Exhaled 8-isoprostane as a prognostic marker in sarcoidosis. A short term follow-up.
BACKGROUND
8-Isoprostane (8-IP) is a marker of lipid peroxidation. Elevated concentrations have been reported in BAL fluid and exhaled breath condensate (EBC) in sarcoidosis (S). To validate the prognostic value of this marker we tested whether: 1. high initial EBC 8-IP predispose to more severe disease; 2. low initial concentrations increase a chance of early remission; 3. remissions are connected with the decrease of EBC 8-IP.


METHODS
40 patients (S) have been examined initially (V1) and after 8.5 +/- 0.5 months (V2). EBC 8-IP concentrations were measured by ELISA. Chest X-ray, lung function test, serum ACE and Ca2+ concentrations, 24 hrs Ca2+loss, abdominal ultrasonography, symptoms evaluation were performed.


RESULTS
We confirmed higher concentrations of 8-IP in EBC of patients with sarcoidosis (p = 0.001). Relative risk (RR) of persistence of disease at V2 when initial 8-IP was above 20 pg/mL was 1.04, and the frequency distributions estimated by chi2 test were not significantly different. A chance (RR) of early complete remission when V1 8-IP was below DL, was 3.33 (p = 0.04 by chi2 test). A significant decrease of 8-IP at V2 was observed only in patients who received treatment (p = 0.03), but not in those with spontaneous remission.


CONCLUSIONS
We come to the conclusion, that low initial 8-IP may be a positive prognostic factor. A decrease of 8-IP in treated patients reflects a non-specific effect of treatment and is not related to mere regression of disease.
Piotrowski
Wojciech J
WJ
Department of Pneumology and Allergy, Medical University of Lodz, Poland. piotrow@toya.net.pl
Kurmanowska
Zofia
Z
Antczak
Adam
A
Marczak
Jerzy
J
Górski
Paweł
P
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D016022:Case-Control Studies; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000378:metabolism; D018450:Disease Progression; D045853:Exhalation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012075:Remission, Spontaneous; D012129:Respiratory Function Tests; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000378:metabolism*; D012720:Severity of Illness Index
D015415:Biomarkers; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost; D002118:Calcium