Oxidative stress markers in exhaled breath condensate in lung fibroses are not significantly affected by systemic diseases

Our plain-English summary of Oxidative stress markers in exhaled breath condensate in lung fibroses are not significantly affected by systemic diseases, by D. Pelclová, Z. Fenclová, K. Syslová, et al (Industrial Health, 2011).

The study

• Authors: D. Pelclová, Z. Fenclová, K. Syslová, S. Vlčková, J. Lebedová, O. Pecha, J. Běláček, T. Navrátil, M. Kuzma, P. Kačer
• Journal: Industrial Health
• Published: 2011;49(6):746-54
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Exhaled breath condensate (EBC) is assumed to reflect processes in the lungs, yet it is unknown whether oxidative stress markers in EBC are affected by systemic disorders (atherosclerosis, hypertension, diabetes) or whether lung diseases increase markers in plasma and urine. 8-isoprostane, 4-hydroxy-trans-2-nonenale (HNE) and malondialdehyde (MDA) were measured using liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS/MS) in EBC, plasma and urine in 82 patients (45 with asbestosis and hyalinosis, and 37 with silicosis) and in 29 control subjects. 8-isoprostane and HNE in EBC, and HNE in urine were higher in both groups of patients. In addition, 8-isoprostane in plasma and urine, and MDA in urine were higher in asbestos-exposed patients and MDA in plasma in silicotics, with this marker in plasma correlated with the grade of silicosis. In all subjects, 8-isoprostane in EBC correlated with urine (r=0.38, p<0.001) and plasma levels (r=0.28, p=0.003), and HNE and MDA with urine levels (r=0.31, p<0.001; r=0.23, p=0.016, respectively). Most markers positively correlated with lung function impairment, EBC markers negatively with vitamin E supplementation. To conclude: The influence of satisfactorily controlled systemic disorders on markers in EBC in patients with pneumoconioses is not significant. In addition to oxidative stress markers in EBC, lung fibroses may increase oxidative stress markers in plasma and urine.

In plain English

This Czech study measured three chemical markers of oxidative stress (8-isoprostane, HNE and MDA) in exhaled breath condensate (moisture collected from cooled breath), blood plasma and urine. It included 45 patients who had worked in making asbestos insulation, textiles, cement roofing and pipe, 37 patients with silicosis, and 29 controls never occupationally exposed to fibrogenic (scar-forming) dusts. All asbestos-exposed patients had pleural hyalinosis, and 17 had X-ray changes corresponding to asbestosis. 8-isoprostane and HNE in breath condensate, and HNE in urine, were higher in both patient groups than in controls. In the asbestos group, 8-isoprostane in urine and plasma and MDA in urine were also higher. Breath markers were not positively correlated with any systemic disease, such as diabetes or hypertension. Vitamin E use was negatively correlated with several breath markers. Most markers correlated with poorer lung function. The authors concluded that satisfactorily controlled systemic disorders did not significantly affect the breath markers in patients with pneumoconioses. They said a possible link between some blood or urine markers and cancer needs more data.

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: Comparison study of patients with occupational lung diseases and control subjects, with breath condensate, blood and urine collected at a single visit
• Who was studied: 111 subjects in Prague, Czech Republic (study dates not stated). There were 45 asbestos-exposed patients (24 men, 21 women, mean age 69.6, exposed for 23.3 years on average) and 37 silica-exposed patients. There were also 29 controls (former office employees and safety inspectors) who had never been occupationally exposed to fibrogenic dusts nor diagnosed with lung fibrosis. All asbestos-exposed patients had pleural hyalinosis. 20 (44.4%) had diffuse pleural thickening, and 17 (37.8%) had opacities corresponding to asbestosis.
• Exposure: Occupational asbestos exposure in the production of asbestos insulation and textile materials, asbestos cement roofing and pipe (fiber types not stated). A comparison group had silica exposure as metal ore miners, tunnelers, foundry workers or stone cutters.
• Main results:
  • 8-isoprostane and HNE in exhaled breath condensate, and HNE in urine, were higher in both the asbestos-exposed and the silicosis patients than in controls.
  • In asbestos-exposed patients, 8-isoprostane in urine and plasma and MDA in urine were also higher.
  • In all subjects, 8-isoprostane in breath condensate correlated with urine levels (r=0.38, p less than 0.001) and plasma levels (r=0.28, p=0.003).
  • MDA in breath condensate was not increased in the patients.
  • Breath condensate markers were not positively correlated with any systemic disease. Only kidney failure was negatively correlated with HNE.
  • Vitamin E supplementation was negatively correlated with several breath condensate markers in most groups.
  • Most oxidative stress markers, in all three fluids, correlated with impaired lung function.
  • Diagnosed cancer was reported in 17.8% of the asbestos-exposed group, 21.6% of the silicosis group and 10.3% of controls.
  • In the asbestos-exposed group, urine HNE was 60.54 ng/mmol creatinine (plus or minus 24.75) in patients with cancer and 49.52 (plus or minus 27.40) in those without. The difference had p=0.196. Table 3 nevertheless lists a correlation of 0.303 (p less than 0.05) between urine HNE and cancer in this group.
• The authors' conclusion: The authors concluded that satisfactorily controlled systemic disorders did not significantly influence breath condensate markers in patients with pneumoconioses. They also concluded that lung fibroses may raise some oxidative stress markers in plasma and urine.
• Limitations the authors state:
  • The timing of drug effects relative to sample collection may have played a role.
  • More data are needed to support a possible use of plasma 8-isoprostane and urine HNE to search for cancer.
  • MDA in breath condensate may be a less reliable marker for lung disorders.
  • Other factors may interfere with markers measured outside the breath condensate.

Topics

Medical terms in this study, explained in our Lexicon: Oxidative Stress, Silicosis.

Related studies

• Increased 8-isoprostane, a marker of oxidative stress in exhaled breath condensate in subjects with asbestos exposure — D. Pelclová, Z. Fenclová, et al. (2008)
• 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)
• Use of exhaled breath condensate to investigate occupational lung diseases — M. Corradi, P. Gergelova, et al. (2010)
• 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)
• The pathophysiological role of mitochondrial oxidative stress in lung diseases — X. Liu, Z. Chen (2017)
• 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)

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