title: Metallic elements in exhaled breath condensate and serum of patients with exacerbation of chronic obstructive pulmonary disease.
abstract: Biomarkers in exacerbated chronic obstructive pulmonary disease may be useful in aiding diagnosis, defining specific phenotypes of disease, monitoring the disease and evaluating the effects of drugs. The aim of this study was the characterization of metallic elements in exhaled breath condensate and serum as novel biomarkers of exposure and susceptibility in exacerbated chronic obstructive pulmonary disease using reference analytical techniques. C-Reactive protein and procalcitonin were assessed as previously validated diagnostic and prognostic biomarkers which have been associated with disease exacerbation, thus useful as a basis of comparison with metal levels. Exhaled breath condensate and serum were obtained in 28 patients at the beginning of an episode of disease exacerbation and when they recovered. Trace elements and toxic metals were measured by inductively coupled plasma-mass spectrometry. Serum biomarkers were measured by immunoassay. Exhaled manganese and magnesium levels were influenced by exacerbation of chronic obstructive pulmonary disease, an increase in their concentrations--respectively by 20 and 50%--being observed at exacerbation in comparison with values obtained at recovery; serum elemental composition was not modified by exacerbation; serum levels of C-reactive protein and procalcitonin at exacerbation were higher than values at recovery. In outpatients who experienced a mild-moderate chronic obstructive pulmonary disease exacerbation, manganese and magnesium levels in exhaled breath condensate are elevated at admission in comparison with values at recovery, whereas no other changes were observed in metallic elements at both the pulmonary and systemic level.
authors.affiliation: Laboratory of Industrial Toxicology, Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Corradi
authors.forename: Olga
authors.initials: O
authors.lastname: Acampa
authors.forename: Matteo
authors.initials: M
authors.lastname: Goldoni
authors.forename: Roberta
authors.initials: R
authors.lastname: Andreoli
authors.forename: Donald
authors.initials: D
authors.lastname: Milton
authors.forename: Susan R
authors.initials: SR
authors.lastname: Sama
authors.forename: Richard
authors.initials: R
authors.lastname: Rosiello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: de Palma
authors.forename: Pietro
authors.initials: P
authors.lastname: Apostoli
authors.forename: Antonio
authors.initials: A
authors.lastname: Mutti
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001944:Breath Tests / Q000379:methods*; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008274:Magnesium / Q000097:blood / Q000378:metabolism*; D008297:Male; D008345:Manganese / Q000097:blood / Q000378:metabolism*; D011498:Protein Precursors / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000378:metabolism*; D013147:Spirometry; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D008345:Manganese; D002116:Calcitonin; D002097:C-Reactive Protein; D008274:Magnesium; D015740:Calcitonin Gene-Related Peptide