Chest
Volume 120, Issue 4, October 2001, Pages 1136-1139
Journal home page for Chest

Clinical Investigations
Asthma
Elevated Concentrations of Exhaled Hydrogen Peroxide in Asthmatic Patients

https://doi.org/10.1378/chest.120.4.1136Get rights and content

Background

Airway inflammation is important in the development and progression of asthma. Activation of inflammatory cells induces a respiratory burst resulting in the production of reactive oxygen species, such as H2O2. The aim of this study was to measure the concentration of H2O2 in exhaled breath condensate and its correlation with airway obstruction, airway hyperresponsiveness, and concentration of eosinophil cationic protein (ECP) in serum in 70 steroid-naive, atopic patients with unstable asthma (20 men; age range, 18 to 62 years) and 17 normal subjects (7 men; age range, 19 to 34 years).

Methods

Exhaled H2O2 was measured using a colorimetric assay, and the concentration of ECP in serum was measured using radioimmunoassay. Airway hyperresponsiveness was expressed as the provocative concentration of inhaled histamine causing a 20% fall in FEV1 (PC20).

Results

In patients with asthma, the mean H2O2 concentration was significantly elevated compared to values in normal subjects: 0.127 ± 0.083 mol/L vs 0.024 ± 0.016 mol/L (p < 0.001). There was a significant correlation among H2O2 concentration, FEV1, PC20, and ECP in serum.

Conclusion

We conclude that exhaled H2O2 is significantly elevated in asthmatic patients. This is correlated with disease severity and indirect markers of airway inflammation. Measurement of exhaled H2O2 may be useful to assess airway inflammation and oxidative stress in asthmatic patients.

Section snippets

Patients

Seventy patients (20 men and 50 women) with unstable, steroid-naive, atopic asthma (age range, 18 to 62 years; median age, 33 years) were examined at the outpatient department of the Hospital Therapeutic Clinic of Pavlov Medical University, St. Petersburg, Russia. They had nocturnal wheezing and daily asthma symptoms. Asthma was diagnosed according to American Thoracic Society criteria.12 Diagnosis was based on clinical history, reversibility of FEV1 > 15%, and diurnal variability of peak

Results

The concentrations of H2O2 in expired breath condensate and ECP in serum in asthmatic patients and normal subjects are shown in Table 1. The concentrations of exhaled H2O2 and ECP in serum were significantly elevated in asthmatic patients compared to normal subjects. There was a negative correlation between expired H2O2 concentration and FEV1 (r = − 0.45; n = 70; p < 0.001; Fig 1) and between H2O2 and PC20 (rs = − 0.40; n = 28; p < 0.05; Fig 2), and a positive correlation between expired H2O2

Discussion

The mean concentration of expired H2O2 was elevated in untreated asthmatic patients in comparison to levels in normal subjects. Most of the asthmatic patients (94%) had an increased level of H2O2. This may indicate an enhanced production of oxidants and/or decreased antioxidant capacity of asthmatic airways. However, the concentrations of H2O2 in four patients with asthma were similar to those in healthy subjects, perhaps reflecting a higher concentration of antioxidants in these patients.9

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    Supported in part by a research grant from MacLab (Melbourne, Australia).

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