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Hydrogen Peroxide in Exhaled Breath Condensate (EBC) vs Eosinophil Count in Induced Sputum (IS) in Parenchymal vs Airways Lung Diseases"

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Abstract

We compared exhaled breath condensate (EBC) and induced sputum (IS) for assessing inflammation in pulmonary diseases in patients with obstructive lung disease (n = 20), persistent cough >6 months (n = 20), interstitial lung disease (n = 25) and controls (n = 10). EBC was collected by suspending a Teflon perfluoroalkoxy tube installed in an ice-filled container and connected to a polypropylene test tube. IS was recovered after 20’ inhalation of 3% saline with an ultrasonic nebulizer, and 300 cells were differentially counted in cytospin Giemsa-stained slides. H202 was measured by a method based on oxidation of phenolsulfonphthalein (phenol red) mediated by horseradish peroxidases and H202. Pulmonary function tests were performed by conventional methods. H202 levels in EBC and % eosinophils in IS were significantly different between groups. A positive and significant correlation was found between % eosinophils in IS and the levels of H202 in EBC for each group and for all patients combined.

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References

  1. Rahman, I., and S. K. Biswas. 2004. Non-invasive biomarkers of oxidative stress: reproducibility and methodological issues. Redox. Rep. 9:125–143.

    Article  PubMed  CAS  Google Scholar 

  2. Wark, P. A. S. J., M. J. Hensley, and P. G. Gibson. 2001. Safety of sputum induction with isotonic saline in adults with acute severe asthma. Clin. Exp. Allergy 31:1745–1753.

    Article  PubMed  CAS  Google Scholar 

  3. Twaddell, S. H., P. G. Gibson, K. Carty, K. L. Woolley, and R. L. Henry. 1996. Assessment of airway inflammation in children with acute asthma using induced sputum. Eur. Respir. J. 9:2104–2108.

    Article  PubMed  CAS  Google Scholar 

  4. Pizzichini, E., M. M. Pizzichini, A. Efthimiadis, S. Evans, M. M. Morris, D. Squillace, G. J. Gleich, J. Dolovich, F. E. Hargreave. 1996. Indices of airway inflammation in induced sputum: reproducibility and validity of cell and fluid-phase measurements. Am. J. Respir. Crit. Care Med. 154:308–317.

    PubMed  CAS  Google Scholar 

  5. Fahy, J. V., H. A. Boushey, S. C. Lazarus, E. A. Mauger, R. M. Cherniack, V. M. Chinchilli, T. J. Craig, J. M. Drazen, J. G. Ford, J. E. Fish, E. Israel, M. Kraft, R. F. Lemanske, R. J. Martin, D. McLean, S. P. Peters, C. Sorkness, S. J. Szefler. NHLBI Asthma Clinical Research Network. 2001. Safety and reproducibility of sputum induction in asthmatic subjects in a multicenter study. Am. J. Respir. Crit. Care Med. 163:1470–1475.

    PubMed  CAS  Google Scholar 

  6. Horvath, I., J. Hunt, P. J. Barnes, K. Alving, A. Antczak, E. Baraldi, G. Becher, W. J. van Beurden, M. Corradi, R. Dekhuijzen, R. A. Dweik, T. Dwyer, R. Effros, S. Erzurum, B. Gaston, C. Gessner, A. Greening, L. P. Ho, J. Hohlfeld, Q. Jobsis, D. Laskowski, S. Loukides, D. Marlin, P. Montuschi, A. C. Olin, A. E. Redington, P. Reinhold, E. L. van Rensen, I. Rubinstein, P. Silkoff, K. Toren, G. Vass, C. Vogelberg, H. Wirtz, and ATS/ERS Task Force on Exhaled Breath Condensate. 2005. Exhaled breath condensate: methodological recommendations and unresolved questions. Eur. Respir. J. 26:371–372.

    Article  CAS  Google Scholar 

  7. Mercken, E. M., G. J. Hageman, A. M. Schols, M. A. Akkermans, A. Bast, E. F. Wouters. 2005. Rehabilitation decreases exercise-induced oxidative stress in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 172:994–1001.

    Article  PubMed  Google Scholar 

  8. Emelyanov, A., G. Fedoseev, A. Abulimity, K. Rudinski, A. Fedoulov, A. Karabanov, and P. J. Barnes. 2001. Elevated concentrations of exhaled hydrogen peroxide in asthmatic patients. Chest 120:1136–1139.

    Article  PubMed  CAS  Google Scholar 

  9. Jobsis, Q., H. C. Raatgeep, S. L. Schellekens, A. Kroesbergen, W. C. Hop, and J. C. de Jongste. 2000. Hydrogen peroxide and nitric oxide in exhaled air of children with cystic fibrosis during antibiotic treatment. Eur. Respir. J. 16:95–100.

    Article  PubMed  CAS  Google Scholar 

  10. National Heart, Lung, and Blood Institute. 1995. Global strategy for asthma management and prevention. In: Global initiative for asthma. National Institutes of Health. Bethesda, MD: Publication No. 95–3659.

  11. Pauwels, R. A., A. S. Buist, P. M. Calverley, C. R. Jenkins, S. S. Hurd, and GOLD Scientific Committee. 2001. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am. J. Respir. Crit. Care Med. 163:1256–1276.

    PubMed  CAS  Google Scholar 

  12. American Thoracic Society (statement). 1987. Standardization of spirometry–1987. Update. Am. Rev. Respir. Dis. 136:1285–1298

    Google Scholar 

  13. Pin, I., P. G. Gibson, R. Kolendowicz, A. Girgis-Gabardo, J. A. Denburg, F. E. Hargreave, and J. Dolovich. 1992. Use of induced sputum cell counts to investigate airway inflammation in asthma. Thorax 47:25–29.

    Article  PubMed  CAS  Google Scholar 

  14. Popov, T., R. Gottschalk, R. Kolendowicz, J. Dolovich, P. Powers, and F. E. Hargreave. 1994. The evaluation of a cell dispersion method of sputum examination. Clin. Exp. Allergy 24:778–783.

    Article  PubMed  CAS  Google Scholar 

  15. Ho, L. P., J. A. Innes, and A. P. Greening. 1998. Nitrite levels in breath condensate of patients with cystic fibrosis is elevated in contrast to exhaled nitric oxide. Thorax 53: 680–684.

    PubMed  CAS  Google Scholar 

  16. Garey, K. W., M. M. Neuhauser, R. A. Robbins, L. H. Danziger, and I. Rubinstein. 2004. Markers of inflammation in exhaled breath condensate of young healthy smokers. Chest 125:22–26

    Article  PubMed  CAS  Google Scholar 

  17. Pick, E., and Y. Keisari. 1980. A simple colorimetric method for the measurement of hydrogen peroxide produced by cells in culture. J. Immunol. Methods 38:161–170.

    Article  PubMed  CAS  Google Scholar 

  18. Fireman, E. 2001. Induced sputum: opening a new window to the lung. Sarcoidosis Vasc. Diffuse Lung Dis. 18:263–271.

    PubMed  CAS  Google Scholar 

  19. Pizzichini, M. M., E. Pizzichini, K. Parameswaran, L. Clelland, A. Efthimiadis, J. Dolovich, and F. E. Hargreave. 1999. Nonasthmatic chronic cough: no effect of treatment with an inhaled corticosteroid in patients without sputum eosinophilia. Can. Respir. J. 6:323–330.

    PubMed  CAS  Google Scholar 

  20. Green, R. H., C. E. Brightling, G. Woltmann, D. Parker, A. J. Wardlaw, and I.D. Pavord. 2002. Analysis of induced sputum in adults with asthma: identification of subgroup with isolated sputum neutrophilia and poor response to inhaled corticosteroids. Thorax 57:875–879.

    Article  PubMed  CAS  Google Scholar 

  21. Brightling, C. E., W. Monteiro, R. Ward, D. Parker, M. D. Morgan, A. J. Wardlaw, and I. D. Pavord. 2000. Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 356:1480–1485.

    Article  PubMed  CAS  Google Scholar 

  22. Green, R. H., C. E. Brightling, S. McKenna, B. Hargadon, D. Parker, P. Bradding, A .J. Wardlaw, and I. D. Pavord. 2002. Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial. Lancet 360:1715–1721.

    Article  PubMed  Google Scholar 

  23. Gibson, P. G., F. E. Hargreave, A. Girgis-Gabardo, M. Morris, J. A. Denburg, and J. Dolovich. 1995. Chronic cough with eosinophilic bronchitis: examination for variable airflow obstruction and response to corticosteroid. Clin. Exp. Allergy 25:1–6.

    Article  Google Scholar 

  24. Fireman, E., B. Boikaner, and I. Priel. 2006. Combined CD4/CD8 ratio in induced sputum and pulmonary function testing for non-invasive identification of sarcoidosis. Transl Research (Past J. Lab. Clin. Med.) 148(2):87–95.

    Google Scholar 

  25. Fireman, E., I. Topilsky, J. Greif, Y. Lerman, Y. Schwarz, A. Man, and M. Topilsky. 1999. Induced sputum compared to bronchoalveolar lavage for evaluating patients with sarcoidosis and non-granulomatous interstitial lung disease. Respir. Med. 93:827–834.

    Article  PubMed  CAS  Google Scholar 

  26. Mund, E., B. Christensson, R. Gronneberg, and K. Larsson. 2005. Noneosinophilic CD4 lymphocytic airway inflammation in menopausal women with chronic dry cough. Chest 127:1714–1721.

    Article  PubMed  Google Scholar 

  27. Yoshida, M., R. M. Watson, T. Rerecich, and P. M. O’ Byrne. 2005. Different profiles of T-cell IFN-gamma and IL-12 in allergen-induced early and dual responders with asthma. J. Allergy Clin. Immunol. 115:1004–1009.

    Article  PubMed  CAS  Google Scholar 

  28. Kharitonov, S. A., and P. J. Barnes. 2003. Exhaled nitric oxide, carbon monoxide, and breath condensate. In: M. Nandor (ed). Lung Biology in Health and Disease Markers in Exhaled Breath vol 170. Portland, Marcel Dekker, pp 199–218.

    Google Scholar 

  29. Dohlman, A. W., H. R. Black, and J. A. Royall. 1993. Expired breath hydrogen peroxide is a marker of acute airway inflammation in pediatric patients with asthma. Am. Rev. Respir. Dis. 148:955–960.

    PubMed  CAS  Google Scholar 

  30. Horvath, I., L .E. Donnelly, A. Kiss, P. Paredi, S. A. Kharitonov, and P. J. Barnes. 1998. Raised levels of exhaled carbon monoxide are associated with an increased expression of heme oxygenase-1 in airway macrophages in asthma: a new marker of oxidative stress. Thorax 53:668–672.

    Article  PubMed  CAS  Google Scholar 

  31. Paredi, P., Kharitonov, S. A., and P. J. Barnes. 2002. Analysis of expired air for oxidation products. Am. J. Respir. Crit. Care Med. 166:S31–S37.

    Article  PubMed  Google Scholar 

  32. Van der Vliet, A., and C. E. Cross. 2000. Oxidants, nitrosants, and the lung. Am. J. Med. 109:398–421.

    Article  PubMed  Google Scholar 

  33. Schleiss, M. B., O. Holz, M. Behnke, K. Richter, H. Magnussen, and R. A. Jorres. 2000. The concentration of hydrogen peroxide in exhaled air depends on expiratory flow rate. Eur. Respir. J. 16:1115–1118.

    Article  PubMed  CAS  Google Scholar 

  34. Ziora, D., K. Kaluska, and J. Kozielski. 2004. An increase in exhaled nitric oxide is not associated with activity in pulmonary sarcoidosis. Eur. Respir. J. 24:609–614.

    Article  PubMed  CAS  Google Scholar 

  35. Chaudhuri, R., A. D. McMahon, C. P. McSharry, K. J. MacLeod, I. Fraser, E. Livingston, and N. C. Thomson. 2005. Serum and sputum neurotrophin levels in chronic persistent cough. Clin. Exp. Allergy 35:949–953.

    Article  PubMed  CAS  Google Scholar 

  36. Harding, S. M. 2001. The potential role of gastroesophageal reflux in asthma. Minerva Gastroenterol. Dietol. 47:75–83.

    PubMed  CAS  Google Scholar 

  37. Berry, M. A., D. E. Shaw, R. H. Green, C. E. Brightling, A. J. Wardlaw, and I. D. Pavord. 2005. The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma. Clin. Exp. Allergy 35:1175–1180.

    Article  PubMed  CAS  Google Scholar 

  38. Loukides, S., D. Bouros, G. Papatheodorou, O. Panagou, and N. M. Siafakas. 2002. The relationships among hydrogen peroxide in expired breath condensate, airway inflammation, and asthma severity. Chest 121:338–346.

    Article  PubMed  CAS  Google Scholar 

  39. Mutlu, G. M., K. W. Garey, R. A. Robbins, L. H. Danziger, and I. Rubinstein. 2001. Collection and analysis of exhaled breath condensate in humans. Am. J. Respir. Crit. Care Med. 164:731–737 (September 1).

    PubMed  CAS  Google Scholar 

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Acknowledgment

Esther Eshkol is thanked for editorial assistance.

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Correspondence to Elizabeth Fireman.

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Fireman, E., Shtark, M., Priel, I.E. et al. Hydrogen Peroxide in Exhaled Breath Condensate (EBC) vs Eosinophil Count in Induced Sputum (IS) in Parenchymal vs Airways Lung Diseases". Inflammation 30, 44–51 (2007). https://doi.org/10.1007/s10753-007-9020-8

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