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Exhaled breath condensate eicosanoid levels associate with asthma and its severity.
J Allergy Clin Immunol. 2013 Sep; 132(3):547-553.JA

Abstract

BACKGROUND

The relationship between anti-inflammatory lipoxins and proinflammatory leukotrienes might be important in the pathobiology and severity of asthma.

OBJECTIVE

We sought to investigate whether exhaled breath condensate (EBC) lipoxin and leukotriene measurements can noninvasively characterize the asthmatic diathesis and its severity.

METHODS

We measured lipoxin A4 (LXA4) and leukotriene B4 (LTB4) levels in EBC collected from patients with asthma of different severities and from healthy control subjects.

RESULTS

EBC LXA4 and LTB4 levels are increased in asthmatic patients compared with those seen in healthy control subjects (LXA4: 31.40 vs 2.41 pg/mL EBC, respectively [P < .001]; LTB4: 45.62 vs 3.82 pg/mL EBC, respectively [P < .001]). Although levels of both eicosanoids are increased in asthmatic patients, the LXA4/LTB4 ratio decreases with increasing asthma severity. It is 41% lower in patients with severe versus moderate asthma (0.52 vs 0.88, P = .034). EBC LXA4 levels correlate with the degree of airflow obstruction measured by using FEV1 (r = 0.28, P = .018). An LXA4 cutoff value of 7 pg/mL EBC provides 90% sensitivity and 92% specificity for the diagnosis of asthma (area under the curve, 0.96; P < .001). An LTB4 cutoff value of 11 pg/mL EBC provides 100% sensitivity and 100% specificity for the diagnosis of asthma (area under the curve, 1; P < .001).

CONCLUSIONS

Proresolving and proinflammatory eicosanoids are generated in the airways of all asthmatic patients. The proportion of proresolving compounds decreases with asthma severity. These findings support the role for EBC eicosanoid measurements in the noninvasive diagnosis of asthma and suggest that proresolving eicosanoid pathways are dysregulated in patients with severe asthma.

Authors+Show Affiliations

Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. Electronic address: skazani@partners.org.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.Pulmonary and Critical Care Division, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23608729

Citation

Kazani, Shamsah, et al. "Exhaled Breath Condensate Eicosanoid Levels Associate With Asthma and Its Severity." The Journal of Allergy and Clinical Immunology, vol. 132, no. 3, 2013, pp. 547-553.
Kazani S, Planaguma A, Ono E, et al. Exhaled breath condensate eicosanoid levels associate with asthma and its severity. J Allergy Clin Immunol. 2013;132(3):547-553.
Kazani, S., Planaguma, A., Ono, E., Bonini, M., Zahid, M., Marigowda, G., Wechsler, M. E., Levy, B. D., & Israel, E. (2013). Exhaled breath condensate eicosanoid levels associate with asthma and its severity. The Journal of Allergy and Clinical Immunology, 132(3), 547-553. https://doi.org/10.1016/j.jaci.2013.01.058
Kazani S, et al. Exhaled Breath Condensate Eicosanoid Levels Associate With Asthma and Its Severity. J Allergy Clin Immunol. 2013;132(3):547-553. PubMed PMID: 23608729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exhaled breath condensate eicosanoid levels associate with asthma and its severity. AU - Kazani,Shamsah, AU - Planaguma,Anna, AU - Ono,Emiko, AU - Bonini,Matteo, AU - Zahid,Muhammad, AU - Marigowda,Gautham, AU - Wechsler,Michael E, AU - Levy,Bruce D, AU - Israel,Elliot, Y1 - 2013/04/19/ PY - 2012/07/18/received PY - 2013/01/28/revised PY - 2013/01/31/accepted PY - 2013/4/24/entrez PY - 2013/4/24/pubmed PY - 2013/11/13/medline KW - Asthma KW - BAL KW - Bronchoalveolar lavage KW - CysLT KW - Cysteinyl leukotriene KW - EBC KW - Exhaled breath condensate KW - Feno KW - Fraction of exhaled nitric oxide KW - ICS KW - Inhaled corticosteroid KW - LTB(4) KW - LXA(4) KW - Leukotriene B(4) KW - Lipoxin A(4) KW - biomarkers KW - breath tests KW - eicosanoids KW - leukotriene B(4) KW - lipoxin A(4) SP - 547 EP - 553 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 132 IS - 3 N2 - BACKGROUND: The relationship between anti-inflammatory lipoxins and proinflammatory leukotrienes might be important in the pathobiology and severity of asthma. OBJECTIVE: We sought to investigate whether exhaled breath condensate (EBC) lipoxin and leukotriene measurements can noninvasively characterize the asthmatic diathesis and its severity. METHODS: We measured lipoxin A4 (LXA4) and leukotriene B4 (LTB4) levels in EBC collected from patients with asthma of different severities and from healthy control subjects. RESULTS: EBC LXA4 and LTB4 levels are increased in asthmatic patients compared with those seen in healthy control subjects (LXA4: 31.40 vs 2.41 pg/mL EBC, respectively [P < .001]; LTB4: 45.62 vs 3.82 pg/mL EBC, respectively [P < .001]). Although levels of both eicosanoids are increased in asthmatic patients, the LXA4/LTB4 ratio decreases with increasing asthma severity. It is 41% lower in patients with severe versus moderate asthma (0.52 vs 0.88, P = .034). EBC LXA4 levels correlate with the degree of airflow obstruction measured by using FEV1 (r = 0.28, P = .018). An LXA4 cutoff value of 7 pg/mL EBC provides 90% sensitivity and 92% specificity for the diagnosis of asthma (area under the curve, 0.96; P < .001). An LTB4 cutoff value of 11 pg/mL EBC provides 100% sensitivity and 100% specificity for the diagnosis of asthma (area under the curve, 1; P < .001). CONCLUSIONS: Proresolving and proinflammatory eicosanoids are generated in the airways of all asthmatic patients. The proportion of proresolving compounds decreases with asthma severity. These findings support the role for EBC eicosanoid measurements in the noninvasive diagnosis of asthma and suggest that proresolving eicosanoid pathways are dysregulated in patients with severe asthma. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/23608729/Exhaled_breath_condensate_eicosanoid_levels_associate_with_asthma_and_its_severity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(13)00369-2 DB - PRIME DP - Unbound Medicine ER -