Increased leukotriene B4 and 8-isoprostane in exhaled breath condensate of patients with exacerbations of COPD.
BACKGROUND
Exacerbations are an important feature of chronic obstructive pulmonary disease (COPD), accounting for a large proportion of health care costs. They are associated with increased airway inflammation and oxidative stress.


METHODS
Concentrations of leukotriene B4 (LTB4), a marker of inflammation, and 8-isoprostane, a marker of oxidative stress, were measured in the exhaled breath condensate of 21 patients (11 M) with COPD during an exacerbation and 2 weeks after treatment with antibiotics. In 12 patients who had no further exacerbations these markers were also measured after 2 months.


RESULTS
LTB4 concentrations were raised during the COPD exacerbation (mean (SE) 15.8 (1.1) pg/ml and fell after treatment with antibiotics to 9.9 (0.9) pg/ml (p<0.0001). In 12 patients the level of LTB4 fell further from 10.6 (1.1) pg/ml to 8.5 (0.8) pg/ml (p<0.005) after 2 months. In 12 normal age matched subjects the LTB4 levels were 7.7 (0.5) pg/ml. Concentrations of 8-isoprostane were also increased during the exacerbation (13.0 (0.9) pg/ml) and fell after antibiotic treatment to 9.0 (0.6) pg/ml (p<0.0001). In 12 patients there was a further fall from 9.3 (0.7) pg/ml to 6.0 (0.7) pg/ml (p<0.001) after 2 months compared with normal subjects (6.2 (0.4) pg/ml).


CONCLUSIONS
Non-invasive markers of inflammation and oxidative stress are increased during an infective exacerbation of COPD and only slowly recover after treatment with antibiotics.
Biernacki
W A
WA
Department of Thoracic Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, Royal Brompton Hospital, London SW3 6LY, UK.
Kharitonov
S A
SA
Barnes
P J
PJ
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058672:Adrenergic beta-2 Receptor Antagonists; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D015237:Dinoprost / Q000031:analogs & derivatives*; D028441:F2-Isoprostanes / Q000032:analysis*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007975:Leukotriene B4 / Q000032:analysis*; D008297:Male; D018384:Oxidative Stress / Q000502:physiology; D011014:Pneumonia / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000378:metabolism*; D014797:Vital Capacity / Q000502:physiology
D000305:Adrenal Cortex Hormones; D058672:Adrenergic beta-2 Receptor Antagonists; D000318:Adrenergic beta-Agonists; D000900:Anti-Bacterial Agents; D015415:Biomarkers; D028441:F2-Isoprostanes; D007975:Leukotriene B4; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost