Inhaled glucocorticosteroids decrease hydrogen peroxide level in expired air condensate in asthmatic patients

Abstract

H2O2 is elevated in the exhaled air condensate in several inflammatory disorders of the lung, including bronchial asthma, and thus may reflect inflammatory processes in the airways. Exhaled H2O2 may be used to guide the anti-inflammatory treatment of patients with asthma. Therefore in this study we analysed the effect of inhaled glucocorticosteroid beclomethasone for 4 weeks on H2O2 level in the exhaled air condensate. Seventeen asthmatics and 10 healthy subjects were included to the study. Eleven patients were given inhaled beclomethasone and six were given placebo (3M Health Care). In all patients pulmonary function tests were performed. H2O2 in the expired air condensate was measured spectrofluorimetically (homovanillic acid method). Inhaled beclomethasone significantly decreased H2O2 in the expired air condensate in the active-treatment group, with a fall from baseline on day 1 which remained on day 43 (follow-up) (P<0.05). Exhaled H2O2 in the active-treatment group was significantly lower than that in placebo group (P<0.05). A negative correlation between H2O2 and forced expiratory volume in 1 sec (FEV1) on day 29 was observed. The decrease in exhaled H2O2 in the active-treatment group was accompanied by an improvement in pulmonary function tests results. Inhaled glucocorticoids reduce the level of H2O2 in the expired air condensate of asthmatic patients over a 4-week period and this may reflect their anti-inflammatory activity in lung diseases.

Exhaled breath condensate: methodological recommendations and unresolved questions

“…Furthermore, a circadian rhythm of exhaled H 2 O 2 was shown in healthy subjects with highest levels at 12:00 and 24:00 h and also in patients with COPD [13]. Increase in EBC H 2 O 2 level was found in asthma [22,58,60,[71][72][73], healthy smokers [35,39], COPD [34,44,45,59,65,74,75], bronchiectasis [76,77], CF [78,79] and acute respiratory distress syndrome (ARDS) [5,80,81], acute hypoxaemic respiratory failure [14], reperfusion injury [82], allergic rhinitis [83], common cold [84], post-operative period after lung resection [85], systemic sclerosis [86] and in experimental models of hypoxia/reoxygenation [87,88].…”

“…In patients with exacerbations higher peroxide levels were reported than in patients with stable disease and treatment with corticosteroids lowered its concentration, but no change was reported after treatment with montelukast [58,72,73]. Expired H 2 O 2 level was shown to be elevated both in healthy smokers [39] and also in patients with COPD compared with values from healthy nonsmokers with no significant difference between their values [44][45][46].…”

A Sensitive Chemiluminescence Method for the Determination of H2O2 in Exhaled Breath Condensate

“…Oxidative stress is mainly produced by inflammatory eosinophils, macrophages and neutrophils, primarily as a defence mechanism against invading organisms. 1,2 Oxidants in EBC have been implicated in the pathophysiology of various respiratory diseases, including bronchial asthma, 3 chronic obstructive pulmonary disease, 4-6 pneumonia, 7 adult respiratory distress syndrome 8 and cystic fibrosis, 9 as well as in asymptomatic cigarette smokers. 10,11 The pathogenesis of these respiratory diseases results from the production of reactive oxygen species (ROS), which cause tissue damage and cell death.…”

Biomarkers in asthma and allergic rhinitis

“…[92]. Alternatively, in patients with similar asthma characteristics, anti-inflammatory therapy with ICS effectively reduced exhaled H 2 O 2 along with improvement in FEV 1 [91,95]. The eicosanoids LTs and 8-isoprostane can be measured in EBC by an enzyme immunoassay (EIA) or by gas chromatography/mass spectrometry [96].…”