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Vol. 45. Issue 12.
Pages 597-602 (December 2009)
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Vol. 45. Issue 12.
Pages 597-602 (December 2009)
Original article
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Inflammation Markers in the Exhaled Air of Patients with Bronchiectasis Unassociated with Cystic Fibrosis
Estudio de marcadores de inflamación en el aire exhalado de pacientes con bronquiectasias no asociadas a fibrosis quística
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Marta Palop-Cerveraa, Alfredo de Diego Damiáa,
Corresponding author
dediego_alf@gva.es

Corresponding author.
, Eva Martínez-Moragónb, Julio Cortijoc, Javier Fullanab, Montserrat Leónb
a Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain
b Sección de Neumología, Hospital de Sagunto, Puerto de Sagunto, Valencia, Spain
c Fundación Hospital General Universitario de Valencia, Valencia, CibeRes, Spain
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Abstract
Introduction

The aim of the study was to analyse the relationship between the intensity of the respiratory tract inflammation, expressed by oxidative stress markers, and the severity of the disease in patients with bronchiectasis unassociated with cystic fibrosis.

Patients and methods

The study included 25 patients with stable bronchiectasis (15 females and 10 males). As determining factors of severity, the following parameters were collected: degree of dyspnoea, number of exacerbations/admissions in the last year, mean daily sputum volume, sputum colour (graduated colour scale), bacterial colonisation, respiratory function tests, quality of life (St. George questionnaire) and radiological extension of the lesions (Bhalla scale). Inflammation was analysed using the measurement of nitric oxide, pH and concentration of nitrites, nitrates and isoprostane in the exhaled air condensate. The C reactive protein and erythrocyte sedimentation rate were also determined in peripheral blood.

Results

There were no significant relationships between the markers in the exhaled air condensate and the clinical, radiological and functional involvement or the quality of life of the patients. Only bacterial colonisation (16 cases) was associated with higher values of nitrates in exhaled air (mean ± standard deviation: 18 ± 4 compared to 7 ± 2 μM; r2 = 0.6) and a higher number of exacerbations (3.1 ± 1.9 compared to 1.7 ± 1.9; r2 = 0.3).

Conclusions

In our study, the measurement of inflammation markers in exhaled air is only associated with some parameters of severity in patients with bacterial bronchiectasis.

Keywords:
Bronchiectasis
Exhaled air condensate
Inflammation
Resumen
Introducción

El propósito del estudio ha sido analizar la relación entre la intensidad de la inflamación de las vías aéreas respiratorias, expresada por marcadores de estrés oxidativo, y la gravedad de la enfermedad en pacientes con bronquiectasias no asociadas a fibrosis quística.

Pacientes y métodos

Se ha estudiado a 25 pacientes con bronquiectasias estables (15 mujeres y 10 varones). Como determinantes de gravedad se recogieron las siguientes variables: grado de disnea, número de exacerbaciones/ingresos en el último año, volumen diario medio de esputo, color del esputo (escala gradual de color), colonización bacteriana, exploración de la función respiratoria, calidad de vida (cuestionario St. George) y extensión radiológica de las lesiones (escala de Bhalla). La inflamación se analizó mediante la medición del óxido nítrico, pH y concentración de nitritos, nitratos e isoprostano en el condensado de aire exhalado. Asimismo se determinaron los valores de proteína C reactiva y la velocidad de sedimentación globular en sangre periférica.

Resultados

No hubo relaciones significativas entre los marcadores en condensado de aire exhalado y la afectación clínica, radiológica, funcional o de calidad de vida de los pacientes. Sólo la colonización bacteriana (16 casos) se relacionó con valores más altos de nitratos en aire exhalado (media ± desviación estándar: 18 ± 4 frente a 7 ± 2 μM; r2=0,6) y un mayor número de exacerbaciones (3,1 ± 1,9 frente a 1,7 ± 1,9; r2 = 0,3).

Conclusiones

En nuestra muestra, el estudio de marcadores de inflamación en aire exhalado sólo se relaciona con algunos parámetros de gravedad en pacientes con bronquiectasias colonizadas.

Palabras clave:
Bronquiectasias
Condensado en aire exhalado
Inflamación
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