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EBC H₂O₂ Resources

Reference Type: Journal Article
Record Number: 45
Author: Baldwin, S. R.; Simon, R. H.; Grum, C. M.; Ketai, L. H.; Boxer, L. A.; Devall, L. J.
Year: 1986
Title: Oxidant activity in expired breath of patients with adult respiratory distress syndrome
Journal: Lancet
Volume: 1
Issue: 8471
Pages: 11-4
Label: 86090980
Keywords: *Breath Tests
Human
Hydrogen Peroxide/*analysis
Leukocyte Count
Muramidase/blood
Neutrophils/enzymology
Oxygen/analysis
Respiration, Artificial
Respiratory Distress Syndrome, Adult/blood/*metabolism/therapy
Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S.
Abstract: Hydrogen peroxide levels were measured in the breath condensate of 43 patients receiving mechanical ventilation. In 16 patients the mean breath condensate peroxide level was 1.68 +/- 0.35 mumol/l on the day they met diagnostic criteria for adult respiratory distress syndrome (ARDS). The peak breath condensate peroxide level in the 27 patients in whom ARDS did not develop was significantly lower (0.34 +/- 0.08 mumol/l). Plasma lysozyme, a measure of in-vivo neutrophil turnover, was significantly higher in ARDS than in non-ARDS patients (9.2 +/- 2.2 U/ml v 3.4 +/- 1.1 U/ml). These findings support the hypothesis that neutrophil activation and oxidant production are involved in the pathogenesis of ARDS.

Reference Type: Journal Article
Record Number: 38
Author: Sznajder, J. I.; Fraiman, A.; Hall, J. B.; Sanders, W.; Schmidt, G.; Crawford, G.; Nahum, A.; Factor, P.; Wood, L. D.
Year: 1989
Title: Increased hydrogen peroxide in the expired breath of patients with acute hypoxemic respiratory failure
Journal: Chest
Volume: 96
Issue: 3
Pages: 606-12
Label: 89356052
Keywords: Breath Tests
Human
Hydrogen Peroxide/*analysis
Intensive Care Units
Respiration, Artificial
Respiratory Distress Syndrome, Adult/etiology/*metabolism
Respiratory Insufficiency/etiology/*metabolism
Spectrophotometry
Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S.
Surgical Procedures, Operative
Abstract: Acute hypoxemic respiratory failure (AHRF) can result from diverse lung insults. Toxic oxygen metabolites have been implicated in this clinical condition and in animal models of pulmonary edema. Hydrogen peroxide (H2O2), an oxygen metabolite, mediates tissue injury. We measured H2O2 levels by a spectrophotometric technique in the breath condensate of 68 mechanically ventilated patients; 13 patients with normal lungs undergoing elective surgery had no such detectable levels of H2O2. Fifty-five patients in the ICU meeting criteria for the adult respiratory distress syndrome (ARDS) had a higher concentration of H2O2 in the expired breath condensate than ICU patients without pulmonary infiltrates (2.34 +/- 1.15 vs 0.99 +/- 0.72 mumol/L, p less than 0.005). This marker had a sensitivity of 87.5 percent and a specificity of 81.3 percent in separating the two patient populations. Patients with AHRF and focal pulmonary infiltrates who did not meet criteria for ARDS also had higher concentrations of H2O2 (2.45 +/- 1.55 mumol/L) than patients without pulmonary infiltrates (p less than 0.001). No difference was observed between the expired H2O2 concentrations of patients with ARDS or patients with focal pulmonary infiltrates. Patients with brain injury or sepsis tended to have higher levels of H2O2 regardless of lung pathology. Increased levels of H2O2 are detected in the expired breath of ICU patients with focal lung infiltrates and in ARDS patients, which is consistent with the hypothesis that oxygen metabolites participate in the pathogenesis of ARDS and other forms of AHRF.

Reference Type: Journal Article
Record Number: 34
Author: Wilson, W. C.; Swetland, J. F.; Benumof, J. L.; Laborde, P.; Taylor, R.
Year: 1992
Title: General anesthesia and exhaled breath hydrogen peroxide
Journal: Anesthesiology
Volume: 76
Issue: 5
Pages: 703-10
Label: 92246318
Keywords: *Anesthesia, General
Anesthesia, Inhalation
Anesthesia, Intravenous
Breath Tests
Cardiopulmonary Bypass
Comparative Study
Human
Hydrogen Peroxide/*analysis
*Isoflurane
*Nitrous Oxide
Random Allocation
Respiratory Distress Syndrome, Adult/metabolism/surgery
Spectrophotometry
Support, Non-U.S. Gov't
Abstract: To study the role of free radical formation on the impairment of pulmonary function seen with general anesthesia, we measured the hydrogen peroxide (H2O2) concentration in the Exhaled Breath Condensate of 27 patients. Patients were divided into three study groups: a healthy patient group (group 1, n = 15) consisting of ASA physical status 1 and 2 patients undergoing elective noncardiothoracic surgery; a specific anesthetic event group (group 2, n = 6) composed of patients undergoing cardiopulmonary bypass (CPB); and a positive control group (group 3, n = 6) consisting of patients with the adult respiratory distress syndrome (ARDS). The Exhaled Breath Condensate was collected by diverting exhaled breath through a glass condensation coil submerged in an ice/salt water bath. The Exhaled Breath Condensate samples were then assayed using a spectrophotometric method. In group 1, samples were collected before and after the induction of general anesthesia with intravenous drugs, and before and after the administration of the inhalational anesthetics isoflurane (1.5%) (n = 7) or N2O (70%) (n = 8). In group 2, samples were collected pre- and post-CPB, and in group 3, when specific diagnostic criteria for ARDS were met. There was no significantly detectable H2O2 (not significantly different from zero) in any of the samples from the group 1 patients. Similarly, group 2 patients had exhaled breath H2O2 concentrations near zero except for one patient who was positive for the lupus anticoagulant. Group 3 patients had a mean (+/- SE) exhaled breath H2O2 concentration of 0.55 (+/- 0.08) microM, which was significantly greater than zero (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Reference Type: Journal Article
Record Number: 29
Author: Dohlman, A. W.; Black, H. R.; Royall, J. A.
Year: 1993
Title: Expired breath hydrogen peroxide is a marker of acute airway inflammation in pediatric patients with asthma
Journal: Am Rev Respir Dis
Volume: 148
Issue: 4 Pt 1
Pages: 955-60
Label: 94028337
Keywords: Acute Disease
Adolescence
Asthma/*physiopathology
Biological Markers/analysis
Breath Tests/methods
Bronchitis/*physiopathology
Child
Comparative Study
Female
Human
Hydrogen Peroxide/*analysis
Male
Respiratory Function Tests/statistics & numerical data
Support, Non-U.S. Gov't
Support, U.S. Gov't, P.H.S.
Abstract: Airway inflammation is important in the development and progression of many pulmonary disorders, including asthma. We hypothesized that the hydrogen peroxide (H2O2) concentration in expired breath may be a marker of airway inflammation. Expired breath condensate was collected by cooling and the H2O2 concentration was measured fluorimetrically. Thirty-five samples were collected from 22 pediatric patients with asthma who were 7 to 18 yr of age and from 11 healthy, nonasthmatic controls. Asthmatic subjects were determined to be well or sick (acute disease of the upper or lower respiratory tract) by clinical examination. Pulmonary function tests were determined to be abnormal if there was a > 15% reduction in FEV1 or > 20% reduction in FEF25-75 compared with baseline values. Expired breath H2O2 was elevated in asthmatic subjects compared with controls (0.81 +/- 0.70 versus 0.25 +/- 0.27 mumol/L). The difference was primarily due to elevation of H2O2 in sick asthmatic subjects, whose expired breath H2O2 level of 1.5 +/- 0.5 (n = 10) was different from that of well asthmatics (0.54 +/- 0.56, n = 25). There was a high correlation between expired breath H2O2 and clinical status. Elevation of expired H2O2 occurred with either acute upper or lower respiratory tract disease. There was no statistically significant correlation between expired breath H2O2 level and pulmonary function test results. We conclude that elevation of H2O2 in the expired breath condensate is a simple, noninvasive method that can be used as a biochemical marker of airway inflammation.

Reference Type: Journal Article
Record Number: 31
Author: Kietzmann, D.; Kahl, R.; Muller, M.; Burchardi, H.; Kettler, D.
Year: 1993
Title: Hydrogen peroxide in expired breath condensate of patients with acute respiratory failure and with ARDS
Journal: Intensive Care Med
Volume: 19
Issue: 2
Pages: 78-81
Label: 93253194
Keywords: Adolescence
Adult
Aged
Blood Gas Analysis
*Breath Tests/instrumentation/methods
Female
Human
Hydrogen Peroxide/*analysis
Intensive Care Units
Lung Compliance
Male
Middle Age
Predictive Value of Tests
Prognosis
Pulmonary Gas Exchange
Respiration, Artificial
Respiratory Distress Syndrome, Adult/*diagnosis/therapy
Respiratory Insufficiency/*diagnosis/therapy
Risk Factors
Support, Non-U.S. Gov't
Survival Rate
Tidal Volume
Abstract: OBJECTIVE: Measurement of hydrogen peroxide concentrations in breath condensate of mechanically ventilated patients with ARDS and with risk factors for developing ARDS. DESIGN: Open study in intensive care patients. SETTING: Intensive care units of the Clinics of the University of Gottingen, a primary care center. PATIENTS: 10 post- operatively ventilated patients as a control group and 26 patients with acute respiratory failure, 7 of them with ARDS, 12 with polytrauma, 4 with pneumonia, 3 with cardiogenic or nephrogenic pulmonary edema. INTERVENTIONS: None. MEASUREMENTS: Breath condensate was collected by a special cold trap and was analysed for H2O2 by a chemiluminescence method. Daily measurements were performed for 4.2 +/- 2.6 days (mean +/- SD) as soon as possible after manifestation of respiratory failure. RESULTS: Patients with acute respiratory failure exhibited higher H2O2 concentrations than control patients (median 95 nmol/l, range 76-144 nmol/l), with the highest median value found in the ARDS group (552 nmol/l, range 154-893). After clinical improvement, H2O2 concentrations decreased to the range of the control group. CONCLUSION: Since high concentrations of H2O2 in breath condensate were only found in patients with ARDS or with risk factors for ARDS, the results add to the existing evidence that reactive oxygen species are associated with some acute lung diseases. Notes: Using Smart Source Parsing

Reference Type: Journal Article
Record Number: 24
Author: Dekhuijzen, P. N.; Aben, K. K.; Dekker, I.; Aarts, L. P.; Wielders, P. L.; van Herwaarden, C. L.; Bast, A. Year: 1996
Title: Increased exhalation of hydrogen peroxide in patients with stable and unstable chronic obstructive pulmonary disease
Journal: Am J Respir Crit Care Med Volume: 154
Issue: 3 Pt 1
Pages: 813-6
Label: 96406509
Keywords: Aged
Aged, 80 and over
Breath Tests
Comparative Study
Female
Forced Expiratory Volume
Human
Hydrogen Peroxide/analysis/*metabolism
Lung Diseases, Obstructive/classification/*metabolism/physiopathology
Male
Middle Age
Pulmonary Gas Exchange
Reference Values
Severity of Illness Index
Abstract: An imbalance between oxidative stress and antioxidative capacity is thought to play an important role in the development and progression of chronic obstructive pulmonary disease (COPD). To assess the lung oxidative status in patients with COPD, we studied whether exhaled hydrogen peroxide (H2O2) is increased in breath condensate of patients with stable COPD (n = 12, mean FEV1 51% pred) and in patients with exacerbated COPD (n = 19, actual FEV1 36% pred) compared with a healthy control group (n = 10, FEV1 108% pred). Expired breath condensate during 15 min of tidal breathing was collected by cooling. The concentration of H2O2 was measured spectrophotometrically by means of horse radish peroxidase-catalyzed oxidation of tetramethylbenzidine. Concentrations of H2O2 (mean +/- SEM) were significantly elevated at 0.205 +/- 0.054 microM in patients with stable COPD compared with 0.029 +/- 0.012 microM in the control group (p 0.05) and were further increased to 0.600 +/- 0.075 microM in patients with acutely exacerbated COPD (p 0.001 compared with patients with stable COPD). Patients with pulmonary infiltrates on chest radiograph showed similar values compared with patients without obvious infiltrates. These findings demonstrate that patients with stable COPD exhibit increased oxidant production in the airways and that oxidant production increases further during exacerbations.

Reference Type: Journal Article
Record Number: 26
Author: Nowak, D.; Antczak, A.; Krol, M.; Pietras, T.; Shariati, B.; Bialasiewicz, P.; Jeczkowski, K.; Kula, P. Year: 1996
Title: Increased content of hydrogen peroxide in the expired breath of cigarette smokers
Journal: Eur Respir J
Volume: 9
Issue: 4
Pages: 652-7
Label: 96326841
Keywords: Adult
*Breath Tests
Comparative Study
Cotinine/analysis/urine
Female
Human
Hydrogen Peroxide/*analysis
Male
Middle Age
Smoking/*metabolism
Support, Non-U.S. Gov't
Abstract: Cigarette smoking causes an influx of mononuclear phagocytes and polymorphonuclear leucocytes into the lower airways. These cells have altered oxygen metabolism and release more H2O2 than phagocytes from nonsmokers. In this study, we intended to determine whether asymptomatic cigarette smokers exhale more H2O2 than healthy nonsmokers. The content of H2O2 in the expired condensate of 27 nonsmokers and 33 cigarette smokers was measured spectrofluorimetrically (homovanillic acid method). The mean H2O2 level in the expired breath condensate of all cigarette smokers was about fivefold higher than that found in the whole nonsmoker group (0.24 +/- 0.32 versus 0.05 +/- 0.11 nM). However, only 16 smokers (49%) and 6 nonsmokers (22%) had detectable levels of H2O2 in expired breath that reached values 0.49 +/- 0.28 and 0.23 +/- 0.10 nM, respectively. Although the cigarette smoking status was similar for both male and female smokers, females expired 2.5 fold less H2O2 than males (0.15 +/- 0.24 (n = 21) versus 0.38 +/- 0.39 (n = 12) nM. No correlation was found between expired H2O2 levels and cigarette smoking status expressed as the daily cigarette consumption, cumulative cigarette consumption and urinary cotinine concentration. It is suggested that in some smokers, expressed H2O2 can be a noninvasive marker of oxidant overload in the lower airways related to cigarette smoking.

Reference Type: Journal Article
Record Number: 19
Author: Antczak, A.; Nowak, D.; Shariati, B.; Krol, M.; Piasecka, G.; Kurmanowska, Z. Year: 1997
Title: Increased hydrogen peroxide and thiobarbituric acid-reactive products in expired breath condensate of asthmatic patients
Journal: Eur Respir J
Volume: 10
Issue: 6
Pages: 1235-41
Label: 97336127
Keywords: Adult
Asthma/*metabolism/physiopathology
*Breath Tests
Female
Forced Expiratory Volume
Human
Hydrogen Peroxide/*analysis
Male
Peak Expiratory Flow Rate
Support, Non-U.S. Gov't
Thiobarbituric Acid Reactive Substances/*analysis
Abstract: Symptoms of bronchial asthma are a manifestation of airway inflammation. Circulatory leucocytes (predominantly eosinophils, mast cells and neutrophils), release inflammatory mediators, including reactive oxygen species, i.e. superoxide anion which is dismutated to hydrogen peroxide (H2O2). Neutrophils from asthmatics generate greater amounts of these species than those of healthy subjects. Some of the H2O2 and thiobarbituric acid-reactive products (TBARs) can evaporate from alveolar lining fluid, and could be expired from the airways of asthmatics. In this study, therefore, we determined whether asthmatic patients exhale more H2O2 and TBARs than healthy subjects. We examined 10 healthy subjects as a control group and 21 asthmatic subjects. In asthmatic subjects, forced expiratory volume in one second (FEV1), was 68+/-9% of predicted value, peak expiratory flow rate (PEFR) was 65+/- 8% pred, and bronchial reversibility was 34+/-5% of prebronchodilated FEV1. The mean H2O2 level measured spectrofluorimetrically in the expired breath condensate of asthmatic subjects was 26 fold higher than that in healthy controls (0.26+/-0.29 vs 0.01+/-0.03 nM; p0.05). The concentration of TBARs in breath condensate was also higher in asthmatic patients compared with nonasthmatics (0.073+/-0.071 vs 0.004+/-0.009 nM; p0.05). There was a significant correlation between H2O2 level and concentration of TBARs in asthmatic patients (r=0.74; p0.01). There was also a strong inverse correlation between H2O2 content of all asthmatics and FEV1% pred (r=-0.63; p0.005) and PEFR% pred (r=-0.52; p0.05). We conclude that there are elevated levels of hydrogen peroxide and thiobarbituric acid-reactive products in expired breath condensate of asthmatic patients, and that measurement of these substances in the expired breath condensate could be a simple, noninvasive method that could be used as a biochemical marker of airway inflammation.

Reference Type: Journal Article
Record Number: 22
Author: Jobsis, Q.; Raatgeep, H. C.; Hermans, P. W.; de Jongste, J. C.
Year: 1997
Title: Hydrogen peroxide in exhaled air is increased in stable asthmatic children
Journal: Eur Respir J
Volume: 10
Issue: 3
Pages: 519-21
Label: 97225708
Keywords: Adult
Anti-Asthmatic Agents/therapeutic use
Anti-Inflammatory Agents, Steroidal/therapeutic use
Asthma/*diagnosis/drug therapy/physiopathology
Breath Tests
Case-Control Studies
Child
Comparative Study
Cross-Sectional Studies
Female
Human
Hydrogen Peroxide/*analysis
Male
Support, Non-U.S. Gov't
Abstract: Exhaled air condensate provides a noninvasive means of obtaining samples from the lower respiratory tract. Hydrogen peroxide (H2O2) in exhaled air has been proposed as a marker of airway inflammation. We hypothesized that in stable asthmatic children the H2O2 concentration in exhaled air condensate may be elevated as a result of airway inflammation. In a cross-sectional study, 66 allergic asthmatic children (of whom, 41 were treated with inhaled steroids) and 21 healthy controls exhaled through a cold trap. The resulting condensate was examined fluorimetrically for the presence of H2O2. All subjects were clinically stable, nonsmokers, without infection. The median H2O2 level in the exhaled air condensate of the asthmatic patients was significantly higher than in healthy controls (0.60 and 0.15 micromol, respectively; p0.05), largely because of high values in the stable asthmatic children who did not use anti-inflammatory treatment (0.8 micromol; p0.01 compared to controls). We conclude that hydrogen peroxide is elevated in exhaled air condensate of children with stable asthma, and may reflect airway inflammation.

Reference Type: Journal Article
Record Number: 15
Author: Jobsis, Q.; Raatgeep, H. C.; Schellekens, S. L.; Hop, W. C.; Hermans, P. W.; de Jongste, J. C. Year: 1998
Title: Hydrogen peroxide in exhaled air of healthy children: reference values
Journal: Eur Respir J
Volume: 12
Issue: 2
Pages: 483-5
Label: 98394789
Keywords: *Breath Tests
Child
Female
Human
Hydrogen Peroxide/*analysis
Male
Reference Values
Reproducibility of Results
Respiratory Function Tests
Support, Non-U.S. Gov't
Abstract: An increased content of hydrogen peroxide (H2O2), a marker of inflammation, has been described in the condensate of exhaled air from adults and children with inflammatory lung disorders, including asthma. However, the normal range of [H2O2] in the exhaled air condensate from healthy children has not been established. Therefore, the aim of this study was to determine the reference range of exhaled [H2O2] in healthy school-aged children. Ninety-three healthy nonsmoking children (48 female and 45 male, mean age 10 yrs, range 8-13 yrs), with a negative history for allergy, eczema or respiratory disease and with a normal lung function, participated. Exhaled air condensate was examined fluorimetrically for the presence of H2O2. In addition, the reproducibility of [H2O2] within subjects and between days and the stability of [H2O2] during storage at -20 degrees C were assessed. The median [H2O2] in the exhaled air condensate of all children was 0.13 microM, with a 2.5-97.5% reference range of 0.01-0.48 microM. No significant difference existed between males and females. There was no correlation between exhaled [H2O2] and age or lung function. Repeated [H2O2] measurements on 2 consecutive days showed satisfactory within- subject reproducibility and [H2O2] in stored samples remained stable for at least 1 month at -20 degrees C. In conclusion, this study provides reference data for exhaled hydrogen peroxide in a large group of healthy children. The observed levels were lower than those reported previously for healthy adults and were independent of age, sex and lung function.

Reference Type: Journal Article
Record Number: 14
Author: Loukides, S.; Horvath, I.; Wodehouse, T.; Cole, P. J.; Barnes, P. J. Year: 1998
Title: Elevated levels of expired breath hydrogen peroxide in bronchiectasis
Journal: Am J Respir Crit Care Med
Volume: 158
Issue: 3
Pages: 991-4
Label: 98402685
Keywords: Administration, Inhalation
Adult
Androstadienes/administration & dosage/therapeutic use
Bronchiectasis/*metabolism/pathology/physiopathology
Bronchitis/metabolism/pathology/physiopathology
Case-Control Studies
Comparative Study
Disease Progression
Eosinophils/metabolism
Female
Forced Expiratory Volume/physiology
Glucocorticoids, Topical/administration & dosage/therapeutic use
Human
Hydrogen Peroxide/*analysis
Lung/physiopathology
Macrophages, Alveolar/metabolism
Male
Middle Age
Neutrophils/metabolism
Oxidative Stress/physiology
Reactive Oxygen Species/metabolism
*Respiration
Respiratory Burst/physiology
Abstract: Airway inflammation is important in the development and progression of many lung diseases, including bronchiectasis. Activation of inflammatory cells such as neutrophils, eosinophils, and macrophages induces a respiratory burst resulting in the production of reactive oxygen species such as hydrogen peroxide (H2O2). We have measured exhaled H2O2 in patients with documented bronchiectasis and investigated whether the concentration of H2O2 is related to the disease severity, as defined by lung function. We also investigated whether the concentrations of expired H2O2 were different in bronchiectatic patients who received inhaled corticosteroids compared with steroid-naive patients. In 37 patients with bronchiectasis (mean age, 45 +/- 2.5 yr; FEV1, 59 +/- 3% pred), mean H2O2 concentration in Exhaled Breath Condensate was significantly elevated as compared with the values in 25 age-matched (mean age, 42 +/- 2 yr) normal subjects (0.87 +/- 0.01 versus 0.26 +/- 0.04 microM, p 0.05). We conclude that H2O2 is elevated in exhaled air condensate of patients with bronchiectasis and is correlated with disease severity. Measurement of H2O2 may be used as a simple noninvasive method to monitor airway inflammation and oxidative stress.
URL: http://www.ncbi.nlm.nih.gov/cgi-bin/Entrez/referer?http://www.ajrccm.org/cgi/content/full/158/3/991

Reference Type: Journal Article
Record Number: 12
Author: Nowak, D.; Kasielski, M.; Pietras, T.; Bialasiewicz, P.; Antczak, A.
Year: 1998
Title: Cigarette smoking does not increase hydrogen peroxide levels in expired breath condensate of patients with stable COPD
Journal: Monaldi Arch Chest
Dis Volume: 53
Issue: 3
Pages: 268-73
Label: 99001988
Keywords: Breath Tests
Case-Control Studies
Female
Human
Hydrogen Peroxide/*metabolism
Lung Diseases, Obstructive/complications/diagnosis/*metabolism
Male
Middle Age
Oxidants/*metabolism
Smoking/*adverse effects
Abstract: Cigarette smoking is the most common factor responsible for the development of chronic obstructive pulmonary disease (COPD) leading to oxidant overload in the lower airways because of the presence of oxidants in cigarette smoke and recruitment and activation of pulmonary phagocytes. In this study we intended to determine whether: 1) patients with stable COPD have higher H2O2 levels in expired breath condensate than healthy nonsmoking subjects and 2) whether cigarette smoking increases H2O2 exhalation in patients with stable COPD. The H2O2 content of the expired breath condensate of 17 healthy nonsmoking subjects and 38 patients (10 current smokers, 17 exsmokers and 11 who have never smoked) with stable COPD (forced expiratory volume in one second (FEV1) 63.3 +/- 15.5% of predicted value) was measured spectrofluorimetrically (homovanillic acid method). The mean H2O2 concentration in the expired breath condensate of COPD subjects was 10- times higher than that found in healthy controls (0.55 +/- 0.69 microM versus 0.05 +/- 0.07 microM, p 0.005). There were no significant differences between H2O2 levels found in current smokers with COPD (0.44 +/- 0.56 microM) and COPD subjects who have never smoked (0.49 +/- 0.70 microM). No correlation was found between expired H2O2 and daily cigarette consumption or cumulative cigarette consumption in current smokers or exsmokers with COPD. These findings demonstrate that subjects with stable chronic obstructive pulmonary disease exhibit increased H2O2 generation in the airways and that cigarette smoking does not increase H2O2 production.

Reference Type: Journal Article
Record Number: 111
Author: Antczak, A.; Nowak, D.; Bialasiewicz, P.; Kasielski, M.
Year: 1999
Title: Hydrogen peroxide in expired air condensate correlates positively with early steps of peripheral neutrophil activation in asthmatic patients
Journal: Arch Immunol Ther Exp
Volume: 47
Issue: 2
Pages: 119-26
Label: 99218890
Keywords: Adult
Asthma/blood/*immunology/*metabolism
Breath Tests
Calcium/metabolism
Female
Human
Hydrogen Peroxide/analysis/*metabolism
Male
Middle Age
N-Formylmethionine Leucyl-Phenylalanine/pharmacology
Neutrophil Activation/*immunology
Neutrophils/drug effects/immunology
Pulmonary Alveoli/metabolism
Reactive Oxygen Species/metabolism
Abstract: We have found an increased H2O2 level in expired air of asthmatic patients. Neutrophils from these subjects generated higher amounts of superoxide radicals after challenge with phorbol esters than those from healthy subjects which may result from an increased activity of NADPH-oxidase. The enhanced Ca2+ mobilisation in neutrophils from asthmatics could be responsible for increased production and subsequent elevated H2O2 concentration in expired breath condensate. In this study we wished to determine whether neutrophils of asthmatic patients have enhanced [Ca2+]i response after N-formyl-methionyl-leucyl-phenylalanine--fMLP challenge as compared with cells from healthy donors, and if so, does it correlate with H2O2 levels in expired air. We examined 21 patients, 10 healthy individuals as a control group (mean age 34.3 +/- 5.5, 6 males and 4 females) and 11 asthmatic subjects (mean age 38.2 +/- 7.2, 7 males and 4 females). The rise of [Ca2+]i as an early event of neutrophil activation, was measured spectrofluorimetically with Fura-2-AM. The mean H2O2 level, measured spectrofluorimetrically in the expired breath of asthmatics, was 20-fold higher than that in healthy control (0.18 +/- 0.20 vs. 0.01 +/- 0.04 microM, p < 0.05). [Ca2+]i increase after challenge by fMLP (delta [Ca2+]i) was much higher in asthmatics than in control group (205.0 +/- 44 vs. 113.0 +/- 22 nM, p < 0.05, respectively). A strong correlation was observed between H2O2 and delta [Ca2+]i and maximal velocity of increase in [Ca2+]i in asthmatics (r = 0.87, p < 0.01 and r = 0.64, p < 0.05). We conclude that elevated H2O2 level in the expired breath condensate of asthmatics can be generated by activated neutrophils in the course of mucosal inflammation observed in bronchial asthma. Notes: Using Smart Source Parsing

Reference Type: Journal Article
Record Number: 106
Author: Heard, S. O.; Longtine, K.; Toth, I.; Puyana, J. C.; Potenza, B.; Smyrnios, N.
Year: 1999
Title: The influence of liposome-encapsulated prostaglandin E1 on hydrogen peroxide concentrations in the exhaled breath of patients with the acute respiratory distress syndrome
Journal: Anesth Analg
Volume: 89
Issue: 2
Pages: 353-7.
Label: 99368620
Keywords: Adult
Alprostadil/*administration & dosage
*Breath Tests
Drug Carriers
Female
Human
Hydrogen Peroxide/*analysis
Infusions, Intravenous
Leukocyte Count
Liposomes
Male
Middle Age
Respiratory Distress Syndrome, Adult/blood/*metabolism/therapy
Support, Non-U.S. Gov't
Abstract: Hydrogen peroxide (H2O2) levels are increased in the exhaled breath of patients with the acute respiratory distress syndrome (ARDS). Because liposome-encapsulated prostaglandin E1 (PGE1) downregulates the CD11/CD18 receptor of the neutrophil, thereby limiting endothelial adhesion, the use of this drug should decrease the excretion of H2O2 in the expiratory condensate of patients with ARDS. Patients > 11 yr of age with ARDS (diffuse, patchy infiltrates by chest radiograph; Pao2/fraction of inspired oxygen [P/F] ratio < or = 200 mm Hg; pulmonary capillary wedge pressure < or = 18 mm Hg; and the requirement for mechanical ventilation) were randomized to receive placebo (n = 14) or escalating doses (0.15-3.6 micrograms/kg) of liposomal PGE1 (n = 14) every 6 h for up to 7 days. Condensate was collected every morning from the expiratory tubing that was submerged in an ice saltwater bath (-5 degrees C). H2O2 levels were measured by using a horseradish peroxidase assay. Other data collected included white blood cell count and P/F ratios. There was no significant difference in the concentration of H2O2 in the expiratory condensate between the liposomal PGE1 group and the control group either before (0.99 +/- 0.52 vs 0.93 +/- 0.48 mumol/L) or during treatment (1.04 +/- 0.45 vs 0.76 +/- 0.25 mumol/L). Liposomal PGE1 treatment improved the P/F ratio and decreased the white blood cell count over time. Despite its ability to downregulate the CD11/CD18 neutrophil receptor, liposomal PGE1 did not reduce exhaled H2O2 excretion. Implications: White blood cells (WBC) are thought to be part of the cause of the acute respiratory distress syndrome, a lung disease. WBC in the lung produce hydrogen peroxide, which is exhaled. Liposomal PGE1 inhibits WBC function but was found to have no effect in decreasing exhaled hydrogen peroxide in patients with the acute respiratory distress syndrome.

Reference Type: Journal Article
Record Number: 94
Author: Ho, L. P.; Faccenda, J.; Innes, J. A.; Greening, A. P.
Year: 1999
Title: Expired hydrogen peroxide in breath condensate of cystic fibrosis patients
Journal: Eur Respir J
Volume: 13
Issue: 1
Pages: 103-6.
Label: 20294321
Keywords: Adult
Breath Tests
Cystic Fibrosis/*metabolism
Female
Human
Hydrogen Peroxide/*metabolism
Male
Support, Non-U.S. Gov't
Abstract: Stimulated inflammatory cells release large amounts of hydrogen peroxide (H2O2). Breath condensate H2O2 has been shown to be elevated in stable asthmatic children, chronic obstructive pulmonary disease and intubated adult respiratory distress syndrome. In cystic fibrosis airways, where neutrophilic inflammation dominates, it is postulated that H2O2 in breath condensate would be elevated and may be used as a marker of airways inflammation. Expired breath condensate was collected from 16 clinically stable cystic fibrosis (CF) patients (mean age 25.3 yrs, mean forced expiratory volume in one second (FEV1) 50.2%) and 14 normal subjects (mean age 29.9 yrs). Total plasma leukocyte, neutrophil, monocyte and eosinophil counts and lung function were also measured on the day of collection. A method of breath condensate collection excluding the confounding factors of nasal air and saliva contamination was validated and used and H2O2 measured fluorometrically using an optimized assay. The median level of H2O2 concentration in breath condensate of CF patients was lower than that in normal subjects (0.064 versus 0.089 microM), but this did not reach statistical significance (p = 0.20, Mann-Whitney rank sum test). Within the CF group, there was no correlation between H2O2 concentration and lung function. Expired breath condensate H2O2 is not elevated in patients with cystic fibrosis, and is thus not a suitable marker of airways inflammation in these patients. Possible explanations include physical barriers to its detection caused by viscous airways secretions, reaction with other reactive species or increased antioxidant activity caused by trapping of positively charged antioxidants in negatively charged airways secretions.

Reference Type: Journal Article
Record Number: 97
Author: Mumby, S.; Block, R.; Petros, A. J.; Gutteridge, J. M.
Year: 1999
Title: Hydrogen peroxide and catalase are inversely related in adult patients undergoing cardiopulmonary bypass: implications for antioxidant protection
Journal: Redox Rep
Volume: 4
Issue: 1-2
Pages: 49-52
Label: 20178654
Keywords: Adult
*Cardiopulmonary Bypass
Catalase/*metabolism
Glutathione/metabolism
Human
Hydrogen Peroxide/*metabolism
Oxidative Stress
Support, Non-U.S. Gov't
Abstract: Adult patients undergoing cardiopulmonary bypass (CPB) surgery are subjected to increased oxidative stress and show a spectrum of lung injury. Increased levels of hydrogen peroxide (H2O2) are often seen during episodes of oxidative stress, such as the use of high FiO2s, and this molecule plays a key role in the formation of highly damaging oxidants such as the hydroxyl radical. Oxidative damage to plasma proteins was assessed by measuring free thiol groups, and antioxidant protection against H2O2 by measuring catalase activity. CPB patients (n = 39) receiving either 100% or 50% oxygen at the end of bypass were studied by measuring levels of H2O2 in breath condensate and levels of catalase in their plasma, and comparing these to pre-bypass levels. Post-bypass, all CPB patients exhaled significantly lower levels of H2O2 (P < 0.0001) at a time when they had significantly increased activity (0.809 +/- 0.11 versus 1.688 +/- 0.18 U/mg protein) of catalase in their plasma. There were no significant differences in these parameters between the 100% and 50% oxygen groups. At a time when oxidative stress is greatest, there appears to be a corresponding plasma increase in the antioxidant catalase. Whether this change is fortuitous or a response to oxidative stress is at present under consideration. Notes: Using Smart Source Parsing

Reference Type: Journal Article
Record Number: 105
Author: Nowak, D.; Kasielski, M.; Antczak, A.; Pietras, T.; Bialasiewicz, P.
Year: 1999
Title: Increased content of thiobarbituric acid-reactive substances and hydrogen peroxide in the expired breath condensate of patients with stable chronic obstructive pulmonary disease: no significant effect of cigarette smoking
Journal: Respir Med
Volume: 93
Issue: 6
Pages: 389-96.
Label: 99394086
Keywords: Antioxidants/*adverse effects/metabolism
Biological Markers/analysis
Breath Tests
Female
Forced Expiratory Volume
Human
Hydrogen Peroxide/*metabolism
Lung Diseases, Obstructive/etiology/*metabolism
Male
Middle Age
Smoking/adverse effects/*metabolism
Thiobarbituric Acid Reactive Substances/*metabolism
Abstract: The imbalance between oxidants and antioxidants is known to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Cigarette smoking is the most frequent factor responsible for development of COPD by leading to oxidant overload in the lower airways, due to presence of its own oxidants and to recruitment and activation of pulmonary phagocytes. We aimed to determine whether (1) patients with stable COPD have higher thiobarbituric acid-reactive substances (TBARs, an end-product of lipid peroxidation) and H2O2 levels in expired breath condensate than healthy subjects who have never smoked; (2) COPD subjects who are current smokers exhale more TBARs and H2O2 than COPD ex-smokers and those who have never smoked; and (3) concentration of TBARs correlates with H2O2 levels in the breath condensate of COPD patients. The TBAR and H2O2 content in expired breath condensate of 17 healthy nonsmoking subjects and 44 patients (11 current smokers, 20 ex-smokers and 13 who had never smoked) with stable COPD [forced expiratory volume in 1 s (FEV1) 63.3 +/- 16.3% and FEV1 reversibility 5.2 +/- 4.3% predicted value] was measured spectrofluorimetrically by the thiobarbituric acid and homovanillic acid methods, respectively. The mean concentrations of TBARs and H2O2 in the expired breath condensate of COPD subjects were 12 (0.48-0.86 microM vs. 0.04 +/- 0.14 microM; P < 0.05) and 10 times (0.48 +/- 0.67 microM vs. 0.05 +/- 0.07 microM; P < 0.005) higher than in healthy controls. Current smokers with COPD did not exhale more H2O2 than COPD ex-smokers and those who had never smoked. TBARs levels shared only a tendency to be higher in the breath condensate of smoking COPD subjects than in that of ex-smokers (0.92 +/- 1.49 microM vs. 0.35 +/- 0.44 microM) and of COPD subjects who had never smoked (0.92 +/- 1.49 microM vs. 0.30 +/- 0.53 microM). No correlation was found between TBAR and H2O2 levels in the whole COPD group. These variables did not correlate with cigarette smoking status and the time from smoking cessation. Subjects with stable COPD exhibit increased lipid peroxidation and H2O2 generation in the airways. Current cigarette smoking does not distinguish COPD subjects with respect to TBARs and H2O2 exhalation.

Reference Type: Journal Article
Record Number: 91
Author: Antczak, A.; Kurmanowska, Z.; Kasielski, M.; Nowak, D.
Year: 2000
Title: Inhaled glucocorticosteroids decrease hydrogen peroxide level in expired air condensate in asthmatic patients
Journal: Respir Med
Volume: 94
Issue: 5
Pages: 416-21.
Label: 20324554
Keywords: Administration, Inhalation
Adult
Asthma/*drug therapy/physiopathology
Beclomethasone/*administration & dosage
Double-Blind Method
Female
Forced Expiratory Volume/physiology
Glucocorticoids, Synthetic/*administration & dosage
Human
Hydrogen Peroxide/*analysis
Male
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.

Reference Type: Journal Article
Record Number: 58
Author: De Benedetto, F.; Aceto, A.; Dragani, B.; Spacone, A.; Formisano, S.; Cocco, R.; Sanguinetti, C. M.
Year: 2000
Title: Validation of a new technique to assess exhaled hydrogen peroxide: results from normals and COPD patients
Journal: Monaldi Arch Chest Dis
Volume: 55
Issue: 3
Pages: 185-8.
Label: 20404463
Keywords: Adult
Aged
Aged, 80 and over
*Breath Tests
Evaluation Studies
Female
Human
Hydrogen Peroxide/*analysis
Lung Diseases, Obstructive/*diagnosis/therapy
Male
Middle Age
Abstract: Chronic airways inflammation in chronic obstructive pulmonary disease (COPD) induces the activation of several cell types with delivery of proteases and reactive oxygen species (ROS). Assessing oxidant content in the exhaled air of COPD patients has proven useful in monitoring airway inflammation. The present study was designed to confirm the usefulness of exhaled hydrogen peroxide concentration determination in COPD patients using a new technique which allows longer storage of the expired air condensate before the H2O2 assay. The technique was applied in 13 healthy nonsmoking subjects (six male, age range 22-40 yrs) and in seven patients (five male, age range 58-81 yrs) with mild or moderate COPD. Subjects breathed into a one-valve mouthpiece, and the exhaled air was directed into a vial kept at 0 degree C. After approximately 15 min of quiet breathing, 1 mL of expired air condensate was collected. An aliquot, 450 microL, of this sample was immediately added to an equal volume of a reaction mixture containing 2 mM 3,5,3',5'-tetramethylbenzidine and 40 microL of enzyme stock solution (0.5 mg.mL-1). After 15 min, 45 microL sulphuric acid was added (1 N final concentration), resulting in a reaction mixture pH of 1.0. After a further 10-min incubation, H2O2 concentration determination was performed spectrophotometrically at 450 nm. This solution, as well as the H2O2 assay, was stable for > or = 24 h if the sample was kept in the dark and at 4 degrees C. There was high stability on repeated measures, with a coefficient of variation equal to zero. The mean +/- SD H2O2 level in exhaled air from normal subjects was 0.12 +/- 0.09 microM, whereas it was significantly increased in COPD patients (0.50 +/- 0.11 microM; p = 0.0001 compared to healthy subjects). In three healthy control subjects, a normal H2O2 level in expired air increased to 0.70-0.80 microM during an acute upper respiratory tract infection. This new technique of hydrogen peroxide assay in expired air condensate greatly minimizes the inaccuracy deriving from the instability of hydrogen peroxide. The preliminary results obtained using this technique provide direct evidence for increased reactive oxygen species production in the airways of stable chronic obstructive pulmonary disease patients. However, the specificity of the procedure could be reduced by the interference of upper respiratory tract infections.

Reference Type: Journal Article
Record Number: 84
Author: Gibson, P. G.; Henry, R. L.; Thomas, P.
Year: 2000
Title: Noninvasive assessment of airway inflammation in children: induced sputum, exhaled nitric oxide, and breath condensate
Journal: Eur Respir J
Volume: 16
Issue: 5
Pages: 1008-15.
Label: 21026461
Keywords: *Breath Tests
Bronchitis/*diagnosis
Child, Preschool
Human
*Nitric Oxide
*Respiration
Sputum/*cytology
Abstract: Noninvasive markers of airway inflammation are needed for use in research and clinical practice in childhood asthma. Induced sputum and exhaled nitric oxide are well established as direct markers of inflammation for use in asthma research. Sputum can be induced from children of >6 yrs using inhalation of hypertonic saline, and, if appropriate, can be combined with an assessment of airway responsiveness to hypertonic saline. The success rate of sputum induction in children is 68-100%. Most studies have processed sputum using the plug selection method, and show that the dominant cell in sputum from normal children is the macrophage, and that the upper normal limit for sputum eosinophils in children is 2.5%. The inflammatory response in childhood asthma is characterized by elevated numbers of sputum eosinophils, and eosinophil cationic protein concentration, as well as increased nitric oxide and hydrogen peroxide levels in exhaled breath. Sputum eosinophils correlate with objective markers of disease severity in steroid-naive children with asthma, and in severe asthma. Inflammatory marker levels are lower in children using glucocorticosteroids. Induced sputum and exhaled gases are important markers of inflammation in childhood asthma. The clinical utility of these markers warrants further study.

Reference Type: Journal Article
Record Number: 55
Author: Guatura, S. B.; Martinez, J. A.; Santos Bueno, P. C.; Santos, M. L.
Year: 2000
Title: Increased exhalation of hydrogen peroxide in healthy subjects following cigarette consumption
Journal: Sao Paulo Med J
Volume: 118
Issue: 4
Pages: 93-8.
Label: 20347629
Keywords: Adult
Breath Tests
Female
Forced Expiratory Volume
Human
Hydrogen Peroxide/analysis/*metabolism
Lung Diseases, Obstructive/etiology
Male
Middle Age
Oxidants/analysis/*metabolism
Oxidative Stress
Prospective Studies
Smoking/*adverse effects
Spirometry
Abstract: CONTEXT: Increased hydrogen peroxide has been described in the expired breath condensate (H2O2-E) of several lung conditions, such as acute respiratory distress syndrome, chronic obstructive pulmonary disease and asthma. This technique has been advocated as being a simple method for documenting airway inflammation. OBJECTIVE: To evaluate H2O2-E in healthy cigarette smokers, and to determine the acute effects of the consumption of one cigarette on H2O2-E levels. TYPE OF STUDY: Prospective, controlled trial. SETTING: A pulmonary function laboratory in a University Hospital. PARTICIPANTS: Two groups of healthy volunteers: individuals who had never smoked (NS; n=10; 4 men; age = 30.6 +/- 6.2 years) and current cigarette smokers (S; n=12; 7 men; age = 38.7 +/- 9.8). None of the volunteers had respiratory symptoms and all showed normal spirometric tests. INTERVENTION: Expired air was collected from all volunteers through a face mask and a plastic collecting system leading into a flask with dry ice and pure ethanol. Samples from the group S were collected twice, before and half an hour after the combustion of one cigarette. MAIN MEASUREMENTS: Expired hydrogen peroxide using the Gallati and Pracht method. RESULTS: The S and NS groups showed comparable levels of H2O2-E at basal conditions [NS = 0.74 microM (DP 0.24) vs. S = 0.75 microM (DP 0.31)]. The smokers showed a significant increase in H2O2-E levels half an hour after the consumption of only one cigarette [0.75 microM (DP 0.31) vs. 0. 95 microM (DP 0.22)]. CONCLUSION: The present results are consistent with the concept that smokers increase oxidative stress with elevated production of reactive oxygen species, contributing to the development of smoking-related disorders. URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802000000400004&lng=en&nrm=iso

Reference Type: Journal Article
Record Number: 88
Author: Jobsis, Q.; Raatgeep, H. C.; Schellekens, S. L.; Kroesbergen, A.; Hop, W. C.; de Jongste, J. C.
Year: 2000
Title: Hydrogen peroxide and nitric oxide in exhaled air of children with cystic fibrosis during antibiotic treatment
Journal: Eur Respir J
Volume: 16
Issue: 1
Pages: 95-100.
Label: 20386212
Keywords: Acute Disease
Antibiotics/*therapeutic use
*Breath Tests
Child
Cystic Fibrosis/complications/metabolism/*pathology
Female
Forced Expiratory Volume
Human
Hydrogen Peroxide/*analysis
Male
Nitric Oxide/*analysis
Respiratory Tract Infections/complications/drug therapy
Support, Non-U.S. Gov't
Abstract: Cystic fibrosis (CF) patients characteristically have severe chronic airway inflammation associated with bacterial infection. A noninvasive marker of airway inflammation could be a useful guide to treatment of CF lung disease. The aim of this study was to assess whether measurement of hydrogen peroxide (H2O2) and nitric oxide (NO) in exhaled air can serve to monitor the effect of treatment with antibiotics in CF-children with acute infective pulmonary exacerbations. Sixteen CF-patients (mean age 12.3 yrs) with exacerbation of their lung infection were treated with intravenous antibiotics in an uncontrolled study. During treatment, H2O2 in exhaled air condensate was measured twice a week. In addition, serial NO measurements were performed in nine patients. During antibiotic treatment the median H2O2 concentration in exhaled air condensate decreased significantly from 0.28 microM (range 0.07-1.20 microM) to 0.16 microM (range 0.05-0.24 microM, p=0.002) and the mean forced expiratory volume in one second significantly increased from 55% predicted to 75% pred (p=0.001). In individual subjects, changes of H2O2 and FEV1 between pairs of serial measurements correlated weakly (p=0.08). Data on exhaled NO were inconclusive; exhaled NO did not change systematically during treatment. It is concluded that cystic fibrosis patients with an acute pulmonary exacerbation have abnormally high concentrations of hydrogen peroxide, but not of nitric oxide, in exhaled air, which decrease during intravenous antibiotic treatment. Further controlled studies should establish if exhaled hydrogen peroxide, may serve as a noninvasive parameter of airway inflammation to guide antibiotic treatment in cystic fibrosis lung disease.

Reference Type: Journal Article
Record Number: 96
Author: Lases, E. C.; Duurkens, V. A.; Gerritsen, W. B.; Haas, F. J.
Year: 2000
Title: Oxidative stress after lung resection therapy: A pilot study
Journal: Chest
Volume: 117
Issue: 4
Pages: 999-1003.
Label: 20231583
Keywords: Aged
Biological Markers
Breath Tests
Chromatography, High Pressure Liquid
Comparative Study
Female
Human
Hydrogen Peroxide/*metabolism
Lung Neoplasms/*metabolism/surgery
Male
Malondialdehyde/*urine
Middle Age
*Oxidative Stress
Pilot Projects
Pneumonectomy/*adverse effects
Prognosis
Prospective Studies
Pulmonary Edema/*metabolism/surgery
Spectrophotometry
Abstract: STUDY OBJECTIVES: To investigate whether oxidative stress occurs following lobectomy and pneumonectomy and to evaluate whether markers of oxidative stress might be of value in the assessment of the diagnosis, course, and prognosis of postoperative complications. DESIGN: A prospective study. SETTING: A specialized thoracic surgical unit in a large referral hospital. PATIENTS: Twenty-eight patients with lung carcinoma undergoing thoracotomy. MEASUREMENTS: Exhaled H(2)O(2) concentrations in breath condensate were measured by spectrophotometry, while malondialdehyde (MDA) levels in urine samples collected every 24 h were measured by reversed-phase, ion-pair high-performance liquid chromatography using ultraviolet detection. RESULTS: Our results show increased H(2)O(2) and MDA levels in lobectomy patients compared with pneumonectomy patients. A strong correlation was found between the levels of H(2)O(2) and MDA. CONCLUSION: The present data support the hypothesis that oxidative stress may occur following pulmonary resection.

Reference Type: Journal Article
Record Number: 63
Author: Schleiss, M. B.; Holz, O.; Behnke, M.; Richter, K.; Magnussen, H.; Jorres, R. A.
Year: 2000
Title: The concentration of hydrogen peroxide in exhaled air depends on expiratory flow rate
Journal: Eur Respir J
Volume: 16
Issue: 6
Pages: 1115-8.
Label: 21187463
Keywords: Adult
*Breath Tests
Female
Forced Expiratory Flow Rates/*physiology
Forced Expiratory Volume/physiology
Human
Hydrogen Peroxide/*analysis
Lung Diseases, Obstructive/diagnosis/physiopathology
Male
Pulmonary Ventilation/physiology
Reference Values
Support, Non-U.S. Gov't
Abstract: Hydrogen peroxide (H2O2) is known to be detectable in exhaled air. The present study aimed to determine whether the concentration of exhaled H2O2 depends on expiratory flow rate in order to make inferences on the site of its production within the lung. Breath condensate was collected in cooled Teflon tubes, at three different expiratorv flow rates, in 15 healthy or mild asthmatic subjects. Tests were repeated 2-5 times to assess reproducibility. Mean+/-SEM concentrations of H2O2 at flow rates of 140, 69 and 48 mL.s(-1) were 0.12+/-0.02, 0.19+/-0.02 and 0.32+/-0.03 microM, respectively. These values differed significantly from each other (p<0.001). For comparison, average coefficients of variability within repeated measurements at each of the three flow rates were 68, 62 and 82%, respectively. These data demonstrate that the concentration of exhaled hydrogen peroxide depends on expiratory flow rate. Since flow dependence is an indicator of production within the airways, this result suggests that, to a large extent, the exhaled hydrogen peroxide originates within the airways. However, even under strictly controlled conditions, a high degree of variability persists, which may limit the usefulness of exhaled hydrogen peroxide as a marker of airway inflammation.

Reference Type: Journal Article
Record Number: 217
Author: Antczak, A.; Gorski, P.
Year: 2001
Title: Endogenous Airway Acidification And Oxidant Overload In Infectious Exacerbation of COPD.
Journal: Am J Respir Crit Care Med
Volume: 163
Issue: 5
Pages: 725A
Abstract: Oxidant/antioxidant imbalance plays a pivotal role in chronic obstructive pulmonary disease (COPD). In this study we hypothesised that levels of hydrogen peroxide (H2O2) and pH of exhaled air condensate are impaired in infectious exacerbation of COPD and that they normalise during therapy. We measured H2O2 (spectrofluorimetrically - homovanillic acid method) and pH (Corning pH microelectrode, Corning, N.Y., USA) in exhaled air condensate in 10 COPD patients with infectious exacerbation (mean age 62±10 yr., 7 male) on 1st, 3rd, and 6th days of antibiotic treatment (cephalosporins or macrolides). There was a significant fall in H2O2 concentration on 3rd and 6th day of therapy compared to baseline (0.54±0.1 and 0.36±0.1 vs. 0.81±0.14 mM, p<0.001, p<0.001, respectively). This was accompanied by 1 log order lower air condensate pH on 1st day compared to that on the 6th (6.25±0.46 vs. 7.46±0.1, p<0.001, respectively) with lowered pH on day 3 (6.75±0.4 0, p<0.01). No correlation between H2O2 and pH of the exhaled air condensate was observed. We conclude that an oxidant overload in the airways can be observed in exacerbation of COPD and that this normalises during antibiotic treatment. We speculate that endogenous airway acidification may have a pathophysiological role in COPD.
[**] Thematic Poster Session (Abstract Page: 725) Session: 8:15 am-4:45 pm, OXIDANTS/ANTIOXIDANTS

Reference Type: Journal Article
Record Number: 66
Author: Emelyanov, A.; Fedoseev, G.; Abulimity, A.; Rudinski, K.; Fedoulov, A.; Karabanov, A.; Barnes, P. J.
Year: 2001
Title: Elevated concentrations of exhaled hydrogen peroxide in asthmatic patients
Journal: Chest
Volume: 120
Issue: 4
Pages: 1136-9.
Label: 21475390
Abstract: BACKGROUND: Airway inflammation is important in the development and progression of asthma. Activation of inflammatory cells induces a respiratory burst resulting in the production of reactive oxygen species, such as H(2)O(2). The aim of this study was to measure the concentration of H(2)O(2) in exhaled breath condensate and its correlation with airway obstruction, airway hyperresponsiveness, and concentration of eosinophil cationic protein (ECP) in serum in 70 steroid-naive, atopic patients with unstable asthma (20 men; age range, 18 to 62 years) and 17 normal subjects (7 men; age range, 19 to 34 years). METHODS: Exhaled H(2)O(2) was measured using a colorimetric assay, and the concentration of ECP in serum was measured using radioimmunoassay. Airway hyperresponsiveness was expressed as the provocative concentration of inhaled histamine causing a 20% fall in FEV(1) (PC(20)). RESULTS: In patients with asthma, the mean H(2)O(2) concentration was significantly elevated compared to values in normal subjects: 0.127 +/- 0.083 mol/L vs 0.024 +/- 0.016 mol/L (p < 0.001). There was a significant correlation among H(2)O(2) concentration, FEV(1), PC(20), and ECP in serum. CONCLUSION: We conclude that exhaled H(2)O(2) is significantly elevated in asthmatic patients. This is correlated with disease severity and indirect markers of airway inflammation. Measurement of exhaled H(2)O(2) may be useful to assess airway inflammation and oxidative stress in asthmatic patients.

Reference Type: Journal Article
Record Number: 67
Author: Ferreira, I. M.; Hazari, M. S.; Gutierrez, C.; Zamel, N.; Chapman, K. R.
Year: 2001
Title: Exhaled nitric oxide and hydrogen peroxide in patients with chronic obstructive pulmonary disease. Effects of inhaled beclomethasone
Journal: Am J Respir Crit Care Med
Volume: 164
Issue: 6
Pages: 1012-5.
Label: 21471714
Abstract: There is controversy about the role of inhaled corticosteroids in chronic obstructive pulmonary disease (COPD). Although they appear to have little impact on airways obstruction or its progression, their use may reduce the frequency and/or severity of exacerbations in a subset of patients. We undertook the following study to determine the impact of inhaled corticosteroid on two noninvasive markers of airways inflammation. We assigned 20 stable nonsmoking patients with COPD in random, double-blind crossover fashion to two 2-wk treatment periods with inhaled beclomethasone 500 &mgr;g twice daily or matching placebo, followed by a 2-wk washout period. We measured exhaled nitric oxide (ENO), breath condensate H(2)O(2), and flow volume spirometry at weekly intervals. Median baseline ENO was 26.2 (19.3 to 54.8) ppb and fell significantly following 1 and 2 wk of beclomethasone (-10.6 ppb, p = 0.002, and -6.3 ppb, p = 0.013, respectively) but was unchanged by placebo inhalation. Breath condensate H(2)O(2) levels did not change significantly with inhaled beclomethasone or placebo. Although there were no significant changes in FEV(1) with BDP therapy, there was a moderate inverse correlation between changes in ENO and changes in FEV(1) (r -0.50). We conclude that inhaled beclomethasone reduces ENO levels in stable nonsmoking patients with COPD, a finding compatible with an antiinflammatory mechanism of action.

Reference Type: Journal Article
Record Number: 70
Author: Ganas, K.; Loukides, S.; Papatheodorou, G.; Panagou, P.; Kalogeropoulos, N.
Year: 2001
Title: Total nitrite/nitrate in expired breath condensate of patients with asthma
Journal: Respir Med
Volume: 95
Issue: 8
Pages: 649-54.
Label: 21421794
Keywords: Adrenergic beta-Antagonists/therapeutic use
Adult
Asthma/drug therapy/*metabolism
Biological Markers/analysis
Breath Tests
Case-Control Studies
Glucocorticoids, Topical/therapeutic use
Human
Hydrogen Peroxide/analysis
Nitrates/*analysis
Nitrites/*analysis
Oxidative Stress
Smoking
Abstract: Production of nitric oxide (NO) is generally increased during inflammatory diseases including asthma. The eventual fate of NO is oxidation to nitrite (NO2) and nitrate (NO3), both of which are end-products of NO metabolism. Hydrogen Peroxide (H2O2) is increased in Exhaled Breath Condensate of asthmatic subjects and may be used as a non-invasive marker of oxidative stress. NO has in some cases been shown to attenuate oxidant-induced lung injury. Total NO2/NO3 concentration and H2O2 levels were measured in expired breath condensate in 50 clinically stable asthmatics [all males, all atopics, mean age 22 (3) SD yrs, forced expiratory volume in 1 sec (FEV1) 91 (10)% predicted, PD20 to histamine 0.262 (0.16) mg 20 on inhaled steroids, 20 smokers, all steroid-naive] and in 10 normal, non-atopic subjects [all males, age 23 (4) yrs, FEV1 101 (14)% predicted, PD20 to histamine 1.3 (0.55) mg]. NO2/NO3 levels were significantly higher in patients with asthma than in normal subjects (1.08, 95% CI 0.86-1.3 microM vs. 0.6; 95% CI 0.46-0.8, P < 0.001). Patients who were on inhaled steroids had significantly ower values compared to steroid-naive (0.71, 95% CI 0.55-0.87 microM vs. 133, 95% CI 1-1.65 microM, P < 0.001). Similar results were observed between smokers and non-smokers (1.11, 95% CI 0.74-1.47 microM vs. 1.77, 95% CI 1.1-24 microM, P < 0.0001).There was a significant positive correlation between NO2/NO3 levels and H2O2 concentration in expired breath condensate (r = 0.48, P < 0.0001). No correlation was observed between NO2/NO3 levels, airway obstruction and bronchial hyper-reactivity as assessed by PD20 to histamine. Total NO2/NO3 levels in expired breath condensate are raised in patients with stable asthma and are significantly related to oxidative stress as assessed by H2O2 concentration. Measurement of expired breath NO2/NO3 and H2O2 levels may be clinically useful in the management of oxidation and inflammation mediated lung injury.

Reference Type: Journal Article
Record Number: 71
Author: Horvath, I.; MacNee, W.; Kelly, F. J.; Dekhuijzen, P. N.; Phillips, M.; Doring, G.; Choi, A. M.; Yamaya, M.; Bach, F. H.; Willis, D.; Donnelly, L. E.; Chung, K. F.; Barnes, P. J.
Year: 2001
Title: "Haemoxygenase-1 induction and exhaled markers of oxidative stress in lung diseases", summary of the ERS Research Seminar in Budapest, Hungary, September, 1999
Journal: Eur Respir J
Volume: 18
Issue: 2
Pages: 420-30.
Label: 21419983
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 H2O2 and 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.

Reference Type: Journal Article
Record Number: 193
Author: Jobsis, R. Q.; Schellekens, S. L.; Fakkel-Kroesbergen, A.; Raatgeep, R. H.; de Jongste, J. C.
Year: 2001
Title: Hydrogen peroxide in breath condensate during a common cold
Journal: Mediators Inflamm
Volume: 10
Issue: 6
Pages: 351-4.
Accession Number: 11817678
Abstract: BACKGROUND: Hydrogen peroxide (H2O2) in exhaled air condensate is elevated in inflammatory disorders of the lower respiratory tract. It is unknown whether viral colds contribute to exhaled H2O2. AIM: To assess exhaled H2O2 during and after a common cold. METHODS: We examined H2O2 in the breath condensate of 20 normal subjects with acute symptoms of a common cold and after recovery 2 weeks later and, similarly, in 10 subjects without infection. H2O2 was measured with a fluorimetric assay. RESULTS: At the time of infection exhaled H2O2 (median, ranges) was 0.20 microM (0.03-1.2 microM), and this decreased to 0.09 microM (< 0.01-0.40 microM) after recovery (p = 0.006). There was no significant difference in lung function (forced vital capacity and forced expiratory volume in 1 sec) during and after colds. In the controls, exhaled H2O2 did not change over a 2-week period. CONCLUSIONS: H2O2 in exhaled air condensate is elevated during a common cold, and returns to normal within 2 weeks of recovery in healthy subjects. Hence, symptomatic upper respiratory tract infection may act as a confounder in studies of H2O2 as a marker of chronic lower airway inflammation.
URL
Author Address: Department of Paediatrics, Division of Paediatric Respiratory Medicine, Erasmus University Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands.

Reference Type: Journal Article
Record Number: 76
Author: Kasielski, M.; Nowak, D.
Year: 2001
Title: Long-term administration of N-acetylcysteine decreases hydrogen peroxide exhalation in subjects with chronic obstructive pulmonary disease
Journal: Respir Med
Volume: 95
Issue: 6
Pages: 448-56.
Label: 21314332
Keywords: Acetylcysteine/*therapeutic use
Adult
Aged
Analysis of Variance
Breath Tests
Double-Blind Method
Female
Free Radical Scavengers/*therapeutic use
Human
Hydrogen Peroxide/*metabolism
Lipid Peroxidation/drug effects
Lung Diseases, Obstructive/*drug therapy/metabolism
Male
Middle Age
Spectrometry, Fluorescence
Statistics, Nonparametric
Support, Non-U.S. Gov't
Thiobarbituric Acid Reactive Substances/analysis
Treatment Outcome
Abstract: Patients with chronic obstructive pulmonary disease (COPD) exhale more hydrogen peroxide (H2O2) and lipid peroxidation products than healthy subjects. This may reflect oxidative stress in the airways that plays important role in the development and progression of COPD. N-acetylcysteine (NAC), a mucolytic drug, possesses antioxidant properties as it is a precursor of reduced glutathione that together with glutathione peroxidase may decompose H2O2 and lipid peroxides. We aimed to determine the effect of NAC, 600 mg effervescent tablets (Fluimucil), once a day for 12 months, and placebo on the concentration of H2O2 and thiobarbituric acid reactive substances (TBARs) in expired breath condensate and serum levels of two lipid peroxidation products (TBARs, lipid peroxides) in patients with COPD. The study was performed as a double-blind, double-dummy comparison between active drug and placebo in two parallel groups. Forty-four outpatients with stable COPD (22 in the NAC group and 22 in the placebo group) completed the study. Specimens of expired breath condensate and serum were collected at the randomization visit and then every 3 months over 1 year. The concentration of TBARs and H2O2 in expired breath condensate was measured spectrofluorimetrically by the thiobarbituric acid and homovanillic acid methods, respectively. Serum levels of lipid peroxides were determined spectrophotometrically after extraction with butanol and pyridine. Initially, H2O2 exhalation did not differ between the placebo and NAC groups up to 6 months of treatment. After this the significant differences were observed. After 9 and 12 months of treatment NAC group exhaled 2.3-fold (0.17+/-0.33 microM vs. 041+/-0.26 microM, P<0.04) [median 0.01 microM, quartile range (qr)=0.22 vs. median 0.15 microM, qr =0.43] and 2.6-fold (0.15+/-0.23 microM vs. 0.40+/-0.25 microN, P<0.05) median = 0.00 microM, qr = 0.23 vs. median = 0.36 microM, qr = 0.51] less H2O2 than placebo receivers, respectively. No significant effect of NAC administration on TBARs exhalation and serum levels of TBARs and lipid peroxides were noted over the whole treatment period. Also no significant associations between exhaled H2O2 and concentrations of lipid peroxidation products were noted in both treatment groups at any time-point. These results indicate that long-term oral administration of NAC attenuates H2O2 formation in the airways of COPD subjects and prove anti-oxidant action of drug. However, further studies are necessary to estimate the clinical significance of this finding.

Reference Type: Journal Article
Record Number: 184
Author: Loukides, S.; Papatheodorou, G.; Ganas, K.; Kostikas, K.; Psathakis, K.; Panagou, P.
Year: 2001
Title: Endogenous airway acidification in expired breath condensate of patients with inflammatory airway diseases
Journal: Am J Respir Crit Care Med
Volume: 163
Issue: 5
Pages: A723
Abstract: Endogenous Airway Acidification In Expired Breath Condensate Of Patients With Inflammatory Airway Diseases, Athens, Greece. Tuesday, May 22, 2001, 8:15 AM, Area J (Hall D, Lower Level), Moscone Center Endogenous airway acidification as assessed by pH in expired breath condensate is implicated in asthma pathophysiology (Hunt et al AJRCCM 2000). Aim of our study was to evaluate pH in expired breath condensate in inflammatory airway diseases and to find out whether its levels might contribute to oxidative stress as assessed by hydrogen peroxide and 8-isoprostane, to nitric oxide metabolism as assessed by total nitrate/nitrite and finally to inflammatory process as assessed by differential cell counts in induced sputum. 20 patients with bronchial asthma (10 with severe disease FEV1 60 ± 10 %pred), 10 with bronchiectasis, 10 with COPD, and 10 normal subjects were studied. Our results showed that both COPD and bronchiectasis patients had significantly lower values compared to asthmatics and normal subjects (7.16 ± 0.17SD, 7.12 ± 0.1, 7.41 ± 0.26, 7.58 ± 0.1, p<0.0001). Further analysis showed that severe asthmatics had significantly lower values compared to mild (7.55 ± 0.18 vs 7.26 ± 0.26, p=0.0003). We additionally showed that the above values of pH were related to sputum neutrophilia and consequently to oxidative stress. However in patients with severe asthma there was a significant correlation between pH and total nitrate/nitrite. We conclude that airway acidification in inflammatory airway diseases is related to sputum neutrophilia and therefore to oxidative stress and might reflect the inflammatory process in diseases, which are neutrophil dependent.
[**] Thematic Poster Session (Abstract Page: 723) Session: 8:15 am-4:45 pm, OXIDANTS/ANTIOXIDANTS

Reference Type: Journal Article
Record Number: 83
Author: Nowak, D.; Kalucka, S.; Bialasiewicz, P.; Krol, M.
Year: 2001
Title: Exhalation of H2O2 and thiobarbituric acid reactive substances (TBARs) by healthy subjects
Journal: Free Radic Biol Med
Volume: 30
Issue: 2
Pages: 178-86.
Label: 21100476
Keywords: Adult
Age Factors
Albuterol/administration & dosage/pharmacology
Body Mass Index
Bronchodilator Agents/pharmacology
Circadian Rhythm/drug effects
Exercise/physiology
Female
Human
Hydrogen Peroxide/*metabolism
Ipratropium/administration & dosage/pharmacology
Male
Pulmonary Ventilation/drug effects
Regression Analysis
*Respiration/drug effects
Sex Factors
Smoking/adverse effects
Spirometry
Thiobarbituric Acid Reactive Substances/*metabolism
Abstract: Enhanced exhalation of H2O2 and TBARs have been reported in various inflammatory lung diseases. This may reflect activated phagocytes influx and free radical generation in the airways. However, to apply these compounds as markers of oxidative stress it is necessary to understand factors influencing their exhalation in healthy subjects. We investigated the concentration of H2O2 and TBARs in expired breath condensate (EBC) of 58 healthy volunteers. EBC was collected seven times every 4 h during 24 h and three times every 7 d during 2 consecutive weeks. The H2O2 exhalation revealed diurnal variation with two-peak values 0.45 +/- 0.29 microM and 0.43 +/- 0.22 microM at 12:00 and 24:00 h. The lowest concentrations, 0.26 +/- 0.13 microM and 0.25 +/- 0.26 microM, were found at 20:00 and 8:00 h. Cigarette smokers exhaled about 2.4 times more H(2)O(2) than never smoked subjects. Moreover, in contrast to nonsmokers, cigarette smokers' H2O2 exhalation was stable over 2 week observation. The mean H2O2 concentration estimated over the whole 2 week period was higher in subjects above 40 years regardless of smoking habit, and it positively correlated with age in never smoked subjects (p <.004). Smoking of one cigarette caused 1.8-fold rise in H2O2 exhalation (p <.01). The baseline H2O2 levels correlated with cumulative cigarette consumption (p <.05) and MEF 25% of predicted (p <.05). Neither moderate exercise nor one puff of salbutamol nor ipratropium influenced significantly the concentration of H2O2 and TBARs in EBC. Only 4 of 120 EBC specimens from never smoked subjects revealed detectable levels of TBARs. Cigarette smokers exhaled more TBARs (p <.05) than never smoked volunteers. Our results indicate that healthy never smoked subjects exhale H2O2 with diurnal variation and significant changes over 2 week observation. Cigarette smoking enhanced H2O2 generation in the airways. These results could be useful for planning studies with exhaled H2O2 as a marker of airway inflammation. Occasional detection of TBARs in EBC of never smoked persons may be a result of sufficient antioxidant activity in the airways that protects tissues from peroxidative damage.

Reference Type: Journal Article
Record Number: 72
Author: Zappacosta, B.; Persichilli, S.; Mormile, F.; Minucci, A.; Russo, A.; Giardina, B.; De Sole, P.
Year: 2001
Title: A fast chemiluminescent method for H(2)O(2) measurement in exhaled breath condensate
Journal: Clin Chim Acta
Volume: 310
Issue: 2
Pages: 187-91.
Label: 21389208
Keywords: Adult
*Chemiluminescence
Human
Hydrogen Peroxide/*analysis
Middle Age
Pulmonary Alveoli/metabolism
Reference Values
*Respiration
Sensitivity and Specificity
Smoking/metabolism
Abstract: BACKGROUND: Breath condensate can give useful information on volatile compounds produced at alveolar level. Actual concentration of H(2)O(2) in breath condensate is dependent on its production at alveolar level and on the efficacy of the detoxifying systems, catalase, glutathione peroxidase, etc. METHODS: In the present paper, a simple chemiluminescent method for the determination of the H(2)O(2) collected in exhaled breath is shown and data of both smokers and nonsmokers volunteers are presented. RESULTS: The chemiluminescent response is linear up to 100 micromol/l H(2)O(2). The analytical sensitivity is about 0.01 micromol/l. Most of the nonsmokers have a H(2)O(2) content lower than 0.05 micromol/l, while smokers have a content ranging from 0.1 to 0.6 micromol/l.

Reference Type: Journal Article
Record Number: 257
Author: Antczak, A.; Gorski, P.
Year: 2002
Title: Markers of pulmonary diseases in Exhaled Breath Condensate
Journal: Int J Occup Med Environ Health
Volume: 15
Issue: 4
Pages: 317-23
Accession Number: 12608619
Keywords: Adult
Biological Markers/*analysis
*Breath Tests
Child
Human
Lung Diseases/*diagnosis
Oxidative Stress
Poland
Abstract: Exhaled Breath Condensate has been more and more extensively used as a novel and non-invasive method to study airway inflammation. It is simple to perform, very well tolerated by patients and no adverse events have been reported so far. Serial measurements can be made with no harmful effects on patients, which is of extreme value in occupational medicine. Exhaled breath condensate has been obtained from both adult and children patients suffering from various pulmonary diseases such as asthma, cystic fibrosis, chronic obstructive pulmonary disease, and interstitial lung diseases. Several markers and mediators are detectable in breath condensate: hydrogen peroxide, thiobarbituric acid-reactive substances, isoprostanes, prostaglandins and leukotrienes. Nitric oxide-related markers have also been studied in the condensate. There is increasing body of evidence that changes in condensate markers reflect local abnormalities of airway lining fluid.
Notes: 1232-1087
Journal Article
Review
Review, Tutorial
URL
Author Address: Department of Pneumology and Allergology, Medical University, Lodz, Poland.

Reference Type: Journal Article
Record Number: 244
Author: Kharitonov, S. A.; Barnes, P. J.
Year: 2002
Title: Biomarkers of some pulmonary diseases in exhaled breath
Journal: Biomarkers
Volume: 7
Issue: 1
Pages: 1-32
Date: Jan-Feb
Accession Number: 12101782
Keywords: Ammonia/analysis
Asthma/diagnosis
Biological Markers
Breath Tests/*methods
Carbon Monoxide/analysis
Cystic Fibrosis/diagnosis
Human
Hydrogen Peroxide/analysis
Lipid Peroxidation
Lung Diseases/*diagnosis
Nitric Oxide/analysis
Pulmonary Disease, Chronic Obstructive/diagnosis
Abstract: Analysis of various biomarkers in exhaled breath allows completely non-invasive monitoring of inflammation and oxidative stress in the respiratory tract in inflammatory lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), bronchiectasis and interstitial lung diseases. The technique is simple to perform, may be repeated frequently, and can be applied to children, including neonates, and patients with severe disease in whom more invasive procedures are not possible. Several volatile chemicals can be measured in the breath (nitric oxide, carbon monoxide, ammonia), and many non-volatile molecules (mediators, oxidation and nitration products, proteins) may be measured in Exhaled Breath Condensate. Exhaled breath analysis may be used to quantify inflammation and oxidative stress in the respiratory tract, in differential diagnosis of airway disease and in the monitoring of therapy. Most progress has been made with exhaled nitric oxide (NO), which is increased in atopic asthma, is correlated with other inflammatory indices and is reduced by treatment with corticosteroids and antileukotrienes, but not (beta 2-agonists. In contrast, exhaled NO is normal in COPD, reduced in CF and diagnostically low in primary ciliary dyskinesia. Exhaled carbon monoxide (CO) is increased in asthma, COPD and CF. Increased concentrations of 8-isoprostane, hydrogen peroxide, nitrite and 3-nitrotyrosine are found in Exhaled Breath Condensate in inflammatory lung diseases. Furthermore, increased levels of lipid mediators are found in these diseases, with a differential pattern depending on the nature of the disease process. In the future it is likely that smaller and more sensitive analyzers will extend the discriminatory value of exhaled breath analysis and that these techniques may be available to diagnose and monitor respiratory diseases in the general practice and home setting.
Notes: 1354-750x
Journal Article
Review
Review, Tutorial
URL
Author Address: Department of Thoracic Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, Royal Brompton Hospital, London, UK. s.kharitonov@ic.ac.uk

Reference Type: Journal Article
Record Number: 214
Author: Latzin, P.; Griese, M.
Year: 2002
Title: Exhaled hydrogen peroxide, nitrite and nitric oxide in healthy children: decrease of hydrogen peroxide by atmospheric nitric oxide
Journal: European Journal of Medical Research
Volume: 7
Issue: 8
Pages: 353-8
Abstract: Hydrogen peroxide (H subset 2O subset 2) and nitrite (NO subset 2-) in Exhaled Breath Condensate have recently been suggested as non-invasive markers of airway inflammation. The goal of this study was to clarify the role of factors that may potentially influence the measurement of H subset 2O subset 2 and nitrite and to look for possible correlations among these inflammatory markers. - H subset 2O subset 2 and nitrite values were assessed fluorometrically in breath condensate of 102 healthy children (age 4-18 years) and a detailed status of atopy (including history, lung function and skin prick test) was taken in all children. To find out the role of atmospheric nitric oxide, eNO and envNO were measured via chemiluminescence in association with the sampling of the breath condensate. - Median (interquartile range) H subset 2O subset 2 was 0.51 (0.26 - 0.74) mgrg;M and nitrite was 3.3 (2.7 4.1) mgrg;M. A significant negative correlation between H subset 2O subset 2 and envNO was observed (r = -0.50; p < 0.0001). ENO was independent of envNO at our envNO range up to 56 ppb. No further correlation was found. - The inflammatory markers in Exhaled Breath Condensate H subset 2O subset 2, nitrite and eNO are not interrelated to each other in healthy children. Whereas eNO was not dependent on envNO values, high envNO values must be taken into account when measuring H subset 2O subset 2 in exhaled breath condensate.
Notes: English
0949-2321

Reference Type: Journal Article
Record Number: 258
Author: Latzin, P.; Griese, M.
Year: 2002
Title: Exhaled hydrogen peroxide, nitrite and nitric oxide in healthy children: decrease of hydrogen peroxide by atmospheric nitric oxide
Journal: Eur J
Med Res Volume: 7
Issue: 8
Pages: 353-8
Date: Aug 30
Accession Number: 12204843
Keywords: Adolescent
Biological Markers
Breath Tests
Child
Female
Hay Fever/*diagnosis/metabolism
Human
Hydrogen Peroxide/*metabolism
Lung Diseases/diagnosis/metabolism
Male
Multivariate Analysis
Nitric Oxide/*metabolism
Nitrites/*metabolism
Respiratory Function Tests
Abstract: Hydrogen peroxide (H2O2) and nitrite (NO2-) in Exhaled Breath Condensate have recently been suggested as non-invasive markers of airway inflammation. The goal of this study was to clarify the role of factors that may potentially influence the measurement of H2O2 and nitrite and to look for possible correlations among these inflammatory markers. H2O2 and nitrite values were assessed fluorometrically in breath condensate of 102 healthy children (age 4-18 years) and a detailed status of atopy (including history, lung function and skin prick test) was taken in all children. To find out the role of atmospheric nitric oxide, eNO and envNO were measured via chemiluminescence in association with the sampling of the breath condensate. Median (interquartile range) H2O2 was 0.51 (0.26 - 0.74) microM and nitrite was 3.3 (2.7 4.1) microM. A significant negative correlation between H2O2 and envNO was observed (r = -0.50; p < 0.0001). ENO was independent of envNO at our envNO range up to 56 ppb. No further correlation was found. The inflammatory markers in Exhaled Breath Condensate H2O2, nitrite and eNO are not interrelated to each other in healthy children. Whereas eNO was not dependent on envNO values, high envNO values must be taken into account when measuring H2O2 in Exhaled Breath Condensate.
Notes: 0949-2321 Journal Article
URL
Author Address: Children's Hospital, Ludwig Maximilians-University of Munich, Germany.

Reference Type: Journal Article
Record Number: 205
Author: Loukides, S.; Bouros, D.; Papatheodorou, G.; Panagou, P.; Siafakas, N. M.
Year: 2002
Title: The relationships among hydrogen peroxide in expired breath condensate, airway inflammation, and asthma severity
Journal: Chest
Volume: 121
Issue: 2
Pages: 338-46.
Accession Number: 11834641
Keywords: Asthma/pathology/*physiopathology
Blood Proteins/analysis
*Breath Tests
Eosinophils/metabolism/pathology
Human
Hydrogen Peroxide/*analysis
Inflammation
Neutrophils/metabolism/pathology
Severity of Illness Index
Sputum/cytology
Abstract: STUDY OBJECTIVE: To investigate which cells are the main source of hydrogen peroxide (H(2)O(2)) production in stable patients with asthma and the associations among H(2)O(2) levels, airway inflammation, and disease severity. SETTING: Inpatient respiratory unit and outpatient clinic in tertiary-care hospital. PATIENTS: Fifty stable asthmatic patients with disease severity ranging from mild to moderate. METHODS: H(2)O(2) was measured in expired breath condensate and was correlated with variables expressing both asthma severity (ie, FEV(1) percent predicted, peak expiratory flow rate [PEFR] variability, symptom score, and histamine airways responsiveness) and airway inflammation (ie, differential cell counts from induced sputum and levels of eosinophil cationic protein [ECP]). RESULTS: The mean (95% confidence interval [CI]) concentration of H(2)O(2) was significantly elevated in patients with asthma compared to that in control subjects (mean, 0.67 microM [95% CI, 0.56 to 0.77 microM] vs 0.2 microM [95% CI, 0.16 to 0.24 microM]; p < 0.0001). The difference was primarily due to the elevation of H(2)O(2) in patients with moderate asthma whose expired breath H(2)O(2) level of 0.95 microM (95% CI, 0.76 to 1.12 microM) was significantly higher from that of patients with mild-persistent and mild-intermittent asthma (mean, 0.59 microM [95% CI, 0.47 to 0.7 microM] and 0.27 [95% CI, 0.23 to 0.32 microM], respectively; p < 0.0001). H(2)O(2) concentration was positively related to sputum eosinophilia as well as to ECP concentration. A similar correlation was found between H(2)O(2) and neutrophils in patients with moderate asthma. A positive correlation was observed between H(2)O(2) level, symptom score, and PEFR variability. H(2)O(2) level was negatively related to FEV(1) percent predicted. Further analysis showed that only patients with moderate asthma who were not receiving inhaled steroids were found to have a strong relationship with the variables tested. CONCLUSIONS: Eosinophils are the predominate cells that generate H(2)O(2) in all forms of the disease, while neutrophils might be responsible for the highest levels that are observed in the more severe forms of the disease. The role of H(2)O(2) concentration in predicting the severity of the disease as well as in the inflammatory process is limited and depends on the use of inhaled steroid therapy and the classification of the severity of the disease.
URL: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11834641
http://www.chestjournal.org/cgi/content/full/121/2/338
http://www.chestjournal.org/cgi/content/abstract/121/2/338
Author Address: Department of Pneumonology and Clinical Research Unit, Athens Army General Hospital, Athens, Greece. ssat@hol.gr

Reference Type: Journal Article
Record Number: 200
Author: van Beurden, W. J.; Harff, G. A.; Dekhuijzen, P. N.; van den Bosch, M. J.; Creemers, J. P.; Smeenk, F. W.
Year: 2002
Title: An efficient and reproducible method for measuring hydrogen peroxide in Exhaled Breath Condensate
Journal: Respir Med
Volume: 96
Issue: 3
Pages: 197-203.
Accession Number: 11908513
Keywords: Aged
Breath Tests/instrumentation/*methods
Cryopreservation
Female
Human
Hydrogen Peroxide/*analysis
Male
Middle Age
Pulmonary Disease, Chronic Obstructive/*diagnosis
Reproducibility of Results
Sensitivity and Specificity
Support, Non-U.S. Gov't
Abstract: We investigated the sensitivity and reproducibility of a test procedure for measuring hydrogen peroxide (H202) in Exhaled Breath Condensate and the effect of storage of the condensate on the H2O2 concentration, and compared the results to previous studies.Twenty stable COPD patients breathed into our collecting device twice for a period of 10 min.The total exhaled air volume (EAV) and condensate volume were measured both times and the H2O2 concentration of the condensate was determined fluorimetrically.The concentration was measured again after freezing the reaction product at -70 degrees C for a period of 10, 20 and 40 days. We collected 2-5 ml condensate in 10 min. The EAV and condensate volumes were strongly correlated. There was no significant difference between the mean H2O2 concentration of the first and second test. We obtained a detect on limit for the H2O2 concentration of 0.02 micromoll(-1). The H2O2 concentration appeared to remain stable for a period up to 40 days of freezing. Compared to previous studies we developed a more efficient breath condensate collecting device and obtained a lower H2O2 detection limit.The measurement of exhaled H2O2 was reproducible. In addition, storage of the samples up to 40 days showed no changes in H2O2 concentration.
URL
Author Address: Department of Pulmonology, Catharina Hospital, Eindhoven, The Netherlands. w.beurden@researchlab-long.demon.nl

Reference Type: Journal Article
Record Number: 246
Author: Van Beurden, W. J.; Dekhuijzen, P. N.; Harff, G. A.; Smeenk, F. W.
Year: 2002
Title: Variability of Exhaled Hydrogen Peroxide in Stable COPD Patients and Matched Healthy Controls
Journal: Respiration
Volume: 69
Issue: 3
Pages: 211-6
Accession Number: 12097763
Abstract: Background: Because inflammation induces oxidative stress, exhaled hydrogen peroxide (H(2)O(2)), which is a marker of oxidative stress, may be used as a non-invasive marker of airway inflammation in chronic obstructive pulmonary disease (COPD). There are no data on the circadian variability of exhaled H(2)O(2) in COPD patients. Objective: The aim of this study was to investigate the variability of the H(2)O(2) concentration in breath condensate of stable COPD patients and of matched healthy control subjects. Methods: We included 20 patients with stable mild COPD (forced expiratory volume in 1 s approximately 70% of predicted) and 20 healthy subjects, matched for age, sex and pack-years, all smokers or ex-smokers. Breath condensate was collected and its H(2)O(2) concentration determined fluorometrically three times on day 0 (9 and 12 a.m., and 3 p.m.) and once on days 1, 2, 3, 8 and 21. Results: The mean H(2)O(2) concentration increased significantly during the day in both the patient and control groups (p = 0.02 and p < 0.01, respectively). Over a longer period up to 21 days, the mean concentration did not change in both groups. There was no significant difference between patients and controls. The mean coefficient of variation over 21 days was 45% in the patient group and 43% in the control group (p = 0.8). Conclusions: The exhaled H(2)O(2) concentration increased significantly during the day in both stable COPD patients and controls. Over a period of 3 weeks, the mean H(2)O(2) concentration did not change and the variability within the subjects was similar in both groups.
Notes: 0025-7931
Journal Article
URL
Author Address: Department of Pulmonology, Catharina Hospital Eindhoven, The Netherlands.

Reference Type: Journal Article
Record Number: 318
Author: Cheah, F. C.; Darlow, B. A.; Winterbourn, C. C.
Year: 2003
Title: Problems associated with collecting breath condensate for the measurement of exhaled hydrogen peroxide from neonates on respiratory support
Journal: Biol Neonate
Volume: 84
Issue: 4
Pages: 338-41
Accession Number: 14593246
Abstract: We developed a bedside method for collecting Exhaled Breath Condensate (EBC) from neonates who were ventilated or receiving nasal continuous positive airway pressure (CPAP) and analyzed their EBC for hydrogen peroxide levels. A sufficient volume for analysis could be collected over 25-40 min from neonates on the ventilator and nasal CPAP (medians 5.3 and 2.7 ml, respectively). There was no significant difference between hydrogen peroxide levels from neonates on a ventilator or CPAP (median 0.28 vs. 0.38 microM, p = 0.06) and these were no different from a background with the ventilator or CPAP system alone (median for each 0.31 microM). The dilution of breath condensate by humidified gases plus the existence of background hydrogen peroxide resulted in this collecting setup being insufficiently sensitive to use for the detection of exhaled hydrogen peroxide in infants who were ventilated or on nasal CPAP.
Notes: 0006-3126
Journal Article
URL
Author Address: Free Radical Research Group, Department of Pathology, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand. fookchoe.cheah@chmeds.ac.nz

Reference Type: Journal Article
Record Number: 322
Author: Kostikas, K.; Papatheodorou, G.; Psathakis, K.; Panagou, P.; Loukides, S.
Year: 2003
Title: Oxidative stress in expired breath condensate of patients with COPD
Journal: Chest
Volume: 124
Issue: 4
Pages: 1373-80
Date: Oct
Accession Number: 14555568
Keywords: Adult
Aged
Androstadienes/therapeutic use
Anti-Inflammatory Agents/therapeutic use
Breath Tests
Bronchodilator Agents/therapeutic use
Exhalation
Human
Male
Middle Aged
*Oxidative Stress
Pulmonary Disease, Chronic Obstructive/drug therapy/immunology/*metabolism
Theophylline/therapeutic use
Abstract: OBJECTIVE: To evaluate the levels of hydrogen peroxide (H(2)O(2)) and 8-isoprostane in the expired breath condensate (EBC) of patients with COPD, and to assess the relationship between the above markers of oxidative stress and parameters expressing inflammatory process and disease severity. SETTING: Inpatient respiratory unit and outpatient clinic in tertiary care hospital. DESIGN: Cross-sectional study. PATIENTS: Thirty stable COPD patients (all smokers) with disease severity ranging from mild to severe. Ten subjects who were smokers with stage 0 disease (ie, at risk for COPD; mean [+/- SD] FEV(1), 88 +/- 5% predicted) were studied as a control group. METHODS: H(2)O(2) and 8-isoprostane levels were measured in EBC, and the values were correlated with variables expressing COPD severity (ie, FEV(1) percent predicted, dyspnea severity score (ie, Medical Research Council scale) and airway inflammation (ie, differential cell counts from induced sputum). RESULTS: The mean concentration of H(2)O(2) was significantly elevated in COPD patients compared to control subjects (mean, 0.66 micromol/L [95% confidence interval (CI), 0.54 to 0.68 micro mol/L) vs 0.31 micro mol/L [95% CI, 0.26 to 0.35 micromol/L], respectively; p < 0.0001). The difference was primarily due to the elevation of H(2)O(2) in patients with severe and moderate COPD, whose expired breath H(2)O(2) levels were significantly higher than those of patients with mild disease (mean, 0.96 micromol/L [95% CI, 0.79 to 1.13 micromol/L], 0.68 micromol/L [95% CI, 0.55 to 0.81 micromol/L], and 0.33 micromol/L [95% CI, 0.24 to 0.43 micromol/L], respectively, p < 0.0001). The mean concentration of 8-isoprostane was significantly elevated in patients with COPD compared to that of the control group (47 pg/mL [95% CI, 41 to 53 pg/mL] vs 29 pg/mL [95% CI, 25 to 33 pg/mL], respectively; p < 0.0001) but did not differ significantly among the different stages of the disease (p = 0.43). Repeatability and stability data within measurements showed that H(2)O(2) has a better repeatability and stability than 8-isoprostane. Furthermore, we observed significant correlations of H(2)O(2) with FEV(1), neutrophil count, and dyspnea score. Those correlations existed only in patients with moderate and severe disease. No correlations were found between levels of 8-isoprostane and the above parameters. CONCLUSIONS: We conclude that levels of H(2)O(2) and 8-isoprostane are elevated in the EBC of patients with COPD, but that H(2)O(2) seems to be a more repeatable and a more sensitive index of the inflammatory process and the severity of the disease.
Notes: 0012-3692 Journal Article
URL
Author Address: Pneumonology and Clinical Research Department, Athens Army General Hospital, Athens, Greece.

Reference Type: Journal Article
Record Number: 316
Author: Latzin, P.; Beck, J.; Bartenstein, A.; Griese, M.
Year: 2003
Title: Comparison of Exhaled Breath Condensate from nasal and oral collection
Journal: Eur J Med Res
Volume: 8
Issue: 11
Pages: 505-10
Date: Nov 12
Accession Number: 14644706
Abstract: BACKGROUND: Analysis of Exhaled Breath Condensate may provide new insights into pulmonary inflammatory processes. A new collection method via suction of nasally expired air especially suitable for younger children was presented recently. Here we compare this nasal suction method with the more widely used oral collection method regarding the amount of condensate collected as well as the concentrations of hydrogen peroxide (H2O2), nitrite and nitrate, respectively. MATERIALS AND METHODS: Exhaled Breath Condensate was collected from 11 healthy adults for the measurements of the amount of condensate and H2O2 concentration and from 17 children for the measurements of nitrite and nitrate. Condensate was collected via nasal suction and oral exhalation from each subject. RESULTS: Overall, no differences between both collection methods were found for all variables assessed except the concentration of H2O2, whereas the latter closely correlated (Spearman r = 0.88, p = 0.0007) between both collection methods. No correlation was found for the amount of condensate collected and the concentration of nitrite and nitrate. The Bland-Altman limits of agreement scattered over a wide range with clinical impact, proving significant differences between both collection methods for all variables measured. CONCLUSIONS: Although nasal and oral collection method proved again suitable for the collection of Exhaled Breath Condensate, the variability of the results obtained precludes the interchangeable usage of the inflammatory markers assessed here.
Notes: 0949-2321 Journal Article
URL
Author Address: CF-Ambulanz, Lindwurmstrasse 4, D-80337 Munich, Germany.

Reference Type: Journal Article
Record Number: 285
Author: Luczynska, M.; Szkudlarek, U.; Dziankowska-Bartkowiak, B.; Waszczykowska, E.; Kasielski, M.; Sysa-Jedrzejowska, A.; Nowak, D.
Year: 2003
Title: Elevated exhalation of hydrogen peroxide in patients with systemic sclerosis
Journal: Eur J Clin Invest
Volume: 33
Issue: 3
Pages: 274-9
Date: Mar
Accession Number: 12641548
Keywords: Breath Tests/methods
Female
Human
Hydrogen Peroxide/analysis/*metabolism
Male
Middle Age
Reactive Oxygen Species/metabolism
Scleroderma, Systemic/*metabolism
Support, Non-U.S. Gov't
Abstract: BACKGROUND: Systemic sclerosis is accompanied by an influx of activated phagocytes into distal airways. These cells release H2O2, which may evaporate from the airways surface and be detected in expired breath condensate. We tested whether patients with systemic sclerosis exhale more H2O2 than healthy subjects and whether breath condensate H2O2 levels correlate with some clinical parameters. MATERIAL AND METHODS: H2O2 was measured fluorimetrically in the expired breath condensate of 27 patients (22 women, five men, mean age 49 +/- 13.1 years) with systemic sclerosis and 27 age- and sex- matched healthy controls. RESULTS: Exhaled H2O2 levels were 3.5-fold higher (0.88 +/- 0.62 microM vs. 0.25 +/- 0.17 microM, P < 0.001) in the patients with systemic sclerosis than in the controls. Treatment with cyclophosphamide and/or prednisone (29 +/- 50 months, range 3-168 months) did not significantly decrease H2O2 exhalation (0.78 +/- 0.50 microM, n= 10 vs. 0.94 +/- 0.67 microM, n= 17, P > 0.05). No significant difference was found between patients with limited and diffuse scleroderma (1.03 +/- 0.69 microM, n= 17 vs. 0.63 +/- 0.41 microM, n= 10, P > 0.05). H2O2 levels correlated with disease duration (r = 0.38, P < 0.05) and time from the first Raynaud's episode (r = 0.44, P < 0.05). CONCLUSIONS: Patients with systemic sclerosis exhale more H2O2 than healthy controls, suggesting involvement of reactive oxygen species in disease processes. Lack of significant intergroups differences in H2O2 levels may have resulted from the small number of patients analyzed.
Notes: 0014-2972 Journal Article
URL
Author Address: Department of Experimental and Clinical Physiology, Institute of Physiology and Biochemistry, Medical University of Lodz, Lodz, Poland.

Reference Type: Journal Article
Record Number: 293
Author: Moloney, E. D.; Mumby, S. E.; Gajdocsi, R.; Cranshaw, J. H.; Kharitonov, S. A.; Quinlan, G. J.; Griffiths, M. J.
Year: 2003
Title: Exhaled Breath Condensate detects markers of pulmonary inflammation after cardio-thoracic surgery
Journal: Am J Respir Crit Care Med
Date: Oct 9
Accession Number: 14551168
Abstract: Cardiac surgery using cardio-pulmonary by-pass and, to a greater extent lung resection, cause acute lung injury that is usually sub-clinical. Analysis of mediators in Exhaled Breath Condensate is a promising means of monitoring inflammation in a variety of airway diseases but the contribution of the airway lining fluid from the lower respiratory tract is uncertain. We compared the analysis of markers of lung injury in Exhaled Breath Condensate and broncho-alveolar lavage, in endo-tracheally intubated patients before and after coronary artery bypass graft surgery with cardio-pulmonary bypass and lobectomy. The neutrophil count and leukotriene B4 concentration in broncho-alveolar lavage fluid rose after coronary artery bypass graft surgery (p < 0.05), but there was no significant change in leukotriene B4, hydrogen peroxide, or hydrogen ion concentrations in Exhaled Breath Condensate. By contrast, after lobectomy, the concentration in Exhaled Breath Condensate of leukotriene B4, hydrogen peroxide and hydrogen ions rose significantly (p < 0.05). Exhaled breath condensate is a safe, non-invasive method of sampling the milieu of the distal lung and is sufficiently sensitive to detect markers of inflammation and oxidative stress in patients after lobectomy, but not after the milder insult associated with cardiac surgery.
Notes: 1073-449x Journal article
URL
Author Address: Unit of Critical Care, Imperial College London at the National Heart and Lung Institute, London, United Kingdom.

Reference Type: Journal Article
Record Number: 221
Author: Sandrini, A.; Ferreira, I. M.; Jardim, J. R.; Zamel, N.; Chapman, K. R.
Year: 2003
Title: Effect of nasal triamcinolone acetonide on lower airway inflammatory markers in patients with allergic rhinitis
Journal: J Allergy Clin Immunol
Volume: 111
Issue: 2
Pages: 313-320
Date: Feb
Accession Number: 12589351
Abstract: BACKGROUND: Allergic rhinitis (AR) and asthma are commonly associated, and similar underlying inflammatory processes link both diseases. AR, even in the absence of asthma, is asso-ciated with increased levels of exhaled nitric oxide (ENO) and hydrogen peroxide (H(2)O(2)) in Exhaled Breath Condensate, 2 noninvasive markers of lower airway inflammation. OBJECTIVE: We sought to evaluate the effect of treatment with the nasal steroid triamcinolone acetonide on ENO and exhaled H(2)O(2) in subjects with AR. METHODS: We allocated 23 subjects in a randomized, double-blind, parallel-controlled fashion to 4-week treatment with triamcinolone acetonide (220 &mgr;g/d) or matching placebo. RESULTS: ENO levels were greater in the subgroup with concomitant asthma (16/23 subjects) and decreased significantly with triamcinolone acetonide treatment in this subgroup of patients in comparison with patients receiving placebo. Breath condensate levels of H(2)O(2) were higher in patients with AR without asthma than in those with asthma but decreased significantly with triamcinolone acetonide treatment in both subgroups. No changes were observed in bronchial hyperresponsiveness, nasal and asthma symptoms, or peak expiratory flow with active treatment or placebo. CONCLUSION: We conclude that treatment of AR with triamcinolone acetonide results in decrease of 2 noninvasive markers of lower airway inflammation, ENO and H(2)O(2), supporting that upper and lower airway inflammation should be seen as a continuum in subjects with AR with and without asthma. ENO might be a more specific marker of the lower airway inflammation present in asthma.
Notes: 0091-6749 Journal article
URL
Author Address: Asthma and Airway Centre of the Toronto Western Hospital, University Health Network, Division of Respiratory Medicine, University of Toronto, Toronto.

Reference Type: Journal Article
Record Number: 286
Author: Sandrini, A.; Ferreira, I. M.; Jardim, J. R.; Zamel, N.; Chapman, K. R.
Year: 2003
Title: Effect of nasal triamcinolone acetonide on lower airway inflammatory markers in patients with allergic rhinitis
Journal: J Allergy Clin Immunol
Volume: 111
Issue: 2
Pages: 313-20
Date: Feb
Accession Number: 12589351
Keywords: Administration, Intranasal
Adolescent
Adult
Aged
Asthma/complications
Biological Markers
Bronchial Hyperreactivity/drug therapy
Double-Blind Method
Female
Forced Expiratory Volume
Hay Fever/complications/*drug therapy/physiopathology
Human
Hydrogen Peroxide/metabolism
Inflammation Mediators/metabolism
Male
Middle Age
Nitric Oxide/metabolism
Respiration
Rhinitis, Allergic, Perennial/complications/*drug therapy/physiopathology
Support, Non-U.S. Gov't
Triamcinolone Acetonide/*administration & dosage
Abstract: BACKGROUND: Allergic rhinitis (AR) and asthma are commonly associated, and similar underlying inflammatory processes link both diseases. AR, even in the absence of asthma, is associated with increased levels of exhaled nitric oxide (ENO) and hydrogen peroxide (H(2)O(2)) in Exhaled Breath Condensate, 2 noninvasive markers of lower airway inflammation. OBJECTIVE: We sought to evaluate the effect of treatment with the nasal steroid triamcinolone acetonide on ENO and exhaled H(2)O(2) in subjects with AR. METHODS: We allocated 23 subjects in a randomized, double-blind, parallel-controlled fashion to 4-week treatment with triamcinolone acetonide (220 microg/d) or matching placebo. RESULTS: ENO levels were greater in the subgroup with concomitant asthma (16/23 subjects) and decreased significantly with triamcinolone acetonide treatment in this subgroup of patients in comparison with patients receiving placebo. Breath condensate levels of H(2)O(2) were higher in patients with AR without asthma than in those with asthma but decreased significantly with triamcinolone acetonide treatment in both subgroups. No changes were observed in bronchial hyperresponsiveness, nasal and asthma symptoms, or peak expiratory flow with active treatment or placebo. CONCLUSION: We conclude that treatment of AR with triamcinolone acetonide results in decrease of 2 noninvasive markers of lower airway inflammation, ENO and H(2)O(2), supporting that upper and lower airway inflammation should be seen as a continuum in subjects with AR with and without asthma. ENO might be a more specific marker of the lower airway inflammation present in asthma.
Notes: 0091-6749 Clinical Trial
Journal Article
Randomized Controlled Trial
URL
Author Address: Asthma and Airway Centre of the Toronto Western Hospital, University Health Network, Division of Respiratory Medicine, University of Toronto, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.

Reference Type: Journal Article
Record Number: 323
Author: Sandrini, A.; Ferreira, I. M.; Gutierrez, C.; Jardim, J. R.; Zamel, N.; Chapman, K. R.
Year: 2003
Title: Effect of montelukast on exhaled nitric oxide and nonvolatile markers of inflammation in mild asthma
Journal: Chest
Volume: 124
Issue: 4
Pages: 1334-40
Date: Oct
Accession Number: 14555563
Keywords: Acetates/*pharmacology
Adult
Anti-Asthmatic Agents/*pharmacology
Asthma/complications/*drug therapy/*metabolism
Biological Markers/analysis
Breath Tests
Cross-Over Studies
Cysteine/*analysis
Double-Blind Method
Exhalation
Female
Forced Expiratory Volume/drug effects
Human
Hydrogen Peroxide/*analysis
Inflammation Mediators/*analysis
Leukotrienes/*analysis
Male
Nitric Oxide/*analysis
Peak Expiratory Flow Rate/drug effects
Pneumonia/etiology/*metabolism
Quinolines/*pharmacology
Severity of Illness Index
Support, Non-U.S. Gov't
Abstract: STUDY OBJECTIVES: Leukotriene receptor antagonists appear to exert anti-inflammatory activity in asthma. We undertook the present study to evaluate the effect of montelukast on levels of exhaled nitric oxide (ENO) and two inflammatory markers, hydrogen peroxide (H(2)O(2)), and cysteinyl leukotrienes (cys-LTs), in the Exhaled Breath Condensate of subjects with mild asthma. PATIENTS: Twenty stable subjects with mild asthma (15 women and 5 men; mean [+/- SD] age, 34.8 +/- 12.6 years) were included in the study. INTERVENTION: A 1-week run-in period was followed by 2 weeks of treatment (with montelukast or placebo) that was administered in randomized, double-blind, crossover fashion. One week of washout followed each treatment arm. RESULTS: Montelukast significantly reduced the levels of ENO from baseline (median, 52.5 parts per billion [ppb]; 25th to 75th percentile, 37.8 to 101.8 ppb) during the entire treatment period (ie, day 1 to day 14), with the effect measurable as early as day 1 (median, 45.9 ppb; 25th to 75th percentile, 29.3 to 92.5 ppb) and with the maximal effect being observed on day 7 (median, 35.7 ppb; 25th to 75th percentile, 27.6 to 66.6 ppb). The levels of ENO did not change significantly with placebo therapy. Montelukast improved symptom score and reduced peak expiratory flow (PEF) variability. Changes in PEF variability correlated positively with changes in ENO (r = 0.46; p = 0.04). No significant changes in FEV(1) or concentration of H(2)O(2) in the Exhaled Breath Condensate were observed. Levels of cys-LTs were undetectable in the exhaled breath condensate. CONCLUSIONS: We concluded that montelukast reduces the levels of ENO in patients with mild asthma, a finding that is compatible with an anti-inflammatory effect of montelukast, and that ENO appears to be more sensitive in detecting this effect than FEV(1) and H(2)O(2) levels in the Exhaled Breath Condensate.
Notes: 0012-3692
Clinical Trial
Journal Article
Randomized Controlled Trial
URL
Author Address: Asthma & Airway Centre of the Toronto Western Hospital, Division of Respiratory Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.

Reference Type: Journal Article
Record Number: 278
Author: Szkudlarek, U.; Maria, L.; Kasielski, M.; Kaucka, S.; Nowak, D.
Year: 2003
Title: Exhaled hydrogen peroxide correlates with the release of reactive oxygen species by blood phagocytes in healthy subjects
Journal: Respir Med
Volume: 97
Issue: 6
Pages: 718-25
Date: Jun
Accession Number: 12814160
Keywords: Adult
Breath Tests
Female
Human
Hydrogen Peroxide/*analysis
Luminescence
Male
Phagocytes/*metabolism
Reactive Oxygen Species/blood/*metabolism
Support, Non-U.S. Gov't
Thiobarbituric Acid Reactive Substances/analysis
Abstract: Various cells including polymorphonuclear leukocytes, alveolar macrophages and type-II pneumocytes may be a source of exhaled hydrogen peroxide (H2O2) in airways of humans. H2O2 can convert into hydroxyl radicals leading to peroxidative damage of airways structures and formation of volatile thiobarbituric acid-reactive substances (TBARs). We tested whether exhalation of H2O2 and TBARs by healthy subjects depends on reactive oxygen species generation from blood phagocytes. The expired breath condensate (EBC) and blood specimens were collected from 41 healthy, never smoked subjects (mean age 20.7 +/- 0.8 years, 18 men, 23 women) and then the EBC concentration of H2O2 and TBARs and 2 x 10(-5) M fMLP-provoked whole blood chemiluminescence response was measured. The mean concentration of H2O2 and TBARs in EBC was 0.28 +/- 0.17 and 0.04 +/- 0.13 microM with ratio of positive readings reaching 36/41 and 4/41, respectively. The chemiluminescence response to n-formyl-methionyl-leveyl-phenylalanine stimulation was obtained in all cases and the following parameters were estimated: basal chemiluminescence (bCl); peak chemiluminescence (pCl); absolute light emission (aCl); and peaktime. H2O2 levels in EBC positively correlated (Spearmann test) with bCl (r=0.41, P<0.01), pCl (r=0.47, P<0.01), aCl (r=0.49, P<0.001), peaktime (r=0.52, P<0.001) in the whole group and with bCl (r=0.56, P<0.01), pCl (r=0.67, P<0.01), aCl (r=0.66, P<0.01) in men and with aCl (r=0.41, P<0.05) and peaktime (r=0.48, P<0.05) in women. No association between exhaled TBARs and blood phagocytes activity was found. These results indicate that H2O2 exhalation in healthy never smoked subjects depends on ability of blood phagocytes to generate reactive oxygen species.
Notes: 0954-6111
Journal Article
URL
Author Address: Department of Experimental and Clinical Physiology, Institute of Physiology and Biochemistry, Medical University of Lodz, Mazowiecka str 6/8, 92-215 Lodz, Poland.

Reference Type: Journal Article
Record Number: 256
Author: Uczynska, L.; Szkudlarek, U.; Dziankowska-Bartkowiak, B.; Waszczykowska, E.; Kasielski, M.; Sysa-Jedrzejowska, A.; Nowak, D.
Year: 2003
Title: Elevated exhalation of hydrogen peroxide in patients with systemic sclerosis
Journal: Eur J Clin Invest
Volume: 33
Issue: 3
Pages: 274-9
Date: Mar
Accession Number: 12641548
Abstract: BACKGROUND: Systemic sclerosis is accompanied by an influx of activated phagocytes into distal airways. These cells release H2O2, which may evaporate from the airways surface and be detected in expired breath condensate. We tested whether patients with systemic sclerosis exhale more H2O2 than healthy subjects and whether breath condensate H2O2 levels correlate with some clinical parameters. MATERIAL AND METHODS: H2O2 was measured fluorimetrically in the expired breath condensate of 27 patients (22 women, five men, mean age 49 +/- 13.1 years) with systemic sclerosis and 27 age- and sex- matched healthy controls. RESULTS: Exhaled H2O2 levels were 3.5-fold higher (0.88 +/- 0.62 micro M vs. 0.25 +/- 0.17 micro M, P < 0.001) in the patients with systemic sclerosis than in the controls. Treatment with cyclophosphamide and/or prednisone (29 +/- 50 months, range 3-168 months) did not significantly decrease H2O2 exhalation (0.78 +/- 0.50 micro M, n= 10 vs. 0.94 +/- 0.67 micro M, n= 17, P > 0.05). No significant difference was found between patients with limited and diffuse scleroderma (1.03 +/- 0.69 micro M, n= 17 vs. 0.63 +/- 0.41 micro M, n= 10, P > 0.05). H2O2 levels correlated with disease duration (r = 0.38, P < 0.05) and time from the first Raynaud's episode (r = 0.44, P < 0.05). CONCLUSIONS: Patients with systemic sclerosis exhale more H2O2 than healthy controls, suggesting involvement of reactive oxygen species in disease processes. Lack of significant intergroups differences in H2O2 levels may have resulted from the small number of patients analyzed.
Notes: 0014-2972
Journal Article
URL
Author Address: Medical University of Lodz, Lodz, Poland.

Reference Type: Journal Article
Record Number: 270
Author: van Beurden, W. J.; Harff, G. A.; Dekhuijzen, P. N.; van der Poel-Smet, S. M.; Smeenk, F. W.
Year: 2003
Title: Effects of inhaled corticosteroids with different lung deposition on exhaled hydrogen peroxide in stable COPD patients
Journal: Respiration
Volume: 70
Issue: 3
Pages: 242-8
Date: May-Jun
Accession Number: 12915742
Abstract: BACKGROUND: The effects of inhaled corticosteroids (ICS) on markers of oxidative stress in patients with stable COPD are unclear. OBJECTIVES: The aim was to investigate the effect of ICS on exhaled H(2)O(2) in stable COPD patients and to compare ICS with different lung deposition. METHODS: Forty-one stable patients with moderate COPD (FEV(1) approximately 60% predicted) were randomized to sequence 1; first HFA-134a beclomethasone dipropionate (HFA-BDP, an ICS with more peripheral deposition) 400 microg b.i.d., then fluticasone propionate (FP, an ICS with more central deposition) 375 microg b.i.d. (n = 20) or sequence 2; first FP, then HFA-BDP (n = 21). Both 4-week treatment periods were preceded by a 4-week washout period. After each period, the concentration of H(2)O(2) in Exhaled Breath Condensate was measured. RESULTS: The H(2)O(2) concentration decreased significantly after the first treatment period in both sequence 1 and 2 (p < 0.05, p = 0.01, respectively). In neither sequence was there a return to baseline values after the second washout, indicating a carry-over effect. The concentrations remained low in both sequences during the second treatment period. CONCLUSIONS: Both ICS appeared to reduce exhaled H(2)O(2) in stable COPD patients. However, this study showed no difference between ICS with different deposition patterns, which in part may be due to the carry-over effect.
Notes: 0025-7931
Journal Article
URL
Author Address: Department of Pulmonology, Catharina Hospital Eindhoven, The Netherlands. wendy.beurden@wanadoo.nl

Reference Type: Journal Article
Record Number: 315
Author: van Beurden, W. J.; van den Bosch, M. J.; Janssen, W. C.; Smeenk, F. W.; Dekhuijzen, P. N.; Harff, G. A.
Year: 2003
Title: Fluorimetric analysis of hydrogen peroxide with automated measurement
Journal: Clin Lab
Volume: 49
Issue: 11-12
Pages: 637-43
Accession Number: 14651334
Abstract: In the pathophysiology of chronic obstructive pulmonary disease (COPD) oxidative stress plays an important role, which can be determined by measuring hydrogen peroxide. Hydrogen peroxide can be measured fluorimetrically in Exhaled Breath Condensate (EBC), however, not standardized. The objective of this study was to investigate the sensitivity and reproducibility of measuring the hydrogen peroxide concentration in EBC of COPD patients using an automated flow injection device with varying flow rates and measurements. METHODS: 10 microl p-hydroxyphenylacetic acid (1.0 mmol/l) and 10 microl horseradish peroxidase (15 mU/l) were manually added to several hydrogen peroxide containing solutions and EBC of patients suffering from COPD. The fluorescence of the reaction product was measured with an automated sampler, flow injection and scanning fluorescence detector, excitation wave 295 nm, emission wave 405 nm, at different flow rates. The degree of fluorescence was expressed as either the area under the curve or the peak value. RESULTS: A flow rate of 1 ml/min gave the best results. There were no significant differences in calibration curves or detection limits using area under the curve or peak value (respectively 0.007 and 0.005 micromol/l) (flow rate 1.0 ml/min). The mean volume of EBC was 2.8 ml, the mean hydrogen peroxide concentration in the patient group was 0.2 micromol/l and the standard deviation of duplication 0.009 micromol/. CONCLUSIONS: The low detection limit may be explained by using flow injection, because it measures the fluorescence over a period of time. It is important to choose an appropriate flow rate. There is no difference in the detection limit between measuring the fluorescence as area under the curve or as peak value.
Notes: 1433-6510
Journal Article
URL
Author Address: Department of Pulmonary Diseases, Catharina Hospital Eindhoven, The Netherlands. wendy.beurdenvan@wanadoo.nl

Reference Type: Journal Article
Record Number: 365
Author: van Beurden, W. J.; Smeenk, F. W.; Harff, G. A.; Dekhuijzen, P. N.
Year: 2003
Title: Markers of inflammation and oxidative stress during lower respiratory tract infections in COPD patients
Journal: Monaldi Arch Chest Dis
Volume: 59
Issue: 4
Pages: 273-80
Date: Oct-Dec
Accession Number: 15148836
Keywords: Administration, Inhalation
Adrenal Cortex Hormones/therapeutic use
Aged
Aged, 80 and over
Analysis of Variance
Blood Chemical Analysis
Comparative Study
Disease Progression
Female
Hospitalization
Human
Inflammation Mediators/*analysis
Male
Middle Aged
Oxidative Stress/*physiology
Pneumonia/complications/*diagnosis
Probability
Prognosis
Pulmonary Disease, Chronic Obstructive/complications/*diagnosis/drug
therapy
Respiratory Function Tests
Risk Assessment
Sampling Studies
Sensitivity and Specificity
Severity of Illness Index
Spirometry
Statistics, Nonparametric
Abstract: BACKGROUND: Lower respiratory tract infections (LRTI) occur frequently in patients with Chronic Obstructive Pulmonary Disease (COPD), and are a major cause of morbidity, mortality and health care utilization. The aim of this study was to investigate if non- or less invasive markers of inflammation and oxidative stress can predict the course of the infections. METHODS: Twenty-five COPD patients who were admitted to hospital with a LRTI were included. Within 24 hours after admittance, spirometry (FEV1, FVC, MEF50), measurement of hydrogen peroxide (H2O2) in Exhaled Breath Condensate (EBC), symptom scores and analyses of ESR, CRP, ECP, and MPO in serum were performed. All patients were treated with intravenous dexamethasone, nebulised salbutamol/ipratropium and, if needed, antibiotics. The tests were repeated at day 2, 3, 7 and 30. RESULTS: Complete data of the first four visits were collected in 19 patients. The H2O2 concentration and spirometry parameters did not change significantly during the study period. CRP, ESR and MPO levels decreased significantly during treatment, while the other serum inflammatory parameters did not change. There were no significant correlations between H2O2 concentration, spirometry and serum inflammatory parameters. CONCLUSIONS: In conclusion, this study showed no significant changes in H2O2 concentration in EBC, or spirometry during treatment of a LRTI in COPD patients. In contrast, several serum inflammatory markers did decrease during hospitalization, thus providing a simple tool to monitor exacerbations.
Notes: 1122-0643
Journal Article
URL
Author Address: Department of Pulmonology, Catharina Hospital, Eindhoven, The Netherlands. wendy.beurdenvan@wanadoo.nl

Reference Type: Journal Article
Record Number: 342
Author: Vass, G.; Huszar, E.; Barat, E.; Horvath, I.
Year: 2003
Title: [Exhaled Breath Condensate and its analysis--a new method in pulmonology]
Journal: Orv Hetil
Volume: 144
Issue: 51
Pages: 2517-24
Date: Dec 21
Accession Number: 14974158
Keywords: Asthma/diagnosis/metabolism
Biological Markers/analysis
Breath Tests/*methods
Bronchiectasis/diagnosis/metabolism
Cystic Fibrosis/diagnosis/metabolism
English Abstract
F2-Isoprostanes/analysis
Human
Hydrogen Peroxide/analysis
Oxidative Stress
Pulmonary Disease, Chronic Obstructive/diagnosis/metabolism
Respiratory Distress Syndrome, Adult/diagnosis/metabolism
Respiratory Tract Diseases/*diagnosis/*metabolism
Smoking/metabolism
Abstract: In the middle of the nineties a new, non-invasive method for investigation of the lung aroused the interest of many researchers: the exhaled breath condensate. It shows the extent of the interest that in the last five years more than 80 original articles have been published in this theme. Many substances are found in the expired breath which are detectable in the liquid that we obtain by cooling (= condensing) the exhaled breath. The advantages of this method are that it is non-invasive, convenient, it could be performed with mechanically ventilated patients as well as with children. The most studied substance is the hydrogen-peroxide, which is the marker of oxidative stress, and its level in condensate is elevated in numerous inflammatory diseases. 8-isoprostane was also studied a lot, which is another marker of oxidative stress. Numerous substances could be even measured in condensate, so the decay-product of nitric-oxide (nitrite, nitrate, nitrotyrosine), further nitrosothiol, adenosine, ammonia, different ions, leukotrienes, cytokines; recently even other feature of condensate is examined, such as its pH. The different mediators could help us to know better the diseases, support the diagnosis, follow the treatment or the disease. In this study the authors attempt to present the most important knowledge till now.
Notes: 0030-6002
Journal Article
Review
Review, Tutorial
URL
Author Address: Orszagos Koranyi Tbc es Pulmonologiai Intezet, Korelettani Osztaly, Budapest. vassgeza@koranyi.hu

Reference Type: Journal Article
Record Number: 280
Author: Wilhelm, J.; Vankova, M.; Maxova, H.; Siskova, A.
Year: 2003
Title: Hydrogen peroxide production by alveolar macrophages is increased and its concentration is elevated in the breath of rats exposed to hypoxia: relationship to lung lipid peroxidation
Journal: Physiol Res
Volume: 52
Issue: 3
Pages: 327-32
Accession Number: 12790764
Abstract: Hypoxic exposure triggers a generation of reactive oxygen species that initiate free radical damage to the lung. Hydrogen peroxide is the product of alveolar macrophages detectable in the expired breath. We evaluated the significance of breath H(2)O(2) concentration for the assessment of lung damage after hypoxic exposure and during posthypoxic period. Adult male rats were exposed to normobaric hypoxia (10 % O(2)) for 3 hours or 5 days. Immediately after the hypoxic exposure and then after 7 days or 14 days of air breathing, H(2)O(2) was determined in the breath condensate and in isolated lung macrophages. Lipid peroxidation was measured in lung homogenates. Three-hour hypoxia did not cause immediate increase in the breath H(2)O(2); 5-day hypoxia increased breath H(2)O(2) level to 458 %. After 7 days of subsequent air breathing H2O2 was elevated in both groups exposed to hypoxia. Increased production of H(2)O(2) by macrophages was observed after 5 days of hypoxia and during the 7 days of subsequent air breathing. Lipid peroxidation increased in the periods of enhanced H(2)O(2) generation by macrophages. As the major increase (1040 %) in the breath H(2)O(2) concentration found 7 days after 3 hours of hypoxia was not accompanied by lipid peroxidation, it can be concluded that the breath H(2)O(2) is not a reliable indicator of lung oxidative damage.
Notes: 0862-8408
Journal Article
URL
Author Address: Department of Medical Chemistry and Biochemistry, Second Faculty of Medicine, Charles University, Prague, Czech Republic. jiri.wilhelm@lfmotol.cuni.cz

Reference Type: Journal Article
Record Number: 328
Author: Deaton, C. M.; Marlin, D. J.; Smith, N. C.; Smith, K. C.; Newton, R. J.; Gower, S. M.; Cade, S. M.; Roberts, C. A.; Harris, P. A.; Schroter, R. C.; Kelly, F. J.
Year: 2004
Title: Breath condensate hydrogen peroxide correlates with both airway cytology and epithelial lining fluid ascorbic acid concentration in the horse
Journal: Free Radic Res
Volume: 38
Issue: 2
Pages: 201-8
Date: Feb
Accession Number: 15104214
Abstract: The relationship between hydrogen peroxide (H2O2) concentration in expired breath condensate (EBC) and cytology of the respiratory tract obtained from tracheal wash (TW) or bronchoalveolar lavage (BAL), and epithelial lining fluid (ELF) antioxidant status is unknown. To examine this we analysed the concentration of H2O2 in breath condensate from healthy horses and horses affected by recurrent airway obstruction (RAO), a condition considered to be an animal model of human asthma. The degree of airway inflammation was determined by assessing TW inflammation as mucus, cell density and neutrophil scores, and by BAL cytology. ELF antioxidant status was determined by measurement of ascorbic acid, dehydroascorbate, reduced and oxidised glutathione, uric acid and alpha-tocopherol concentrations. RAO-affected horses with marked airway inflammation had significantly higher concentrations of breath condensate H2O2 than control horses and RAO-affected horses in the absence of inflammation (2.0 +/- 0.5 micromol/l. 0.4 +/- 0.2 micromol/l and 0.9 +/- 0.2 micromol/l H2O2, respectively; p < 0.0001). The concentration of breath condensate H2O2 was related inversely to the concentration of ascorbic acid in ELF (r = -0.80; p < 0.0001) and correlated positively with TW inflammation score (r = 0.76, p < 0.0001) and BAL neutrophil count (r = 0.80, p < 0.0001). We conclude that the concentration of H2O2 in breath condensate influences the ELF ascorbic acid concentration and provides a non-invasive diagnostic indicator of the severity of neutrophilic airway inflammation.
Notes: 1071-5762
Journal Article
URL
Author Address: Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Suffolk CB8 7UU, UK. chris.deaton@aht.org.uk

Reference Type: Journal Article
Record Number: 359
Author: Majewska, E.; Kasielski, M.; Luczynski, R.; Bartosz, G.; Bialasiewicz, P.; Nowak, D.
Year: 2004
Title: Elevated exhalation of hydrogen peroxide and thiobarbituric acid reactive substances in patients with community acquired pneumonia
Journal: Respir
Med Volume: 98
Issue: 7
Pages: 669-76
Date: Jul
Accession Number: 15250234
Keywords: Adult
Aged
Biological Markers/analysis
Breath Tests/methods
C-Reactive Protein/metabolism
Community-Acquired Infections/metabolism
Female
Human
Hydrogen Peroxide/*metabolism
Male
Middle Aged
Oxidative Stress
Pneumonia, Bacterial/drug therapy/*metabolism
Support, Non-U.S. Gov't
Thiobarbituric Acid Reactive Substances/*metabolism
Abstract: BACKGROUND: Bacterial pneumonia involves influx of activated phagocytes into distal airways. These cells release oxidants including H2O2, that may be exhaled or induce peroxidative damage to lung tissues with formation of thiobarbituric reactive substances (TBARs). STUDY OBJECTIVES: To determine whether concentrations of H2O2 and TBARs in Exhaled Breath Condensate (EBC) is elevated and correlate with systemic response to pneumonia during 10 days of hospital treatment. DESIGN: The concentration of H2O2 and TBARs was measured in EBC of 43 inpatients with community acquired pneumonia (CAP) and 20 healthy never smoked subjects over 10 days and were accompanied by monitoring of WBC count, serum concentration of C-reactive protein (CRP) and peroxyl radical-trapping capacity. RESULTS: Patients with CAP exhaled 4.6-, 3.7-, 3.9-, 3.3-times more H2O2 than healthy controls at 1st, 3rd, 5th and 10th day of treatment (P<0.05), respectively. EBC concentrations of TBARs were elevated at 1st and 3rd day. H2O2 and TBARs levels decreased along with treatment course. Correlation (P<0.05) was found between H2O2 levels and CRP and WBC count (r = 0.31) at 1st day and between TBARs and CRP at 5th (r = 0.34) and 10th day (r = 0.46). The mean H2O2 exhalation estimated over ten days of treatment correlated with pneumonic chest X-ray score (r = 0.42), CRP levels (r = 0.46) and WBC count (r = 0.33) at admission (P<0.05). CONCLUSIONS: Pneumonia is accompanied by oxidative stress in airways that moderately correlates with intensity of systemic inflammatory response. Determination of H2O2 in EBC may be helpful for non-invasive monitoring of oxidants production during lower respiratory tract infection.
Notes: 0954-6111
Journal Article
URL
Author Address: Department of Experimental and Clinical Physiology, Institute of Physiology and Biochemistry, Medical University of Lodz, Mazowiecka St. 6/8, 92-215 Lodz, Poland.

Reference Type: Journal Article
Record Number: 296
Author: Moloney, E. D.; Mumby, S. E.; Gajdocsi, R.; Cranshaw, J. H.; Kharitonov, S. A.; Quinlan, G. J.; Griffiths, M. J.
Year: 2004
Title: Exhaled Breath Condensate detects markers of pulmonary inflammation after cardiothoracic surgery
Journal: Am J Respir Crit Care Med
Volume: 169
Issue: 1
Pages: 64-9
Date: Jan 1
Accession Number: 14551168
Abstract: Cardiac surgery using cardiopulmonary by-pass and, to a greater extent, lung resection, causes acute lung injury that is usually subclinical. Analysis of mediators in Exhaled Breath Condensate is a promising means of monitoring inflammation in a variety of airway diseases but the contribution of the airway lining fluid from the lower respiratory tract is uncertain. We compared the analysis of markers of lung injury in Exhaled Breath Condensate and bronchoalveolar lavage in endotracheally intubated patients before and after coronary artery bypass graft surgery with cardiopulmonary bypass and lobectomy. The neutrophil count and leukotriene B4 concentration in bronchoalveolar lavage fluid rose after coronary artery bypass graft surgery (p < 0.05), but there was no significant change in leukotriene B4, hydrogen peroxide, or hydrogen ion concentrations in Exhaled Breath Condensate. By contrast, after lobectomy, the concentration in Exhaled Breath Condensate of leukotriene B4, hydrogen peroxide and hydrogen ions rose significantly (p < 0.05). Exhaled breath condensate is a safe, noninvasive method of sampling the milieu of the distal lung and is sufficiently sensitive to detect markers of inflammation and oxidative stress in patients after lobectomy, but not after the milder insult associated with cardiac surgery.
Notes: 1073-449x
Journal Article
URL
Author Address: M.R.C.P., Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP UK. m.griffiths@imperial.ac.uk

Reference Type: Journal Article
Record Number: 295
Author: Rysz, J.; Kasielski, M.; Apanasiewicz, J.; Krol, M.; Woznicki, A.; Luciak, M.; Nowak, D.
Year: 2004
Title: Increased hydrogen peroxide in the exhaled breath of uraemic patients unaffected by haemodialysis
Journal: Nephrol Dial Transplant
Volume: 19
Issue: 1
Pages: 158-163
Date: Jan
Accession Number: 14671051
Abstract: BACKGROUND: Uraemia is accompanied by conditions favouring the rise of H(2)O(2) activity in body fluids. This results from the increased release of H(2)O(2) by polymorphonuclear leukocytes and decreased plasma glutathione peroxidase activity. The purpose of this study was to determine if patients on chronic haemodialysis (HD) exhale more H(2)O(2) than healthy individuals, and if dialysis affects breath H(2)O(2) content. METHODS: We studied 29 chronic HD patients (mean age 49 +/- 11 years) and 40 healthy persons (mean age 44 +/- 9 years). H(2)O(2), which is volatile, was measured fluorimetrically with the homovanillic acid method in the exhaled breath condensate (EBC) of the study cohort. EBC was collected immediately before and after the HD session and also at 20 and 60 min of HD treatment (n = 14) and once in controls. Peak expiratory flow (PEF), white blood cell (WBC) count, PaO(2) and circulatory cyclic guanosine monophosphate (cGMP), Il-6 and Il-8 concentrations were measured concomitantly. Finally, H(2)O(2) diffusion through the dialyser cuprophane membrane was determined in an in vitro experiment. RESULTS: At baseline, EBC H(2)O(2) concentration was 22 times higher in HD patients than in controls (2.92 +/- 4.64 vs 0.16 +/- 0.13 micro M, P < 0.001). Although the maximum decrease in PEF (431 +/- 52 vs 398 +/- 56 l/min, P < 0.01) and WBC count (6.72 +/- 1.02 vs 3.82 +/- 1.51 x 10(3)/ micro l, P < 0.01) occurred at 20 min after the start of HD, no significant changes in breath H(2)O(2) levels were noted throughout the session. Plasma IL-6 and IL-8 levels remained unchanged whereas cGMP rose 1.3 times at 60 min (P < 0.01). In vitro, H(2)O(2) rapidly diffused through the cuprophane membrane. CONCLUSION: Chronic HD patients exhale more H(2)O(2) than healthy subjects. Although no change of breath H(2)O(2) concentration was observed during HD, as H(2)O(2) easily diffuses through the dialyser membrane, it is not possible to rule out that HD stimulates H(2)O(2) generation.
Notes: 0931-0509
Journal article
URL
Author Address: Department of Internal Medicine and Dialysotherapy Medical University of Lodz, Lodz, Practical Clinical Training Centre, Medical University of Lodz, Lodz and Department of Experimental and Clinical Physiology, Institute of Physiology and Biochemistry, Medical University of Lodz, Lodz, Poland.

Reference Type: Journal Article
Record Number: 354
Author: Svensson, S.; Olin, A. C.; Larstad, M.; Ljungkvist, G.; Toren, K.
Year: 2004
Title: Determination of hydrogen peroxide in Exhaled Breath Condensate by flow injection analysis with fluorescence detection
Journal: J Chromatogr B Analyt Technol Biomed Life Sci
Volume: 809
Issue: 2
Pages: 199-203
Date: Oct 5
Accession Number: 15315765
Abstract: A method for the determination of hydrogen peroxide in exhaled breath condensate (EBC) by automated flow injection analysis (FIA) with fluorescence detection was developed and validated. In the enzymatic assay a fluorescent dimer of para-hydroxyphenyl acetic acid (HPAA) was formed by the redox coupling reaction between hydrogen peroxide and horseradish peroxidase (HRP). The calibration curve of hydrogen peroxide was linear over a range of 40-5000nM. The coefficient of variation (CV) for within-day precision was 1-3%; for between-day precision, it was 2-5% over the validated range. The assay requires a small sample aliquot (150microl) and no incubation time, and has an analytical runtime of <2min. It is therefore suitable for larger studies. The method was used to detect hydrogen peroxide in EBC of asthmatic patients and healthy volunteers. A statistically significant difference was found between patients with asthma (n = 19) and control subjects without asthma (n = 19), 780nM versus 480nM (P = 0.03).
Notes: 1570-0232
Journal Article
URL
Author Address: Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy at Goteborg University, Sankt Sigfridsgatan 85, SE-41266 Goteborg, Sweden.

Reference Type: Journal Article
Record Number: 368
Author: Szkudlarek, U.; Zdziechowski, A.; Witkowski, K.; Kasielski, M.; Luczynska, M.; Luczynski, R.; Sarniak, A.; Nowak, D.
Year: 2004
Title: Effect of inhaled N-acetylcysteine on hydrogen peroxide exhalation in healthy subjects
Journal: Pulm Pharmacol Ther
Volume: 17
Issue: 3
Pages: 155-62
Accession Number: 15123225
Keywords: Acetylcysteine/administration & dosage/*pharmacology
Administration, Inhalation
Adult
Antioxidants/administration & dosage/*pharmacology
Breath Tests
Exhalation
Female
Human
Hydrogen Peroxide/*metabolism
Male
Support, Non-U.S. Gov't
Abstract: N-acetylcysteine (NAC) has antioxidant properties and its oral administration decreased H(2)O(2) exhalation in patients with chronic obstructive pulmonary disease. In this study we tested whether inhaled NAC could suppress H(2)O(2) levels in Exhaled Breath Condensate (EBC) of eight healthy subjects that have never smoked (never-smokers). Original NAC solution (ACC vial, 300 mg NAC in 3 ml solvent), NAC-placebo (vehicle), sterile 0.9% NaCl or distilled water were nebulized via the pneumatic De Vilbiss nebulizer once daily every 7 days and H(2)O(2) and thiols exhalation was measured just before, 30 min and 3 h after the end of drug administration. Additional in vitro experiments were performed to evaluate NAC stability during nebulization, reactivity with H(2)O(2) and possible H(2)O(2) generation in aqueous NAC solutions. NAC almost completely abolished H(2)O(2) exhalation 30 min after inhalation (0.02+/-0.04 vs. 0.21+/-0.09 microM, p<0.001). However, 3 h later the H(2)O(2) levels raised 1.8-fold from baseline (p<0.01). Other inhaled solutions did not affect H(2)O(2) levels. Mean thiol concentration in EBC rose (p<0.05) after treatment with NAC and reached 1.03+/-0.48 microM at 3 h. Although, 25 and 50 mM NAC completely inhibited H(2)O(2)-peroxidase-luminol-dependent chemiluminescence, detectable amounts of H(2)O(2) were generated in NAC solutions. It was accompanied by moderate loss of -SH groups. Catalase and ascorbic acid prevented H(2)O(2) formation in NAC solutions. In conclusion inhaled NAC revealed biphasic effect on H(2)O(2) exhalation in healthy subjects, which depends on direct H(2)O(2) scavenging and H(2)O(2) generation related to drug oxidation. The net result of these processes may determine anti- or pro-oxidant action of inhaled NAC.
Notes: 1094-5539
Clinical Trial
Journal Article
URL
Author Address: Department of Experimental and Clinical Physiology, Institute of Physiology and Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland.

Reference Type: Journal Article
Record Number: 334
Author: Van Hoydonck, P. G.; Wuyts, W. A.; Vanaudenaerde, B. M.; Schouten, E. G.; Dupont, L. J.; Temme, E. H.
Year: 2004
Title: Quantitative analysis of 8-isoprostane and hydrogen peroxide in exhaled breath condensate
Journal: Eur Respir J
Volume: 23
Issue: 2
Pages: 189-92
Date: Feb
Accession Number: 14979489
Abstract: Exhaled Breath Condensate (EBC) provides a noninvasive means of sampling the lower respiratory tract. Collection of EBC might be useful in the assessment of airway oxidative stress in smokers. The aim of this study was to determine 8-isoprostane and hydrogen peroxide levels in EBC, and, in addition, to investigate the reproducibility of these measurements. EBC samples were collected from 12 healthy male smokers at three time points within 1 week. 8-isoprostane and H2O2 were measured in nonconcentrated EBC using immunochemical and colorimetric assays, respectively. 8-isoprostane and H2O2 were detected in only 36 and 47% of all EBC samples, respectively. It was not possible to calculate the within-subject variation in a reliable manner since only three of the 12 smokers exhibited detectable 8-isoprostane concentrations on all three occasions (mean 4.6 pg x mL(-1); range 3.9-7.7 pg x mL(-1)), whereas H2O2 could not be detected on all three occasions in any of the smokers. Spiking experiments revealed a recovery of 83.5-109.5% for 8-isoprostane and 69.9-129.0%, for H2O2 in fresh EBC samples. It was concluded that levels of 8-isoprostane and hydrogen peroxide cannot be reproducibly assessed in Exhaled Breath Condensate from healthy smokers because of their low concentration and/or the lack of sensitivity of the available assays.
Notes: 0903-1936
Journal Article
URL
Author Address: Dept of Public Health, Division of Nutritional Epidemiology, Catholic University of Leuven, Leuven, Belgium.

Reference Type: Journal Article
Record Number: 367
Author: Weissmann, N.; Vogels, H.; Schermuly, R. T.; Ghofrani, H. A.; Hanze, J.; Fink, L.; Rose, F.; Seeger, W.; Grimminger, F.
Year: 2004
Title: Measurement of exhaled hydrogen peroxide from rabbit lungs
Journal: Biol Chem
Volume: 385
Issue: 3-4
Pages: 259-64
Date: Mar-Apr
Accession Number: 15134339
Keywords: Animals
Comparative Study
Exhalation/*physiology
Female
Hydrogen Peroxide/analysis/*metabolism
Intubation, Intratracheal/methods
Lung/chemistry/*metabolism
Male
Pulmonary Ventilation/physiology
Rabbits
Support, Non-U.S. Gov't
Abstract: Exhaled H2O2 is considered an indicator of lung inflammatory and oxidative stress. Moreover, H2O2 may be involved in signal transduction processes. It is not fully elucidated to what extent (i) H2O2 escapes from the intravascular compartment, and (ii) pulmonary H2O2 generation and nasopharyngeal H2O2 generation contribute to exhaled H2O2. We investigated H2O2 concentrations in breath condensate from isolated buffer-perfused and ventilated rabbit lungs, and from both intubated and spontaneously breathing rabbits with a horseradish peroxidase/2',7'dichlorofluorescin assay. For the perfused lungs, a H2O2 concentration of 58 +/- 19 nM was found. Addition of H2O2 to the buffer fluid resulted in only minute appearance in the exhaled air (<0.001%). Levels of exhaled H2O2 in intubated rabbits and perfused lungs were virtually identical. Nearly ten-fold higher levels were detected in spontaneously breathing rabbits. Decreasing the inspired oxygen concentration from 21% to 1% resulted in a tendency toward decreased H2O2 exhalation in perfused lungs. In contrast, phorbol-12-myristate-13-acetate (PMA) prompted a approximately 4-fold increase in H2O2 exhalation. We conclude that the horseradish peroxidase/2',7'dichlorofluorescin assay is a feasible technique to measure H2O2 in Exhaled Breath Condensate in rabbits. When collecting exhaled air via the tracheal tube, the signal represents pulmonary H2O2 generation with the contribution of the remaining body being negligible.
Notes: 1431-6730
Journal Article
URL
Author Address: Department of Internal Medicine, Justus-Liebig-University Giessen, Klinikstrasse 36, D-35392 Giessen, Germany. Norbert.Weissmann@innere.med.uni-giessen.de