Leukotrienes B4, C4, D4 and E4 in the exhaled breath condensate (EBC), blood and urine in patients with pneumoconiosis

Our plain-English summary of Leukotrienes B4, C4, D4 and E4 in the exhaled breath condensate (EBC), blood and urine in patients with pneumoconiosis, by D. Pelclová, Z. Fenclová, S. Vlcková, et al (Industrial Health, 2012).

The study

• Authors: D. Pelclová, Z. Fenclová, S. Vlcková, J. Lebedová, K. Syslová, O. Pecha, J. Belácek, T. Navrátil, M. Kuzma, P. Kacer
• Journal: Industrial Health
• Published: 2012;50(4):299-306
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Leukotrienes (LTs) are involved in the pathogenesis of lung fibrosis and were increased in exhaled breath condensate (EBC) of the patients with pneumoconiosis. However the possible influence of extra-pulmonary disorders on the EBC markers is not known. Therefore in parallel with EBC, LTs' levels in the plasma and urine were measured in patients with pneumoconiosis (45 × asbestos exposure, 37 × silica exposure) and in 27 controls. Individual LTs B4, C4, D4 and E4 were measured by liquid chromatography - electrospray ionization - tandem mass spectrometry (LC-ESI-MS/MS). In EBC, LT D4 and LT E4 were increased in both groups of patients (p<0.001 and p<0.05), comparing with the controls. Both LT B4 and cysteinyl LTs were elevated in asbestos-exposed subjects (p<0.05). Asbestosis with more severe radiological signs (s1/s2-t3/u2) and lung functions impairment has shown higher cysteinyl LTs and LT C4 in the EBC (p<0.05) than mild asbestosis (s1/s0-s1/s1). In addition, in the subjects with asbestosis, cysteinyl LTs in EBC correlated with TLC (-0.313, p<0.05) and TLCO/Hb (-0.307, p<0.05), and LT C4 with TLC (-0.358, p<0.05). In pneumoconioses, EBC appears the most useful from the 3 fluids studied.

In plain English

This Czech study measured four leukotrienes (LT B4, C4, D4 and E4), substances involved in inflammation, in three body fluids: exhaled breath condensate (EBC, moisture collected from cooled breath), blood plasma and urine. It compared 45 patients formerly exposed to asbestos in making asbestos insulation, textiles, cement roofing and pipe, 37 formerly exposed to silica, and 27 controls never occupationally exposed to fibrogenic dusts. In EBC, average LT D4 was 31.9 pg/ml in asbestos patients, 30.8 in silica patients and 23.0 in controls, each with a confidence interval of plus or minus 1.8 (p less than 0.001 for both versus controls). LT E4 in EBC was also higher in both patient groups. LT B4 and cysteinyl LTs in EBC were higher in the asbestos group than in controls. Among those with asbestosis, the 17 with more severe X-ray changes had higher EBC LT C4 and cysteinyl LTs than the 21 with mild changes. In these patients, higher levels went with lower total lung capacity. Some leukotrienes in plasma and urine were also raised in patients. The authors concluded that EBC appears to be the matrix of choice for studying these markers in respiratory disorders.

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 of patients with occupational lung disease and control subjects, with leukotrienes measured at the same time in exhaled breath condensate, plasma and urine
• Who was studied: 82 patients with occupational lung diseases, seen at the Department of Occupational Medicine, Charles University in Prague, Czech Republic. 45 were asbestos-exposed: 24 men and 21 women, mean age 69.6 years, all with pleural hyalinosis. 37 were silica-exposed: 36 men and 1 woman. There were also 27 controls (18 men, 9 women) who had worked as office employees and safety inspectors.
• Exposure: Asbestos exposure for an average of 23.3 years in the production of asbestos insulation and textile materials, and asbestos cement roofing and pipe. No fiber type is named. The comparison group had silica exposure as metal ore miners, tunnelers, foundry workers or stone cutters.
• Main results:
  • LT D4 in EBC averaged 31.9 plus or minus 1.8 pg/ml in the asbestos group and 30.8 plus or minus 1.8 pg/ml in the silica group, compared with 23.0 plus or minus 1.8 pg/ml in controls (p less than 0.001 for each patient group versus controls). The table presents these as arithmetic mean plus or minus confidence interval, without stating the confidence level.
  • LT B4 in EBC averaged 26.5 plus or minus 4.6 pg/ml in the asbestos group versus 20.3 plus or minus 2.0 pg/ml in controls (p less than 0.001). In the silica group (19.0 plus or minus 1.8 pg/ml) the difference from controls was not significant.
  • Among patients with asbestosis, those with more severe radiological signs (s1/s2 to t3/u2, n=17) had higher EBC LT C4 than those with mild asbestosis (s1/s0 to s1/s1, n=21): mean 123.71 versus 66.07 pg/ml (p=0.007). They also had higher EBC cysteinyl LTs (p less than 0.05).
  • In the asbestosis patients, EBC cysteinyl LTs correlated negatively with total lung capacity (TLC, -0.313) and with TLCO/Hb, a measure of how well the lungs transfer gas (-0.307). EBC LT C4 correlated negatively with TLC (-0.358). All were at p less than 0.05.
  • In the silica group, only one correlation with lung function was found: LT D4 with RV/TLC% (r=-0.336, p less than 0.05).
  • Some markers outside the breath were also raised. Plasma LT B4 was 36.6 plus or minus 3.8 pg/ml in the asbestos group and 33.5 plus or minus 3.7 in the silica group, versus 26.9 plus or minus 3.3 in controls (p less than 0.001 and p=0.008).
  • Across all subjects, LT D4 in EBC correlated with LT D4 in urine (r=0.254) and in plasma (r=0.435).
• The authors' conclusion: The authors concluded that EBC appears to be the most useful of the three fluids for analysing leukotrienes in respiratory disorders. They suggested that urine LT D4 and plasma LT B4 and LT E4 might be used when EBC collection equipment is not available, provided medications and other illnesses are recorded and considered.
• Limitations the authors state:
  • The authors note that EBC collection and analysis is not yet considered a standard method in medical practice.

Topics

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

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Fibrosis, Asbestos Exposure.

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)
• Increased 8-isoprostane, a marker of oxidative stress in exhaled breath condensate in subjects with asbestos exposure — D. Pelclová, Z. Fenclová, et al. (2008)
• Use of exhaled breath condensate to investigate occupational lung diseases — M. Corradi, P. Gergelova, et al. (2010)
• An electronic nose distinguishes exhaled breath of patients with Malignant Pleural Mesothelioma from controls — S. Dragonieri, M.P. van der Schee, et al. (2012)
• 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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