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. 2009:4:79-86.
Epub 2009 Apr 15.

Measurement of tumor necrosis factor-alpha, leukotriene B4, and interleukin 8 in the exhaled breath condensate in patients with acute exacerbations of chronic obstructive pulmonary disease

Fanny W S Ko  1 , Ting-Fan Leung, Gary W K Wong, Jenny Ngai, Kin W To, Susanna Ng, David S C Hui
Affiliations

Measurement of tumor necrosis factor-alpha, leukotriene B4, and interleukin 8 in the exhaled breath condensate in patients with acute exacerbations of chronic obstructive pulmonary disease

Fanny W S Ko et al. Int J Chron Obstruct Pulmon Dis. 2009.

Abstract

Background: Assessment of airway inflammation in the clinical course of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) may advance our understanding of the pathogenesis and treatment.

Objectives: To assess airway inflammation in patients during the course of AECOPD by serial analyses of their exhaled breath condensates (EBC).

Methods: Twenty-six patients with AECOPD (22 males, mean[SD] percentage predicted forced expiratory volume in one second (FEV(1)) 44.8 [14.3]), 11 with stable COPD, and 14 age and sex-matched healthy controls were studied. Patients with AECOPD were treated with systemic steroid and antibiotic for 7 days. EBC was collected from each patient with AECOPD on Day 5, 14, 30, and 60 post-hospitalization using EcoScreen (VIASYS Healthcare, USA) during tidal breathing over 10 minutes. Concentrations of tumor necrosis factor-alpha (TNF-alpha), leukotriene B4 (LTB4), and interleukin-8 (IL-8) were measured by enzyme-linked immunosorbent assay.

Results: The median (IQR) of TNF-alpha level on Day 5 was 5.08 (3.80-6.32) pg/ml, which was lower than on Day 14 (5.84 [4.91-9.14] pg/ml, p = 0.017), Day 30 (6.14 [3.82-7.67] pg/ml, p = 0.045), and Day 60 (5.60 [4.53-8.80] pg/ml, p = 0.009). On Day 60, subjects receiving inhaled corticosteroid (ICS) had a lower level of TNF-alpha than those who were not (4.82 [4.06-5.65] vs 7.66 [5.48-10.9] pg/ml, p = 0.02). EBC LTB4 level did not change significantly during recovery from AECOPD whereas IL-8 was mostly undetectable.

Conclusions: EBC TNF-alpha level was low in patients receiving systemic steroid and antibiotic therapy for AECOPD. These findings suggest a potential role for serial EBC TNF-alpha for non-invasive monitoring of disease activity.

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Figures

Figure 1
Figure 1
Levels of TNF-α in the subjects with AECOPD, stable COPD and normal controls Abbreviations: AECOPD, acute exacerbations of chronic obstructive pulmonary disease; COPD, chronic obstructive pulmonary disease; TNF-α, tumor necrosis factor-α.
Figure 2
Figure 2
Bland and Altman’s plot of the repeatability measurements of TNF-α and LTB4. Abbreviations: LTB4, leukotriene B4; TNF-α, tumor necrosis factor-α.
See this image and copyright information in PMC

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