Inflammatory markers in exhaled breath condensate following lung resection for bronchial carcinoma.
OBJECTIVE
Pulmonary resection may cause inflammatory changes with subsequent injury to the remaining lung and deterioration in respiratory function. This study investigated the pattern of serum inflammatory markers and exhaled breath condensate (EBC) in patients undergoing major lung resection due to bronchial carcinoma compared with minimally invasive thoracic surgery.


METHODS
The pro-inflammatory markers IL-1-beta, IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha) and soluble intercellular adhesion molecule-1 (sICAM-1) were measured preoperatively (day -1) and on three postoperative days (day 1, 3, 7) in serum and EBC in patients after lobectomy or pneumonectomy due to bronchial carcinoma (test group) and in patients undergoing thoracoscopy with minimal wedge resection (control group).


RESULTS
All mediators were detectable in serum and all but IL-8 were detectable in EBC. No patient suffered postoperative respiratory failure. In the test group, serum IL-6 was significantly higher postoperatively compared with day -1 (P < 0.001). For EBC (test group), the postoperative values of IL-1-beta were significantly higher compared with day -1 (P = 0.005). In EBC (test group), day -1 TNF-alpha and sICAM-1 were significantly higher compared with controls (P < 0.029 and P = 0.032, respectively). There was no correlation between the levels of mediators and the extent of resection.


CONCLUSIONS
Pro-inflammatory markers are detected in EBC following pulmonary surgery. Mediators are detectable in both serum and EBC in patients with bronchial carcinoma undergoing pulmonary resection, but the levels are higher in EBC.
Jungraithmayr
Wolfgang
W
Department of Thoracic Surgery, University Hospital Freiburg, Freiburg, Germany. jungraithmayr@usz.ch
Frings
Christina
C
Zissel
Gernot
G
Prasse
Antje
A
Passlick
Bernward
B
Stoelben
Erich
E