title: Serum tryptase level and inflammatory markers in exhaled breath condensate of children with exercise-induced symptoms.
abstract: BACKGROUND
  The pathogenesis of exercise-induced bronchoconstriction (EIB) is poorly understood.
  
  
  OBJECTIVE
  To evaluate the biomarkers concentration in exhaled breath condensate (EBC) in schoolchildren with postexercise symptoms. We also evaluated changes in fractional exhaled nitric oxide (FeNO) value and the serum tryptase level after exercise.
  
  
  METHODS
  One hundred children with postexercise symptoms were included. Methacholine challenge testing (MCT) was performed at visit 2, and exercise challenge testing (ECT) was performed at visit 3. Before and after ECT serum tryptase levels and FeNO values were measured. EBC was collected after ECT from 10 randomly selected children from each group. The children were assigned to the following groups: ECT(+) MCT(+), ECT(+) MCT(-), ECT(-) MCT(+), ECT(-) MC(-). We measured the following molecules: eotaxin, interleukin (IL) 8, IL-1ra, IL-1 beta, IL-6, IL-1 alpha, IL-12(p40), IL-5, granulocyte-macrophage colony-stimulating factor, IL-7, IL-15, IL-4, IL-2, IL-10, tumor necrosis factor alpha, interferon gamma, IL-13, tumor necrosis factor beta, monocyte chemoattractant protein-1, IL-17A, macrophage inflammatory proteins-1 alpha, macrophage inflammatory proteins-1 beta, IL-12(p70), and regulated on activation, normal T-cell expressed and secreted by using a multiplex immunoassay. Prostaglandin E2 (PGE2), leukotriene B4, and cysteinyl leukotriene were analyzed by using separate enzyme-linked immunosorbent assay kits.
  
  
  RESULTS
  In the MCT(+) group, a detectable level of IL4 in EBC and detectible levels of eicosanoids were seen in the ECT(+) group. We observed the opposite direction of ECT-induced changes in FeNO and serum tryptase concentrations in patients with detectable compared with patients without detectable levels of cytokines in EBC. We showed ECT-induced reduction in the tryptase level in patients with a nondetectable PGE2 level in EBC and an increase in tryptase levels in patients who had detectable levels of PGE2 in EBC.
  
  
  CONCLUSIONS
  EBC was a useful method to estimate inflammation but only in children with symptoms and with EIB shown by a positive ECT. Children with a positive ECT had detectable levels of eicosanoids in EBC; the opposite direction of ECT-induced changes in FeNO and serum tryptase concentrations was observed. The results of above study confirm the role of mast cells and eicosanoids in the pathogenesis of EIB in children.
authors.affiliation: Department of Pediatrics and Allergy, Medical University of Lodz, Lodz, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Stelmach
authors.forename: Magdalena
authors.initials: M
authors.lastname: Zaczeniuk
authors.forename: Anna
authors.initials: A
authors.lastname: Sztafińska
authors.forename: Paweł
authors.initials: P
authors.lastname: Majak
authors.forename: Joanna
authors.initials: J
authors.lastname: Jerzyńska
authors.forename: Anna
authors.initials: A
authors.lastname: Kuklinska-Pijanka
authors.forename: Wlodzimierz
authors.initials: W
authors.lastname: Stelmach
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001250:Asthma, Exercise-Induced / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers; D001944:Breath Tests; D002648:Child; D016207:Cytokines / Q000097:blood*; D045853:Exhalation; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D009569:Nitric Oxide; D011446:Prospective Studies; D012129:Respiratory Function Tests; D016896:Treatment Outcome; D053802:Tryptases / Q000097:blood*
chemical_list: D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D009569:Nitric Oxide; D053802:Tryptases