Determinants of Exhaled Breath Condensate pH in a Large Population With Asthma

Liu, Lei; Teague, W. Gerald; Erzurum, Serpil C.; Fitzpatrick, Anne M.; Mantri, Sneha; Dweik, Raed A.; Bleecker, Eugene R.; Meyers, Deborah A.; Busse, William W.; Calhoun, William J.; Castro, Mario; Chung, Kian Fan; Curran‐Everett, Douglas; Israel, Elliot; Jarjour, Wael; Moore, Wendy C.; Peters, Stephen P.; Wenzel, Sally E.; Hunt, J.F.; Gaston, Benjamin

doi:10.1378/chest.10-0163

Cited by 63 publications

(44 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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].…”

Section: Discussionmentioning

confidence: 66%

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

Lozano¹,

Cruz²,

Piquer³

et al. 2014

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Introduction: The aim of this study was to evaluate the effectiveness of specific immunotherapy (SIT) management with allergoids in children with allergic asthma by monitoring changes in clinical parameters and inflammatory markers in exhaled breath. Methods: The study population included 43 patients (24 males) of 6-14 years of age, who had allergic asthma and were sensitized to mites. Twenty-three individuals were treated with subcutaneous SIT (PURETHALt Mites, HAL Allergy) for 8 months, i.e. the SIT group, and 20 were given medication to treat symptoms only, i.e. the control group. Before treatment and after 4 and 8 months, several clinical parameters, the levels of exhaled nitric oxide and the pH of exhaled breath condensate (EBC) were determined. Results: The SIT group presented with an improvement in asthma classification, a reduction in maintenance drug therapy and improved scores on the quality-of-life questionnaire. These changes were not observed in the control group. Both groups presented significant decreases in EBC pH values at 4 and 8 months after treatment compared to at baseline. However, analysis of the variable ‘ratio' showed an increase in the EBC pH values after 8 months of treatment in the SIT group compared with the values at 4 months. Conclusions: SIT with standardized mite extract reduces asthma symptoms in children. A decrease in EBC pH values was observed in both groups, although the SIT group presented a tendency of recovered values after 8 months. Future studies of EBC pH monitoring in the longer term are needed to determine the effectiveness of this marker. i 2014 S. Karger AG, Basel

show abstract

Section: Discussionmentioning

confidence: 66%

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

Lozano¹,

Cruz²,

Piquer³

et al. 2014

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…Therefore, as BMI increases in subjects with asthma, a reduced L-arginine/ADMA results in greater airway epithelial iNOS uncoupling. This may explain why several studies have found lower FE NO levels in obese subjects with asthma and potentially why higher BMI has been associated with greater airway oxidative stress (1)(2)(3)(4). This mechanism may be potentially constrained to the airways, as biomarkers of systemic oxidative stress have been found not to explain the obesity-asthma association (24).…”

Section: Discussionmentioning

confidence: 99%

“…Although adiposity imposes an important load on the respiratory system, beyond worsening dyspnea, there is little evidence that obesity affects asthma by increasing traditional biomarkers of airway inflammation or bronchial hyperresponsiveness. In fact, increasing body mass index (BMI) has been paradoxically associated with reduced levels of fractional exhaled nitric oxide (FE NO ) and sputum eosinophils (1)(2)(3)(4). In addition, cluster analyses identify obesity as part of a phenotype characterized by less atopy and adult-onset asthma, with additional analyses suggesting obesity may be causally related to asthma among those with adult-onset asthma with less atopy (5,6).…”

mentioning

confidence: 99%

An Association between l-Arginine/Asymmetric Dimethyl Arginine Balance, Obesity, and the Age of Asthma Onset Phenotype

Holguín

Comhair

Hazen

et al. 2013

Am J Respir Crit Care Med

Self Cite

154

114

View full text Add to dashboard Cite

Rationale: Increasing body mass index (BMI) has been associated with less fractional exhaled nitric oxide (FE NO ). This may be explained by an increase in the concentration of asymmetric dimethyl arginine (ADMA) relative to L-arginine, which can lead to greater nitric oxide synthase uncoupling. Objectives: To compare this mechanism across age of asthma onset groups and determine its association with asthma morbidity and lung function. The log of plasma L-arginine/ADMA was inversely correlated with BMI in the late-(r ¼ 20.4, P ¼ 0.0006) in contrast to the early-onset phenotype (r ¼ 20.2, P ¼ 0.07). Although FE NO was inversely associated with BMI in the late-onset phenotype (P ¼ 0.02), the relationship was lost after adjusting for L-arginine/ADMA. Also in this phenotype, a reduced L-arginine/ADMA was associated with less IgE, increased respiratory symptoms, lower lung volumes, and worse asthma quality of life. Conclusions: In late-onset asthma phenotype, plasma ratios of L-arginine to ADMA may explain the inverse relationship of BMI to FE NO . In addition, these lower L-arginine/ADMA ratios are associated with reduced lung function and increased respiratory symptom frequency, suggesting a role in the pathobiology of the late-onset phenotype.Keywords: asthma; obesity; age of asthma onset; ADMA; arginine The extent to which obesity affects the health of people with asthma, and by what mechanisms, remains largely undetermined. Although adiposity imposes an important load on the respiratory system, beyond worsening dyspnea, there is little evidence that obesity affects asthma by increasing traditional biomarkers of airway inflammation or bronchial hyperresponsiveness. In fact, increasing body mass index (BMI) has been paradoxically associated with reduced levels of fractional exhaled nitric oxide (FE NO ) and sputum eosinophils (1-4). In addition, cluster analyses identify obesity as part of a phenotype characterized by less atopy and adult-onset asthma, with additional analyses suggesting obesity may be causally related to asthma among those with adult-onset asthma with less atopy (5, 6). In contrast, in those with childhood-onset more atopic asthma, the asthma appears to be causative for the weight gain (7). This difference in relationship among early-and late-onset asthma was conditionally confirmed in a study of obese subjects with asthma undergoing bariatric surgery (8). Loss of body weight improved respiratory Author Contributions: Contributed to manuscript preparation and design: F.H., S.S.K., S.C.E., S.E.W. Analyzed samples: S.C.E., R.W.P., S.L.H., S.A.A.C. Contributed with participant recruitment/sample: S.S.K., E.R.B., W.W.B., W.J.C., M.C., A.M.F., B.G., E.I., N.N.J., W.C.M., S.P.P., W.G.T., K.F.C., S.C.E., S.E.W.Correspondence and requests for reprints should be addressed to Fernando Holguin, M.D., M.P.H., Asthma Institute, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, MUH 628, 3459 Fifth Avenue, Pittsburgh, PA 15213. E-mail: holguinf@upmc.edu This article has an on...

show abstract

“…Hunt et al showed that pharyngeal acidification leads to decreased EBC pH within 15 min and proton-pump inhibitor (PPI)-responder chronic cough patients had lower EBC pH values [30]. In COPD patients [31] and in a large cohort of asthmatic subjects [32] reduced EBC pH was associated with GORD. In spite of the lack of difference in condensate pH between asthmatic patients with and without GORD in another study, EBC pH was increased in the GORD group after PPI treatment [33].…”

Section: Discussionmentioning

confidence: 99%

Exhaled Breath Condensate pH in Lung Cancer, the Impact of Clinical Factors

Bikov

Lázár

Gyulai

et al. 2015

Lung

View full text Add to dashboard Cite

show abstract

Determinants of Exhaled Breath Condensate pH in a Large Population With Asthma

Abstract: Asthma is a complex syndrome. Subjects who are not experiencing an exacerbation but have low EBC pH appear to be a unique subpopulation.

Cited by 63 publications

References 39 publications

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

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

An Association between l-Arginine/Asymmetric Dimethyl Arginine Balance, Obesity, and the Age of Asthma Onset Phenotype

Exhaled Breath Condensate pH in Lung Cancer, the Impact of Clinical Factors

Contact Info

Product

Resources

About