title: Biomarkers of inflammation in persons with chronic tetraplegia.
abstract: In addition to lung volume restriction, individuals with chronic tetraplegia exhibit reduced airway caliber and bronchodilator responsiveness similar to persons with asthma. In asthma, airflow obstruction is closely linked to airway inflammation. Conversely, little is known regarding the airway inflammatory response in tetraplegia. To compare levels of biomarkers of inflammation in exhaled breath condensate (EBC) and serum in subjects with chronic tetraplegia, mild asthma, and able-bodied controls.Prospective, observational pilot study. Thirty-four subjects participated: tetraplegia (n = 12), asthma (n = 12), controls (n = 10). Biomarkers in EBC [8-isoprostane (8-IP), leukotriene B4 (LT-B4), prostaglandin E2 (PG-E2), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6)] and serum (8-IP, LT-B4, TNF-α, IL-6) were determined using commercially available EIA kits (Cayman Chemical Company, Ann Arbor, MI). Separate, one-way ANOVA with Bonferroni's post-hoc analyses were performed to determine group differences in demographic and dependent variables [EBC and serum biomarkers, fractional exhaled nitric oxide (FeNO), pulmonary function parameters, and specific airway conductance (sGaw)]. The tetraplegia group had significantly elevated 8-IP levels in EBC compared to the asthma (68 ± 38 versus 21 ± 13 pg ml(-1); p < 0.001) and control groups (22 ± 13 pg ml(-1); p < 0.01), respectively. FeNO levels were significantly elevated in the asthma compared to the control group (26 ± 18 versus 11 ± 4 ppb; p < 0.05), and trended higher than levels in the tetraplegia group (15 ± 6; p = 0.08). Levels of serum biomarkers did not differ significantly among groups. Through analysis of EBC, levels of 8-IP were significantly elevated compared to levels found in individuals with mild asthma and healthy controls. Further studies are needed to extend upon these preliminary findings that suggest the presence of airway inflammation in subjects with chronic tetraplegia, and how this relates to pulmonary dysfunction in this population.
authors.affiliation: Rehabilitation Research and Development Center of Excellence for the Medical Consequences of Spinal Cord Injury, The James J. Peters VA Medical Center, Bronx, NY 10468, USA. Medical Service, The James J. Peters VA Medical Center, Bronx, NY 10468, USA. Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Radulovic
authors.forename: William A
authors.initials: WA
authors.lastname: Bauman
authors.forename: Jill M
authors.initials: JM
authors.lastname: Wecht
authors.forename: Michael
authors.initials: M
authors.lastname: LaFountaine
authors.forename: Nighat
authors.initials: N
authors.lastname: Kahn
authors.forename: Joshua
authors.initials: J
authors.lastname: Hobson
authors.forename: Kamaldeep
authors.initials: K
authors.lastname: Singh
authors.forename: Christopher
authors.initials: C
authors.lastname: Renzi
authors.forename: Christina
authors.initials: C
authors.lastname: Yen
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Schilero
mesh_terms: D001249:Asthma / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D001944:Breath Tests; D016022:Case-Control Studies; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D045853:Exhalation; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D015850:Interleukin-6 / Q000097:blood; D007975:Leukotriene B4 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D010865:Pilot Projects; D011446:Prospective Studies; D011782:Quadriplegia / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007975:Leukotriene B4; C075750:8-epi-prostaglandin F2alpha; D009569:Nitric Oxide; D015237:Dinoprost