Increased leukotriene B4 and 8-isoprostane in exhaled breath condensate of patients with exacerbations of COPD

• Published in: Thorax Vol. 58; no. 4; pp. 294 - 298
• Main Authors: Biernacki, W A, Kharitonov, S A, Barnes, P J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 01-04-2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adrenal Cortex Hormones - therapeutic use; Adrenergic beta-2 Receptor Antagonists; Adrenergic beta-Agonists - therapeutic use; Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics; Biological and medical sciences; Biomarkers - analysis; Breath Tests; Care and treatment; Chronic Obstructive Pulmonary Disease; Dinoprost - analogs & derivatives; exacerbation; F2-Isoprostanes - analysis; Female; Forced Expiratory Volume - physiology; Humans; Inflammation; Investigative techniques, diagnostic techniques (general aspects); Leukotriene B4 - analysis; Leukotrienes; Lung diseases, Obstructive; Male; Medical sciences; Neutrophils; Oxidative stress; Oxidative Stress - physiology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Penicillin; Pneumonia - metabolism; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - metabolism; Respiratory system; Synthesis; Tumor necrosis factor-TNF; Vital Capacity - physiology; United Kingdom; Human; Lung disease; Oxidative stress; Respiratory disease; Arachidonic acid derivatives; Treatment efficiency; Expiration; Biological marker; Exploration; Inflammation; Antibiotic; Chemotherapy; Treatment; Leukotriene B4; Bronchus disease; Obstructive pulmonary disease; Aggravation
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax.58.4.294

Background: Exacerbations are an important feature of chronic obstructive pulmonary disease (COPD), accounting for a large proportion of health care costs. They are associated with increased airway inflammation and oxidative stress. Methods: Concentrations of leukotriene B4 (LTB4), a marker of inflammation, and 8-isoprostane, a marker of oxidative stress, were measured in the exhaled breath condensate of 21 patients (11 M) with COPD during an exacerbation and 2 weeks after treatment with antibiotics. In 12 patients who had no further exacerbations these markers were also measured after 2 months. Results: LTB4 concentrations were raised during the COPD exacerbation (mean (SE) 15.8 (1.1) pg/ml and fell after treatment with antibiotics to 9.9 (0.9) pg/ml (p<0.0001). In 12 patients the level of LTB4 fell further from 10.6 (1.1) pg/ml to 8.5 (0.8) pg/ml (p<0.005) after 2 months. In 12 normal age matched subjects the LTB4 levels were 7.7 (0.5) pg/ml. Concentrations of 8-isoprostane were also increased during the exacerbation (13.0 (0.9) pg/ml) and fell after antibiotic treatment to 9.0 (0.6) pg/ml (p<0.0001). In 12 patients there was a further fall from 9.3 (0.7) pg/ml to 6.0 (0.7) pg/ml (p<0.001) after 2 months compared with normal subjects (6.2 (0.4) pg/ml). Conclusions: Non-invasive markers of inflammation and oxidative stress are increased during an infective exacerbation of COPD and only slowly recover after treatment with antibiotics.