Journal Information
Vol. 42. Issue 3.
Pages 113-119 (March 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 3.
Pages 113-119 (March 2006)
Original Articles
Full text access
Analysis of Oxidative Stress in Exhaled Breath Condensate From Patients With Severe Pulmonary Infections
Visits
4369
P.V. Romeroa,
Corresponding author
pvromero@csub.scs.es

Correspondence: Dr. P.V. Romero. Laboratorio de Función Pulmonar. Servicio de Neumología. Hospital Universitario de Bellvitge. IDIBELL. Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España
, B. Rodrígueza, S. Martíneza, R. Cañizaresb, D. Sepúlvedab, F. Manresaa
a Servicio de Neumología, Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
b Servicio de Medicina Intensiva, Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
This item has received
Article information
Objective

Oxidative stress is an intrinsic part of the chain of events leading to inflammation of the airways caused by bacterial infection. The aim of this study was to determine whether analysis of exhaled breath condensate from patients with severe lung infections reveals changes in the redox state at the airway surface.

Patients and methods

The study included a total of 48 subjects divided into 4 groups: individuals without respiratory disease (n=14), patients with multilobar pneumonia (n=13), patients who had chronic obstructive pulmonary disease with superinfection (n=14), and mechanically ventilated patients with severe pneumonia (n=7). A sample of exhaled breath condensate was obtained within the first 72 hours of hospital admission and the concentrations of nitrite, nitrate, 8-isoprostane, and myeloperoxidase (MPO) were determined.

Results

Significant differences in the concentrations of nitrite, 8-isoprostane, and MPO were observed between patients and individuals without respiratory disease but no differences were found between the 3 patient groups. The concentration of MPO was correlated with the concentrations of 8-isoprostane and nitrate, which were normalized to the nitrite concentration.

Conclusions

Analysis of the concentrations of 8-isoprostane and MPO in exhaled breath condensate allows assessment of oxidative stress in the airways of patients with severe lung infections.

Key words:
Pneumonia
Chronic obstructive pulmonary disease
Reactive nitrogen species
Reactive oxygen species
Pulmonary inflammation
8-isoprostane
Myeloperoxidase
Nitrate
Nitrite
Objetivo

El estrés oxidativo forma parte esencial de la cadena de acontecimientos que conducen al estado inflama-torio de la vía aérea tras la agresión bacteriana. El objetivo del presente trabajo ha sido investigar si el análisis del condensado del vapor exhalado (CER) de pacientes con infección pulmonar grave refleja las alteraciones del estado oxidativo de la interfase aérea.

Pacientes y métodos

Se ha estudiado a un total de 48 pacientes divididos en 4 grupos: sujetos sin enfermedad respiratoria (n = 14), pacientes con neumonía multilobular (n = 13), con enfermedad pulmonar obstructiva crónica sobreinfectados (n = 14) y con neumonía grave ventilados mecánicamente (n = 7). Se obtuvo una muestra de CER en las primeras 72 h tras el ingreso y se determinó la concentración de nitrito, nitrato, 8-isoprostano y mieloperoxidasa (MPO).

Resultados

Se apreciaron variaciones significativas de la concentración de nitrito, 8-isoprostano y MPO en los pacientes respecto del grupo control, pero no entre los diferentes grupos de pacientes. La concentración de MPO se rela-cionó con las concentraciones de 8-isoprostano y nitrato normalizadas para el valor de nitrito.

Conclusiones

El análisis de la concentración de 8-isoprostano y MPO en el CER permite apreciar el estrés oxidativo en la interfase aérea de los pacientes con infección pulmonar grave.

Palabras clave:
Neumonía
Enfermedad pulmonar obstructiva crónica
Especies reactivas del nitrógeno
Especies reactivas del oxígeno
Inflamación pulmonar
8-isoprostano
Mieloperoxidasa
Nitrato
Nitrito
Full text is only aviable in PDF
REFERENCES
[1]
G Vass, E Huszar, E Barat, M Valyon, D Kiss, I Penzes, et al.
Comparison of nasal and oral inhalation during exhaled breath condensate collection.
Am J Respir Crit Care Med, 167 (2003), pp. 850-855
[2]
JD Crapo.
Oxidative stress as an initiator of cytokine release and cell damage.
Eur Respir J Suppl, 44 (2003), pp. 4S-6S
[3]
SS Fam, JD Morrow.
The isoprostanes: unique products of arachidonic acid oxidation-a review.
Curr Med Chem, 10 (2003), pp. 1723-1740
[4]
MB Hampton, AJ Kettle, CC Winterbourn.
Involvement of superoxide and myeloperoxidase in oxygen-dependent killing of Staphylococcus aureus by neutrophils.
Infect Immun, 64 (1996), pp. 3512-3517
[5]
CC Winterbourn, AJ Kettle.
Reactions of superoxide with myeloperoxidase and its products.
Jpn J Infect Dis, 57 (2004), pp. S31-S33
[6]
I Rahman, F Kelly.
Biomarkers in breath condensate: a promising new non-invasive technique in free radical research.
Free Radic Res, 37 (2003), pp. 1253-1266
[7]
RM Effros, J Biller, B Foss, K Hoagland, MB Dunning, D Castillo, et al.
A simple method for estimating respiratory solute dilution in exhaled breath condensates.
Am J Respir Crit Care Med, 168 (2003), pp. 1500-1505
[8]
WA Biernacki, SA Kharitonov, PJ Barnes.
Increased leukotriene B4 and 8-isoprostane in exhaled breath condensate of patients with exacerbations of COPD.
Thorax, 58 (2003), pp. 294-298
[9]
WJ van Beurden, FW Smeenk, GA Harff, PN Dekhuijzen.
Markers of inflammation and oxidative stress during lower respiratory tract infections in COPD patients.
Monaldi Arch Chest Dis, 59 (2003), pp. 273-280
[10]
E Huszar, G Vass, E Vizi, Z Csoma, E Barat, G Molnar Vilagos, et al.
Adenosine in exhaled breath condensate in healthy volunteers and in patients with asthma.
Eur Respir J, 20 (2002), pp. 1393-1398
[11]
E Baraldi, S Carraro, R Alinovi, A Pesci, L Ghiro, A Bodini, et al.
Cysteinyl leukotrienes and 8-isoprostane in exhaled breath condensate of children with asthma exacerbations.
Thorax, 58 (2003), pp. 505-509
[12]
GE Carpagnano, SA Kharitonov, AU Wells, P Pantelidis, RM du Bois, PJ Barnes.
Increased vitronectin and endothelin-1 in the breath condensate of patients with fibrosing lung disease.
Respiration, 70 (2003), pp. 154-160
[13]
GE Carpagnano, PJ Barnes, DM Geddes, ME Hodson, SA Kharitonov.
Increased leukotriene B4 and interleukin-6 in exhaled breath condensate in cystic fibrosis.
Am J Respir Crit Care Med, 167 (2003), pp. 1109-1112
[14]
RM Effros, J Su, R Casaburi, R Shaker, J Biller, M Dunning.
Utility of exhaled breath condensates in chronic obstructive pulmonary disease: a critical review.
Curr Opin Pulm Med, 11 (2005), pp. 135-139
[15]
NR Anthonisen, J Manfreda, CP Warren, ES Hershfield, GK Harding, NA Nelson.
Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease.
Ann Intern Med, 106 (1987), pp. 196-204
[16]
JB Galdiz Iturri.
Métodos de valoración de la inflamación de las vías respiratorias.
Arch Bronconeumol, 40 (2004), pp. 2-7
[17]
N González Mangado.
Análisis del condensado exhalado: ¿una técnica con futuro?.
Arch Bronconeumol, 41 (2005), pp. 540-541
[18]
C Almonacid, J Castelao, JL Izquierdo.
Condensado de aire exhalado en patología respiratoria.
Rev Patol Respir, 7 (2004), pp. 123-130
[19]
G Vass, E Huszar, E Barat, M Valyon, D Kiss, I Penzes, et al.
Comparison of nasal and oral inhalation during exhaled breath condensate collection.
Am J Respir Crit Care Med, 167 (2003), pp. 850-855
[20]
P Latzin, J Beck, A Bartenstein, M Griese.
Comparison of exhaled breath condensate from nasal and oral collection.
Eur J Med Res, 8 (2003), pp. 505-510
[21]
JB de Lema, M González, L Vigil, P Casan.
Condensado exhalado: estandarización de la recogida de muestras en voluntarios sanos.
Arch Bronconeumol, 4 (2005), pp. 584-586
[22]
MB Schleiss, O Holz, M Behnke, K Richter, H Magnussen, RA Jorres.
The concentration of hydrogen peroxide in exhaled air depends on expiratory flow rate.
Eur Respir J, 16 (2000), pp. 1115-1118
[23]
C Gessner, S Hammerschmidt, H Kuhn, T Lange, L Engelmann, J Schauer, et al.
Exhaled breath condensate nitrite and its relation to tidal volume in acute lung injury.
Chest, 124 (2003), pp. 1046-1052
[24]
GE Carpagnano, SA Kharitonov, MP Foschino-Barbaro, O Resta, E Gramiccioni, PJ Barnes.
Supplementary oxygen in healthy subjects and those with COPD increases oxidative stress and airway inflammation.
Thorax, 59 (2004), pp. 1016-1019
[25]
B Balint, LE Donnelly, T Hanazawa, SA Kharitonov, PJ Barnes.
Increased nitric oxide metabolites in exhaled breath condensate after exposure to tobacco smoke.
Thorax, 56 (2001), pp. 456-461
[26]
M Corradi, A Pesci, R Casana, R Alinovi, M Goldoni, MV Vettori, et al.
Nitrate in exhaled breath condensate of patients with different airway diseases.
Nitric Oxide, 8 (2003), pp. 26-30
[27]
PG van Hoydonck, WA Wuyts, BM Vanaudenaerde, EG Schouten, LJ Dupont, EH Temme.
Quantitative analysis of 8-isoprostane and hydrogen peroxide in exhaled breath condensate.
Eur Respir J, 23 (2004), pp. 189-192
[28]
JA Nightingale, DF Rogers, KF Chung, PJ Barnes.
No effect of inhaled budesonide on the response to inhaled ozone in normal subjects.
Am J Respir Crit Care Med, 161 (2000), pp. 479-486
[29]
MA Wheeler, SD Smith, G García-Cardena, CF Nathan, RM Weiss, WC Sessa.
Bacterial infection induces nitric oxide synthase in human neutrophils.
J Clin Invest, 99 (1997), pp. 110-116
[30]
I Rahman, SK Biswas.
Non-invasive biomarkers of oxidative stress: reproducibility and methodological issues.
Redox Rep, 9 (2004), pp. 125-143
[31]
JD Morrow, LJ Roberts.
The isoprostanes: their role as an index of oxidant stress status in human pulmonary disease.
Am J Respir Crit Care Med, 166 (2002), pp. S25-S30
[32]
CT Carpenter, PV Price, BW Christman.
Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS.
Chest, 114 (1998), pp. 1653-1659

This work was funded by grants from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) 2002 and Red Respira (ISCiii RTIC 03/111, project CER).

Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?