Inflammatory markers and acid-base equilibrium in exhaled breath condensate of stable and unstable asthma patients

Int Arch Allergy Immunol. 2012;159(2):121-9. doi: 10.1159/000335674. Epub 2012 May 30.

Abstract

Background: Nitrosative and acid stress play an important role in the pathogenesis of asthma. The aim of this study was to evaluate whether, in asthmatics, a link exists between the concentrations of nitrite/nitrate, ammonia and pH values in exhaled breath condensate (EBC) and asthma severity, lung function, exhaled nitric oxide (F(ENO)), total IgE, eosinophil cationic protein (ECP) and blood eosinophilia.

Methods: The above-mentioned parameters were measured in 19 healthy volunteers and 91 allergic asthmatics divided into three groups, i.e. 22 subjects with steroid-naïve stable asthma, 35 with inhaled corticosteroid (ICS)-treated stable asthma and 34 with ICS-treated unstable asthma.

Results: Compared with healthy subjects, EBC from asthmatics had significantly lower pH values and ammonia concentrations and significantly higher levels of nitrite/nitrate. The extent of these changes was higher in patients with unstable than in patients with steroid-naïve and stable ICS-treated asthma. The EBC pH was positively correlated with ammonia and negatively correlated with nitrite/nitrate, F(ENO) or blood eosinophilia in all three groups of asthmatics. Significant positive correlations between EBC nitrite/nitrate and blood eosinophilia, ECP levels or F(ENO) were observed in all groups of asthmatics. Significant negative correlations between EBC ammonia and nitrite/nitrate, F(ENO), ECP concentrations or blood eosinophilia were demonstrated in the groups of ICS-naïve and ICS-treated stable asthmatics.

Conclusions: In asthmatic patients there is a relationship between EBC pH, ammonia and nitrite/nitrate concentrations and other recognized markers of airway inflammation. EBC pH values, ammonia and nitrite/nitrate levels measured together may help to assess airway inflammatory status and asthma severity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acid-Base Equilibrium
  • Adult
  • Aged
  • Ammonia / metabolism
  • Asthma / complications
  • Asthma / immunology
  • Asthma / metabolism*
  • Asthma / physiopathology
  • Biomarkers / metabolism
  • Case-Control Studies
  • Eosinophil Cationic Protein / blood
  • Eosinophilia / blood
  • Eosinophilia / complications
  • Exhalation
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Immunoglobulin E / blood
  • Inflammation Mediators / metabolism*
  • Male
  • Middle Aged
  • Nitrates / metabolism
  • Nitric Oxide / metabolism
  • Nitrites / metabolism
  • Respiratory Function Tests
  • Young Adult

Substances

  • Biomarkers
  • Inflammation Mediators
  • Nitrates
  • Nitrites
  • Nitric Oxide
  • Immunoglobulin E
  • Ammonia
  • Eosinophil Cationic Protein
  • RNASE3 protein, human