Airway acidification in childhood asthma exacerbations

Abstract

Exhaled breath condensate (EBC) is being used increasingly to sample airway lining fluid. In asthmatic patients, the concentration of pH in EBC has been found to be decreased and to be related to airway inflammation. The aim of this study was to determine exhaled pH levels during acute asthma exacerbations in relation to pharmacologic treatment in asthmatic children and compare these with control subjects. Twelve asthmatic children with asthma exacerbation and 27 healthy children were enrolled. Clinical observations and pH in EBC before and after standard treatment for asthma attack, based administration of inhaled beta2-agonist, and corticosteroid, according to international Global Initiative for Asthma guidelines, were compared with those in healthy subjects. All children performed skin-prick tests to aeroallergens. Asthmatic children underwent spirometry. Exhaled pH levels were significantly lower in children with asthma exacerbation before treatment (mean ± SD = 7.87 ± 0.66; p = 0.03) but not after treatment (8.11 ± 0.06; p = 0.40) compared with controls (8.12 + 0.19). Intragroup analyses found that condensate pH levels in asthmatic children before treatment were lower, but not significantly, than those after treatment. No correlation was found between pH values and treatment with systemic corticosteroids or lung function. Asthmatic children were atopic in 75% of cases. Levels of pH are decreased in EBC of asthmatic children with exacerbation before treatment. Larger studies are required to determine whether EBC pH levels may be a useful noninvasive biomarker to guide treatment of asthma exacerbations in childhood.

Assessing the Efficacy of Immunotherapy with a Glutaraldehyde-Modified House Dust Mite Extract in Children by Monitoring Changes in Clinical Parameters and Inflammatory Markers in Exhaled Breath

“…In acute asthma, acidification of EBC has been reported by several independent investigators [9,31,32,33]. These changes in EBC pH have also been observed in pediatric populations [10,34,35,36,37]. In this study, significant reductions in EBC pH values after SIT were observed.…”

“…Its ease of collection makes it suitable for studies in the pediatric population [9,10], even in children younger than 4-6 years [11,12,13]. The exhaled air and aerosol contain water vapor that can be condensed by freezing.…”

Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis

“…Fresh fruit and vegetables are rich dietary sources of antioxidants such as vitamin C, E and β-carotene as well as flavonoids, isoflavonoids and polyphenolic compounds [1,7]. It has been reported that oxidative stress is elevated in asthma and increases further during acute asthma exacerbations [72,73,74], so a high intake of antioxidants may be beneficial. Vitamin C is a major antioxidant in the extracellular respiratory lining fluid that protects immune cells from oxidative stress, and may also contribute to lung growth and development and reduce airway hyper-reactivity, both of which are determinants of childhood and adult lung function [50].…”

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