Inflammatory markers and acid-base equilibrium in exhaled breath condensate of stable and unstable asthma patients.
BACKGROUND
Nitrosative and acid stress play an important role in the pathogenesis of asthma. The aim of this study was to evaluate whether, in asthmatics, a link exists between the concentrations of nitrite/nitrate, ammonia and pH values in exhaled breath condensate (EBC) and asthma severity, lung function, exhaled nitric oxide (F(ENO)), total IgE, eosinophil cationic protein (ECP) and blood eosinophilia.


METHODS
The above-mentioned parameters were measured in 19 healthy volunteers and 91 allergic asthmatics divided into three groups, i.e. 22 subjects with steroid-naïve stable asthma, 35 with inhaled corticosteroid (ICS)-treated stable asthma and 34 with ICS-treated unstable asthma.


RESULTS
Compared with healthy subjects, EBC from asthmatics had significantly lower pH values and ammonia concentrations and significantly higher levels of nitrite/nitrate. The extent of these changes was higher in patients with unstable than in patients with steroid-naïve and stable ICS-treated asthma. The EBC pH was positively correlated with ammonia and negatively correlated with nitrite/nitrate, F(ENO) or blood eosinophilia in all three groups of asthmatics. Significant positive correlations between EBC nitrite/nitrate and blood eosinophilia, ECP levels or F(ENO) were observed in all groups of asthmatics. Significant negative correlations between EBC ammonia and nitrite/nitrate, F(ENO), ECP concentrations or blood eosinophilia were demonstrated in the groups of ICS-naïve and ICS-treated stable asthmatics.


CONCLUSIONS
In asthmatic patients there is a relationship between EBC pH, ammonia and nitrite/nitrate concentrations and other recognized markers of airway inflammation. EBC pH values, ammonia and nitrite/nitrate levels measured together may help to assess airway inflammatory status and asthma severity.
Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland. maria.lozowska@umwb.edu.pl
Maria Magdalena
MM
Tomasiak-Lozowska
Ziemowit
Z
Zietkowski
Katarzyna
K
Przeslaw
Marian
M
Tomasiak
Roman
R
Skiepko
Anna
A
Bodzenta-Lukaszyk
D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D000641:Ammonia / Q000378:metabolism; D001249:Asthma / Q000150:complications / Q000276:immunology / Q000378:metabolism* / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D047150:Eosinophil Cationic Protein / Q000097:blood; D004802:Eosinophilia / Q000097:blood / Q000150:complications; D045853:Exhalation; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007073:Immunoglobulin E / Q000097:blood; D018836:Inflammation Mediators / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D009573:Nitrites / Q000378:metabolism; D012129:Respiratory Function Tests; D055815:Young Adult
D015415:Biomarkers; D018836:Inflammation Mediators; D009566:Nitrates; D009573:Nitrites; D009569:Nitric Oxide; D007073:Immunoglobulin E; D000641:Ammonia; D047150:Eosinophil Cationic Protein; C479220:RNASE3 protein, human