“Haemoxygenase-1 induction and exhaled markers of oxidative stress in lung diseases”, summary of the ERS Research Seminar in Budapest, Hungary, September, 1999

Abstract

In recent years, there has been increasing interest in noninvasive monitoring of airway inflammation and oxidative stress. Several volatile and nonvolatile substances can be measured in exhaled breath and have been suggested as potential biomarkers of these events.Exhaled gases, including carbon monoxide (CO), alkanes (ethane, pentane), and substances measured in breath condensate, such as hydrogen peroxide (H2O2) and isoprostanes were all suggested as potential markers of oxidative stress in the lung.A European Respiratory Society (ERS) International Research Seminar entitled “Haemoxygenase-1 induction and exhaled markers of oxidative stress in lung diseases” was organized by the Airway Regulation and Provocation Group of the Clinical Allergy and Immunology Assembly in Budapest, Hungary in September, 1999 to integrate the latest knowledge on these issues and accelerate further improvement in this area. During this 2-day event several issues were raised about: the use and standardization of measurements in exhaled breath; problems of measuring expired H2O2and other mediators in breath condensate; role and regulation of haemoxygenase (HO)-1 in the lung; and conditions and factors influencing exhaled CO.This report is a summary of the main presentations at the seminar, together with the current areas of research in this rapidly expanding field.

Hydrogen Peroxide in Exhaled Breath Condensate in Asthmatic Children during Acute Exacerbation and after Treatment

“…We used the fluorometric method [33,34], even if the lack of established reference values has not permitted to ascertain sensitivity and specificity and has hampered the validation of measurements [35]. However, data reproducibility has been shown in a previous study by Goldoni et al [20].…”

End-tidal Carbon Monoxide Levels in Prematurely Born Infants Developing Bronchopulmonary Dysplasia

“…CO is produced endogenously in lung tissue as a by-product of this reaction (6). Not surprisingly, then, exhaled CO levels have been shown to be increased in a number of inflammatory lung conditions including asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) (7).…”

“…Inflammatory mediators can induce an isoform of hemoxygenase (HO), an enzyme that catalyses the rate-limited oxidative cleavage of hemoglobin (6). CO is produced endogenously in lung tissue as a by-product of this reaction (6).…”

Breath Analysis: Potential for Clinical Diagnosis and Exposure Assessment

“…There were no significant differences between males and females. The authors concluded that the spectrum of alkanes in the breath of healthy humans contains apparent markers of oxidative stress (27 ). Furthermore, they found significantly increased concentrations of breath markers indicative of oxidative stress in younger as well as older persons compared with individuals 20 -40 years of age (21 ), in women with uncomplicated pregnancies (20 ), in women with preeclampsia (20 ), and in patients with diabetes mellitus (19 ).…”

“…Exhaled concentrations of ethane and n-pentane can therefore be used to monitor the degree of oxidative damage in the body (9,23 ). In addition, H 2 O 2 measured in breath condensate is considered a breath marker of oxidative stress in lung diseases as well as a marker of oxygen radical-mediated tissue damage in cystic fibrosis (CF) (27)(28)(29)(30) and 8-isoprostane in the EBC of patients with COPD and assessed the relationship between the above markers of oxidative stress and indices of inflammatory process and disease severity. They concluded that H 2 O 2 and 8-isoprostane concentrations are increased in the EBC of patients with COPD but that H 2 O 2 seems to be a more repeatable and more sensitive index of the inflammatory process and disease severity.…”