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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