increase its concentration at the CD/solvent interface, as revealed by all-atom molecular dynamics simulations. Based on this behavior, a fluorescence "turn-on" alcohol sensor for exhaled breath condensate (EBC) analysis has been developed. This provided an easy method to detect alcohols among other common interferents in EBC with a low detection limit (100 ppm), which has a potential to become an inexpensive and noninvasive clinically useful diagnostic tool for early stage lung cancer screening.

23255 Devices Engineered to Collect Exhaled Breath Condensate (EBC) and their Applications

ABSTRACT IMPACT: Human exhaled breath is rich in metabolomic content that represents pulmonary function and gas exchange with blood, which can provide insights into an individual’s state of health. OBJECTIVES/GOALS: Human exhaled breath is rich in metabolomic content that represents pulmonary function and gas exchange with blood. It contains a mixture of compounds that offer insight into an individual’s state of health. Here, we present two novel non-invasive breath sampling devices for use in basic medical practice. METHODS/STUDY POPULATION: The two breath samplers have a disposable mouthpiece, a set of inhale and exhale one-way flap valves to allow condensation of exhaled breath only, and a saliva filter. The housing is constructed out of Teflon®, a chemically inert material to reduce chemical absorbance. The first device condenses exhaled breath into a frozen condensate using dry ice pellets and the other is a miniaturized design that liquifies exhaled breath on a condenser surface with micropatterned features on a cooling plate. Both designs have individual strategic and analytical advantages: frozen exhaled breath condensate (EBC) has high retention of analytes and sample volume; EBC collected in liquid phase offers facilitated sample collection and device portability. RESULTS/ANTICIPATED RESULTS: We investigated if breath aerosol size distribution affects the types or abundances of metabolites. We modified the geometry of the first device to redirect aerosol trajectories based on size. The trapping of larger aerosols increases with filter length, thus altering the aerosol size distribution although no significant changes in the metabolite profiles were found. With the miniaturized device, metabolite abundances were measured in a small cohort of healthy control and mild asthmatic subjects. Differences among subjects were found, as well as main differences between control and asthmatic groups. All analyses of EBC were performed with liquid chromatography - mass spectrometry. Inflammatory suppression found in asthmatic subjects can be explained by prescribed daily use of inhaled corticosteroids. DISCUSSION/SIGNIFICANCE OF FINDINGS: Breath collection devices can be used in intensive care units, outpatient clinics, workplaces, and at home. EBC analysis has been used to monitor asthma and chronic obstructive pulmonary disease. It can be applied to infectious respiratory diseases (e.g. influenza, COVID-19) and for monitoring environmental and occupational chemical exposures.

Three-Year Study of Markers of Oxidative Stress in Exhaled Breath Condensate in Workers Producing Nanocomposites, Extended by Plasma and Urine Analysis in Last Two Years.

Human data concerning exposure to nanoparticles are very limited, and biomarkers for monitoring exposure are urgently needed. In a follow-up of a 2016 study in a nanocomposites plant, in which only exhaled breath condensate (EBC) was examined, eight markers of oxidative stress were analyzed in three bodily fluids, i.e., EBC, plasma and urine, in both pre-shift and post-shift samples in 2017 and 2018. Aerosol exposures were monitored. Mass concentration in 2017 was 0.351 mg/m3 during machining, and 0.179 and 0.217 mg/m3 during machining and welding, respectively, in 2018. In number concentrations, nanoparticles formed 96%, 90% and 59%, respectively. In both years, pre-shift elevations of 50.0% in EBC, 37.5% in plasma and 6.25% in urine biomarkers were observed. Post-shift elevation reached 62.5% in EBC, 68.8% in plasma and 18.8% in urine samples. The same trend was observed in all biological fluids. Individual factors were responsible for the elevation of control subjects’ afternoon vs. morning markers in 2018; all were significantly lower compared to those of workers. Malondialdehyde levels were always acutely shifted, and 8-hydroxy-2-deoxyguanosine levels best showed chronic exposure effect. EBC and plasma analysis appear to be the ideal fluids for bio-monitoring of oxidative stress arising from engineered nanomaterials. Potential late effects need to be targeted and prevented, as there is a similarity of EBC findings in patients with silicosis and asbestosis.

Exhaled breath condensates from healthy children induce cell death of in vitro cultured cells by activation of apoptosis.

IntroductionExhaled breath condensate (EBC) is a liquefied air, containing a mixture of non-volatile compounds, reflecting pathophysiological status of the bronchopulmonary system. Therefore, EBC analysis may be useful in diagnostics and monitoring of various respiratory diseases. In previous studies it was found that EBC from asthmatic children contained several regulators of angiogenesis. In vitro experiments with EBCs from children with asthma revealed their weak influence on proliferation of various cells. Surprisingly, EBCs from healthy children led to apoptosis of all tested cells.AimTo assess the expression of selected apoptosis-related proteins in human and murine cells exposed to EBC from healthy children.Material and methodsEBCs from healthy children were added to cultures of murine endothelial cells (C166) or human lung fibroblasts (HLF) to induce their apoptosis. For proteome analysis the apoptosis pathway-specific protein microarrays were used.ResultsThe homogenates from EBC-treated C166 cells contained low amounts of Hsp27, which correlated with their fast death. Contrary to C166, the lysates from EBC-treated fibroblasts displayed increased amounts of Hsp27, which correlated with delayed HLF response to the induction of apoptosis. Except for increased caspase-3 in EBC-treated HLF, none of the other apoptosis regulators revealed any significant changes in that analysis.ConclusionsThe screening of apoptosis pathways with microarray technology allowed identification of two molecules, Hsp27 and caspase-3, involved in cellular response to EBC. However, the factor responsible for induction of the cytotoxic effect of EBC from healthy children still remains unknown.

Exhaled Biomarkers in Idiopathic Pulmonary Fibrosis-A Six-Month Follow-Up Study in Patients Treated with Pirfenidone.

The mechanism of action of pirfenidone in idiopathic pulmonary fibrosis (IPF) has not been fully elucidated. To offer additional insight, we evaluated the change in the cytokine profile in exhaled breath condensate (EBC) following a six-month treatment with pirfenidone in patients with IPF. EBC concentrations of interleukin (IL)-6, IL-8, IL-15, TNF-α and VEGF-A were assessed with ELISA and compared at baseline and after six months of pirfenidone treatment. Twenty-nine patients with IPF and 13 controls were evaluated at baseline. With the exception of IL-8 concentration, which was lower in patients with IPF when compared to controls (p = 0.005), the cytokine levels did not differ between the groups. Despite the use of a high sensitivity assay, IL-8 reached detectable values only in 24% of IPF patients. EBC analysis after six months of treatment with pirfenidone did not reveal any differences in the cytokine levels. The change in EBC vascular endothelial growth factor A (VEGF-A) correlated with the change in the 6 min walk distance (r = 0.54, p = 0.045). We conclude that a six-month treatment with pirfenidone did not significantly change the EBC cytokine profile. Our findings support the potential usefulness of VEGF-A as a marker in IPF. The low EBC IL-8 level in patients with IPF is a novel finding which needs confirmation in larger studies.

Exhaled Breath Condensate: A Non-Invasive Source for Tracking of Genetic and Epigenetic Alterations in Lung Diseases

Lung diseases have been recognized as an extensive cause of morbidity and mortality in the worldwide. The high degree of clinical heterogeneity and nonspecific initial symptoms of lung diseases contribute to a delayed diagnosis. So, the molecular and genomic profiling play a pivotal role in promoting the pulmonary diseases. Exhaled breath condensate (EBC) as a novel and potential method for sampling the respiratory epithelial lining fluid is to assess the inflammatory and oxidative stress biomarkers, drugs and genetic alterations in the pathophysiologic processes of lung diseases. The recent studies on the analysis of EBC from both a genetic and epigenetic point of view were searched from database and reviewed. This review provides an overview of the current findings in the tracking of genomic and epigenetic alterations which are potentially effective in better management of cancer detection. In addition, respiratory microbiota DNA using EBC samples in association with pulmonary disease especially lung cancer were investigated. Various studies have concluded that EBC has a great potential for analysis of nuclear and mitochondrial DNA alterations as well as epigenetic modifications and identification of respiratory microbiome. Next-generation sequencing (NGS) based genomic profiling of EBC samples is recommended as a promising approach to establish personalized based prevention, diagnosis, treatment and post-treatment follow-ups for patients with lung diseases especially lung cancer.

Safety and Yield of Exhaled Breath Condensate Analysis in Acutely Ill, Mechanically Ventilated Infants with RSV Bronchiolitis

Exhaled breath condensate (EBC) analysis is a rapidly growing field of research and may be a useful non-invasive technique to evaluate lung pathology. There is little information in the literature on the safety of collecting these samples in acutely ill infants needing mechanical ventilation. Viral bronchiolitis is a common lower respiratory tract infection contributing to the majority of hospitalizations in children under 2 years of age. The pathophysiology of severe bronchiolitis resulting in ventilatory support is illdefined. Our study objective was to evaluate the tolerability of collection and utility of exhaled breath condensate (EBC) in molecular evaluation of viral bronchiolitis. We obtained proteomic profile of sequential EBCs over three days of illness from two infants who were intubated and ventilated. Mass spectrometry analysis of these samples identified cytokeratin at all time-points and time-dependent increase of proteins related to intracellular adhesions, epidermal morphogenesis, cell repair and differentiation that may be used to monitor the status of epithelial barrier function and integrity of intercellular communication in the bronchiolitis lung in the future. Our pilot study highlights that EBC collection is a well- tolerated procedure to obtain meaningful longitudinal data to profile and study the molecular parameters in acutely ill bronchiolitis infants.

Portable exhaled breath condensate metabolomics for daily monitoring of adolescent asthma

Portable methods for measurement and quantification of biological analytes have tremendous promise to advance non-invasive personal health monitoring. Exhaled breath metabolomics shares this promise and has been gaining popularity as a non-invasive technique amenable to a vast range of medical uses. 
 
 This work compares breath metabolite abundances in six healthy control subjects and five asthmatic subjects. Exhaled breath condensate (EBC) samples were collected with a novel miniaturized sampler. This device enables breath sample collection in multiple environments, including intensive care units, outpatient clinics, workplaces, and at home. A total of 293 breath samples were collected and analysed longitudinally, including about 28 samples per subject. EBC was analysed with liquid chromatography-mass spectrometry (LC-MS) to define specific metabolite differences between subjects. Untargeted and targeted metabolomic analyses were performed simultaneously, but with separate data analysis procedures. 
 
 Individual differences among subjects were found longitudinally. When presented by health condition, group differences were enhanced with a clear separation between subjects belonging to either the control or asthmatic group. Unexpectedly, targeted compounds consistently had lower intensities in asthmatics. There is a distinct pattern of a day/night cycle with elevations of peak area values in evening samples. These differences were presented mainly in asthmatic subjects, which can be explained by asthma being a representation of exaggerated amplitudes compared to healthy circadian patterns.
 
 Untargeted and targeted analysis of EBC using this device allows the discovery of novel endogenous metabolic signals in a biological sample and the daily monitoring of selected metabolites related to diseases and medical conditions.&#13.

Can proteomics predict the prognosis in chronic dioxin intoxication?

Untargeted proteomic analysis of exhaled breath condensate (EBC) was used to estimate the effects and prognosis of chronic intoxication with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) to elucidate the mechanisms involved. EBC was collected from eight males (72.4 ± 1.3 years) exposed to TCDD in 1965–1968 and seven control males (66 ± 16 years). The median TCDD blood level was 112 (46–390) ng/kg fat in the patients 50 years after exposure and 12 ng/kg in the controls. The shotgun method for identifying proteins was performed after proteolytic digestion and high-performance liquid chromatography combined with mass spectrometry. Raw data were evaluated using the MaxQuant software and protein atlas. A total of 332 proteins were detected: one protein was unique to TCDD patients and 11 to the controls. These proteins may have come from many organs, in addition to the lungs and bronchi. The salivary contribution based on alpha amylase proportion to the overall protein’s intensity was only 0.003%. The intensity of nine proteins was correlated with TCDD plasma level (two positively, seven negatively), but not with alpha amylase. This excludes saliva contamination, as this enzyme is the marker of salivary contamination. Several of the changes in intensity were associated with an unfavourable prognosis of cancers. Proteomics of EBC may bring new information and point to the mechanisms by which this highly toxic chemical and human carcinogen potentially affects any organ.

Sulphurous thermal water inhalation impacts respiratory metabolic parameters in heavy smokers.

Sulphurous thermal water inhalations have been traditionally used in the treatment of airway diseases. In vivo and in vitro studies reported that they ameliorate mucus rheology, mucociliary clearance and reduce inflammation. Cigarette smoking induces an inflammatory damage, with consequent remodeling of respiratory airways, which in turn affect pulmonary functions. Despite the anti-inflammatory effects of H2S are clinically documented in several airway inflammatory diseases, data on the effects of sulphurous thermal water treatment on pulmonary function and biomarkers of airways inflammation in smokers are still scant. Therefore, we investigated whether a conventional cycle of sulphurous thermal water inhalation produced changes in markers of respiratory inflammation and function. A cohort of 504 heavy current and former smokers underwent 10-day cycles of sulphurous thermal water inhalation. Pulmonary function and metabolic analyses on exhaled breath condensate were then performed at day 0 and after the 10-day treatment. Spirometric data did not change after spa therapy, while exhaled breath condensate analysis revealed that a single 10-day cycle of sulphurous water inhalation was sufficient to induce a statistically significant increase of citrulline levels along with a decrease in ornithine levels, thus shifting arginine metabolism towards a reduced nitric oxide production, i.e. an anti-inflammatory profile. Overall, sulphurous thermal water inhalation impacts on arginine catatabolic intermediates of airways cells, shifting their metabolic balance towards a reduction of the inflammatory activity, with potential benefits for smokers.

Exhaled Breath Condensate in Childhood Asthma: A Review and Current Perspective.

Exhaled breath condensate (EBC) was introduced more than two decades ago as a novel, non-invasive tool to assess airway inflammation. This review summarizes the latest literature on the various markers in EBC to predict asthma in children. Despite many recommendations and two comprehensive Task Force reports, there is still large heterogeneity in published data. The biggest issue remains a lack of standardization regarding EBC collection, preservation, processing, and analysis. As a result, published studies show mixed or conflicting results, questioning the reproducibility of findings. A joint, multicenter research study is urgently needed to address the necessary methodological standardization.

Responses of healthy young males to fine-particle exposure are modified by exercise habits: a panel study

BackgroundAerobic exercise benefits health but increases inhalation of fine particles (PM2.5) in ambient air. Acute cardiopulmonary responses to PM2.5 exposure in individuals with different exercise habits, especially in areas with severe air pollution, are not well understood.MethodsTo examine acute cardiopulmonary responses to PM2.5 exposure modified by exercise habits, a panel of 20 healthy non-smoking male subjects, recruited in Beijing, China, completed seven visits. The exercise frequency per week and preferred exercise place were recorded using a baseline questionnaire to describe exercise habits. Fractional exhaled nitric oxide (FeNO), cytokines in exhaled breath condensate, blood pressure, and pulse-wave analysis (PWA) indices were measured during each visit as biomarkers of acute cardiopulmonary responses. The hourly average mass concentration of PM2.5 and black carbon (BC), and the number concentrations of ultrafine particles (UFP) and accumulation mode particles (AMP) were monitored throughout the follow-up period at an outdoor fixed monitoring station beginning 14 days prior to each visit. Linear mixed-effects models were used to evaluate the associations between acute changes in biomarker levels and exposure to PM2.5 and its constituents. The primary aim was to assess the modification of long-term exercise habits on these associations.ResultsFeNO concentration, systolic blood pressure, ejection duration, aortic augmentation pressure, and aortic pressure index were positively associated with exposure to PM2.5 and its constituents. However, no associations with cytokine levels or diastolic blood pressure were observed. In a stratified analysis, we found that acute cardiopulmonary responses were modified by exercise habit. Specifically, the interquartile ranges (IQR) of increases in the 6–12-h moving average (MA) PM2.5 and AMP exposure were associated with 19–21% and 24–26% increases in FeNO, respectively, in subjects with high exercise frequency; these associations were significantly stronger than those in subjects with low exercise frequency. An IQR increase in 3–11-d MA AMP exposure was associated with a 10–26% increase in aortic augmentation pressure in subjects with low exercise frequency; this association was significantly stronger than that in subjects with high exercise frequency. An IQR increase in 9–13-d MA UFP exposure was associated with a 13–17% increase in aortic augmentation pressure in subjects who preferred outdoor exercise; this association was stronger than that in subjects who preferred indoor exercise.ConclusionsIn highly polluted areas, frequent exercise might protect against PM2.5-associated arterial stiffness but exacerbate airway inflammation.

Metabolomics of tracheal wash samples and exhaled breath condensates in healthy horses and horses affected by equine asthma

The present work characterized the metabolomic profile of tracheal wash (TW) and exhaled breath condensate (EBC) in healthy horses and horses with respiratory disease. Six asthma-affected horses (group A) and six healthy controls (group H) underwent clinical, endoscopic and cytologic examinations of upper airways to confirm the active phase of asthma. TW and EBC samples were collected from each animal and investigated by proton nuclear magnetic resonance (1H-NMR) metabolomic analysis. A total of ten out of 38 metabolites found in the TW were significantly different between the groups (p < 0.05). Higher concentrations of histamine and oxidant agents, such as glutamate, valine, leucine and isoleucine, as well as lower levels of ascorbate, methylamine, dimethylamine and O-phosphocholine, were found in group A compared to group H. Eight metabolites were found in equine EBC, namely methanol, ethanol, formate, trimethylamine, acetone, acetate, lactate and butanone, previously observed also in human EBC. Despite the fact that this was a pilot study, the results showed that the metabolomic analysis of TW and EBC has the potentiality to serve as a basis for diagnostic tools in horses with asthma.

Non-volatile compounds in exhaled breath condensate: review of methodological aspects.

In contrast to bronchial and nasal lavages, the analysis of exhaled breath condensate (EBC) is a promising, simple, non-invasive, repeatable, and diagnostic method for studying the composition of airway lining fluid with the potential to assess lung inflammation, exacerbations, and disease severity, and to monitor the effectiveness of treatment regimens. Recent investigations have revealed the potential applications of EBC analysis in systemic diseases. In this review, we highlight the analytical studies conducted on non-volatile compounds/biomarkers in EBC. In contrast to other related articles, this review is classified on the basis of analytical techniques and includes almost all the applied methods and their methodological limitations for quantification of non-volatile compounds in EBC samples, providing a guideline for further researches. The studies were identified by searching the SCOPUS database with the keywords "biomarkers," "non-volatile compounds," "determination method," and "EBC."

Exhaled breath condensate hydrogen peroxide, pH and leukotriene B4 are associated with lower airway inflammation and airway cytology in the horse.

Exhaled breath condensate (EBC) analysis is a noninvasive method to assess the lower respiratory tract. In human subjects, EBC hydrogen peroxide (H2 O2 ), pH and leukotriene B4 (LTB4 ) are useful for detection and monitoring of inflammatory lung diseases, including asthma. To determine associations between EBC biomarkers and cytological and endoscopic definitions of lower airway inflammation (LAI) while controlling for sampling and environmental variables. Prospective, cross-sectional study. Clinical, endoscopic and airway cytological findings from 47 horses were compared with EBC pH and concentrations of H2 O2 and LTB4 by univariate and multivariable analyses. Dichotomous (presence/absence of airway inflammation) and continuous outcome variables (differential cell counts in tracheal aspirate and bronchoalveolar lavage fluid, BALF) were evaluated and potential effects of collection and methodological factors were included. EBC pH and H2 O2 concentrations were higher in horses with LAI and both were positively associated with the percentage of neutrophils in BALF (P<0.05). Mast cell percentage in BALF was negatively associated with EBC pH, and BALF eosinophil percentage was positively associated with EBC LTB4 (P<0.05). Ambient temperature, relative humidity and assay methodology significantly impacted some analytes. LAI is challenging to categorise due to a variety of clinical and cytological phenotypes. Although the study was designed to overcome this limitation, numbers of horses were small in some categories. EBC pH and H2 O2 concentrations are altered by airway inflammation, suggesting a role for these biomarkers in the diagnosis and monitoring of airway disease. Environmental and methodological factors can influence these biomarkers and should be considered in the interpretation of results.

Capillary Electrophoretic Analysis of Exhaled Breath Condensate in the Diagnosis of Gastroesophageal Reflux Disease

Abstract In this work, capillary electrophoresis with contactless conductometric detection (CCD) was used for the analysis of the ionic content of exhaled breath condensate (EBC) to differentiate between healthy individuals and patients with gastroesophageal reflux disease (GERD). The exhaled breath condensate was collected using a miniature sample collection device and the content analyzed using a separation electrolyte composed of 20 mM 2-(N-morpholino)ethanesulfonic acid, 20 mM L-histidine, 2 mM 18-Crown-6 and 30 M cetyltrimethylammonium bromide. The separation of anions took less than 2.5 minutes, while the cations were separated in less than 1.5 minutes. The most significantly elevated ions in the group of patients suffering from gastroesophageal reflux disease were chloride, nitrate, propionate and butyrate. Although the number of subjects was too small to draw definite conclusions with regard to the discriminatory power of these ions, the pilot data are promising for EBC as a useful non-invasive alternative for other methods used in the diagnosis of gastroesophageal reflux disease

Exhaled Breath Condensate: Pilot Study of the Method and Initial Experience in Healthy Subjects.

Analysis of Exhaled breath condensate (EBC) is a re-discovered approach to monitoring the course of the disease and reduce invasive methods of patient investigation. However, the major disadvantage and shortcoming of the EBC is lack of reliable and reproducible standardization of the method. Despite many articles published on EBC, until now there is no clear consensus on whether the analysis of EBC can provide a clue to diagnosis of the diseases. The purpose of this paper is to investigate our own method, to search for possible standardization and to obtain our own initial experience. Thirty healthy volunteers provided the EBC, in which we monitored the density, pH, protein, chloride and urea concentration. Our results show that EBC pH is influenced by smoking, and urea concentrations are affected by the gender of subjects. Age of subjects does not play a role. The smallest coefficient of variation between individual volunteers is for density determination. Current limitations of EBC measurements are the low concentration of many biomarkers. Standardization needs to be specific for each individual biomarker, with focusing on optimal condensate collection. EBC analysis has a potential become diagnostic test, not only for lung diseases.

Exhaled breath condensate as an alternative sample for drug monitoring.

Exhaled breath condensate as an alternative sample for drug monitoring.