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Eur Respir J 2008, doi:10.1183/09031936.00089807
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ORIGINAL ARTICLE |
Extracellular Purines are Biomarkers of Neutrophilic Airway Inflammation
1 paediatric Pulmonology
2 CEMALB
3 CF Research Center
4 Division of General Medicine and Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
* To whom correspondence should be addressed. E-mail: Charles_Esther{at}med.unc.edu.
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Abstract |
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Purinergic signaling regulates airway defense mechanisms, suggesting that extracellular purines could serve as airway inflammation biomarkers in cystic fibrosis (CF).
The purines ATP, ADP, AMP, and adenosine were measured in sputum from 21 adults (spontaneously expectorated from 7 CF, induced from 14 healthy controls) to assess normal values and CF associated changes. Subsequently, purine levels were measured in bronchoalveolar lavage fluid (BALF) from 37 children (25 CF, 12 disease controls) and compared to neutrophilic counts, presence of airway infection, and lung function. To non-invasively assess airway purines, ATP levels were measured using luminometry in exhaled breath condensate (EBC) from 14 children with CF and 14 healthy controls, then 14 CF children during a pulmonary exacerbation.
Both ATP and AMP were elevated in sputum and BALF from CF subjects compared to controls. In BALF, ATP and AMP levels were inversely related to lung function and strongly correlated with neutrophil counts. In EBC, ATP levels were increased in CF relative to controls and decreased after treatment of CF pulmonary exacerbation.
The purines ATP and AMP are candidate biomarkers of neutrophilic airways inflammation. Measurement of purines in sputum or EBC may provide a relatively simple and non-invasive method to track this inflammation.
Keywords: Biomarker, bronchoalveolar lavage fluid, cystic fibrosis, exhaled breath condensate, inflammation, purinergic signaling
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