Increased 8-isoprostane, a marker of oxidative stress in exhaled breath condensate in subjects with asbestos exposure

Our plain-English summary of Increased 8-isoprostane, a marker of oxidative stress in exhaled breath condensate in subjects with asbestos exposure, by D. Pelclová, Z. Fenclová, P. Kacer, et al (Industrial Health, 2008).

The study

• Authors: D. Pelclová, Z. Fenclová, P. Kacer, M. Kuzma, T. Navrátil, J. Lebedová
• Journal: Industrial Health
• Published: 2008;46(5):484-9
• Cited by: 53 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestosis and pleural plaques exhibit unpredictable but progressive development, and there are no markers routinely available to measure their prognosis. Asbestos exposure induces the generation of reactive oxygen species, and 8-isoprostane is involved in experimental asbestos-related lung toxicity. This oxidative stress marker was measured in exhaled breath condensate (EBC) in 92 former asbestos workers with mean age 68.8+/-1.7 yr and mean duration of asbestos exposure 24.1+/-2.0 yr. The control group had 46 subjects with mean age 65.2+/-3.3 yr. The mean level of 8-isoprostane, analyzed by liquid chromatography-electrospray ionization-mass spectrometry, was higher in asbestos-exposed subjects (69.5+/-6.6 pg/ml, p=0.0001) compared with the control group, where the concentration was 47.0+/-7.8 pg/ml. The results presented support the hypothesis that oxidative stress due to asbestos is the main cause of increased 8-isoprostane in EBC. Measurement of 8-isoprostane in EBC is a promising non-invasive means for assessing the activity of asbestos-induced diseases.

In plain English

This short communication from Prague, Czech Republic, measured 8-isoprostane, an oxidative stress marker, in exhaled breath condensate (moisture collected from breath). It compared 92 former asbestos workers with 46 hospital technical workers without occupational asbestos exposure. The workers had been employed a mean of 24.1 years (plus or minus 2.0) in three asbestos manufacturing plants using about 95% chrysotile and 5% crocidolite. Mean 8-isoprostane was 69.5 pg/ml (confidence interval plus or minus 6.6) in the exposed group and 47.0 pg/ml (plus or minus 7.8) in controls (p=0.0001). Levels did not correlate with estimated asbestos fiber-years. Compared with controls, the difference was significant for the 47 workers with both asbestosis and pleural hyalinosis and the 23 with pleural hyalinosis only. It was not significant for the 9 with asbestosis only. Two workers with lung cancer had high levels. No correlation was found between 8-isoprostane and alcohol consumption or smoking in either group. The authors concluded that asbestos exposure appeared to be the main factor. They stated the method was not yet ready for screening and follow-up data were needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional comparison (published as a short communication) of former asbestos workers and unexposed controls
• Who was studied: 92 former asbestos workers (46 women and 46 men) attending regular follow-up at the Department of Occupational Medicine, Charles University, Prague, Czech Republic, with a mean age of 68.8. The controls were 46 hospital technical workers (23 men and 23 women) without occupational asbestos exposure, with a mean age of 65.2.
• Exposure: Work for a mean of 24.1 years (printed as 24.1 plus or minus 2.0; median 1964 to 1990) in three asbestos manufacturing plants using about 95% chrysotile and 5% crocidolite. Most work was in producing asbestos insulation and textile materials, asbestos-cement roofing, and pipe. Median estimated exposure was 147.5 fiber-years (range 6 to 1150).
• Main results:
  • Mean 8-isoprostane in exhaled breath condensate was 69.5 pg/ml in the 92 asbestos-exposed subjects and 47.0 pg/ml in the 46 controls (p=0.0001). Table 2 gives the confidence intervals of these means as plus or minus 6.6 and plus or minus 7.8.
  • 8-isoprostane did not correlate with asbestos fiber-years, or with latency since first or last exposure.
  • By chest radiograph findings, 8-isoprostane differed significantly from controls in only two groups: the 47 subjects with both asbestosis and hyalinosis, and the 23 with hyalinosis only.
  • 8-isoprostane was not significantly increased in the 9 subjects with asbestosis only.
  • Two exposed subjects with lung cancer had high 8-isoprostane levels.
  • In both the exposed and control groups, 8-isoprostane did not correlate with alcohol intake or cigarette pack-years.
  • Erythrocyte sedimentation (ESR 1.H and ESR 2.H), alpha1-microglobulin and alpha1-antitrypsin were higher in the asbestos-exposed group than in controls.
  • Rheumatoid factor positivity was more frequent in exposed subjects (20.7%) than in controls (4.4%), p=0.0119.
  • Several lung function measures were lower in exposed subjects than in controls.
• The authors' conclusion: The authors concluded that asbestos exposure appeared to be the main factor behind the increased 8-isoprostane, because no other factor they studied was significant. They described exhaled breath condensate analysis as a promising method.
• Limitations the authors state:
  • HRCT scans were done only where needed for diagnosis or compensation, and were not done in 5 of the 13 subjects without radiological changes. The authors state that minor parenchymal and pleural changes could therefore have been overlooked.
  • The asbestosis-only group was small (9 patients) and had relatively low profusion of opacities, which the authors say could have influenced the result.
  • Absolute concentrations of breath condensate markers are difficult to compare across studies because collection and analysis methods differ.
  • The authors state that breath condensate analysis is not yet ready for screening, and that follow-up data are needed to judge its usefulness.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Oxidative Stress, Asbestos Exposure, Pleural Plaques, Prognosis, Reactive Oxygen Species (ROS).

Related studies

• Increased alveolar nitric oxide concentration and high levels of leukotriene B(4) and 8-isoprostane in exhaled breath condensate in patients with asbestosis — H. Lehtonen, P. Oksa, et al. (2007)
• Oxidative stress markers in exhaled breath condensate in lung fibroses are not significantly affected by systemic diseases — D. Pelclová, Z. Fenclová, et al. (2011)
• Rapid and easy method for monitoring oxidative stress markers in body fluids of patients with asbestos or silica-induced lung diseases — K. Syslová, P. Kacer, et al. (2009)
• Leukotrienes B4, C4, D4 and E4 in the exhaled breath condensate (EBC), blood and urine in patients with pneumoconiosis — D. Pelclová, Z. Fenclová, et al. (2012)
• Use of exhaled breath condensate to investigate occupational lung diseases — M. Corradi, P. Gergelova, et al. (2010)
• Chemical characterization of exhaled breath to differentiate between patients with malignant plueral mesothelioma from subjects with similar professional asbestos exposure — G. de Gennaro, S. Dragonieri, et al. (2010)

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