title: Changes in the Concentrations of Mediators of Inflammation and Oxidative Stress in Exhaled Breath Condensate During Liver Transplantation and Their Relations With Postoperative ARDS.
abstract: BACKGROUND
  Oxidative stress and inflammatory responses are thought to be involved in the pathogenesis of ARDS, which is one of the most serious complications of orthotopic liver transplantation (OLT). The collection of exhaled breath condensate (EBC) is a noninvasive method for obtaining clinical samples from the lungs. However, the changes of mediators of inflammation and oxidative stress in EBC remain unclear. Therefore, the aim of this study was to investigate the changes of mediators in EBC from OLT subjects and the relations between these mediators and ARDS.
  
  
  METHODS
  The levels of mediators of oxidative stress (superoxide dismutase [SOD], malondialdehyde [MDA], H2O2, NO, and 8-iso-prostaglandin F2α) and of inflammatory factors (tumor necrosis factor-α[TNF-α], interleukin [IL]-8, and IL-10) were measured in EBC and serum samples collected from 28 subjects before OLT surgery and at 2 and 4 h after the anhepatic phase. The diagnostic value for ARDS until the 3 days following transplantation was evaluated.
  
  
  RESULTS
  Eighteen subjects developed ARDS after OLT. The concentrations of TNF-α, IL-8, MDA, NO, H2O2, and 8-iso-prostaglandin F2α were much higher in the ARDS group than in the control group, whereas the levels of IL-10 and SOD were lower in the ARDS group than in the control group. The serum levels of mediators of oxidative stress or inflammation were closely related to EBC levels. Receiver operating characteristic analysis showed that areas under the curves for MDA, NO, H2O2, 8-iso-prostaglandin F2α, TNF-α, IL-8, SOD, and IL-10 were 0.88, 0.88, 0.78, 0.84, 0.84, 0.94, 0.81, and 0.84 at 2 h after graft reperfusion and 0.98, 0.88, 0.92, 0.79, 0.95, 0.83, 0.88, and 0.97 at 4 h after graft reperfusion.
  
  
  CONCLUSIONS
  EBC analysis is a noninvasive method for detecting mediators of inflammation and oxidative stress from the lungs. This method could be used to predict the higher incidence of ARDS induced by OLT.
authors: Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China.
authors: Dezhao
authors: D
authors: Liu
authors: Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China.
authors: Gangjian
authors: G
authors: Luo
authors: Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China.
authors: Chenfang
authors: C
authors: Luo
authors: Department of Cardiothoracic Surgery, Longgang People's Hospital, Shenzhen City, People's Republic of China.
authors: Tao
authors: T
authors: Wang
authors: Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China.
authors: Guoliang
authors: G
authors: Sun
authors: Department of Anesthesiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, People's Republic of China. heiziqing@sina.com.
authors: Ziqing
authors: Z
authors: Hei
mesh_terms: D000368:Aged; D001944:Breath Tests; D045853:Exhalation; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000378:metabolism; D018836:Inflammation Mediators / Q000378:metabolism*; D016753:Interleukin-10 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology*; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D011184:Postoperative Period; D011453:Prostaglandins / Q000378:metabolism; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000209:etiology; D013482:Superoxide Dismutase / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: C508606:CXCL8 protein, human; C508609:IL10 protein, human; D018836:Inflammation Mediators; D016209:Interleukin-8; D011453:Prostaglandins; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D009569:Nitric Oxide; D008315:Malondialdehyde; D006861:Hydrogen Peroxide; D013482:Superoxide Dismutase
keywords: ARDS; exhaled breath condensate; orthotopic liver transplantation