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Independent information of nonspecific biomarkers in exhaled breath condensate

: Dressel, H.; Müller, F.; Fischer, R.; Römmelt, H.; Hohlfeld, J.M.; Behr, J.; Huber, R.M.; Nowak, D.; Jörres, R.A.


Respiration 80 (2010), Nr.5, S.401-409
ISSN: 0025-7931
ISSN: 1423-0356
Fraunhofer ITEM ()
exhaled breath condensate; conductivity; pH; Nitrite; exhaled nitric oxide; factor analysis; ammonia; Nitrates

Background: Exhaled breath condensate (EBC) has been used for diagnosing and monitoring respiratory disorders. For clinical purposes the assessment of easy-to-obtain nonspecific markers seems particularly interesting.
Objectives: As these measures are related to each other, our objective was to extract the independent information in global EBC markers across a range of respiratory disorders. Methods: EBC was collected from patients with asthma (n = 18), chronic obstructive pulmonary disease (n = 17), and cystic fibrosis (n = 46), as well as from lung transplant (LTX) recipients (n = 14) and healthy controls (n = 26). Samples were assessed for electrical conductivity, ammonia, pH, and nitrite/nitrate. pH was measured after both deaeration with argon and CO2 standardization. Additionally, the fraction of exhaled nitric oxide (FENO) was assessed. Factor analysis was applied to identify major factors concerning these measures.
Results: Three independent factors were detected; the first comprised conductivity, ammonia, and pH, especially when standardized using CO2, the second nitrite/nitrate, and the third FENO. Conductivity and ammonia were highly correlated (r = 0.968; p < 0.001). FENO provided independent information mainly in asthma. The nonspecific EBC markers showed considerable overlap between patient groups and healthy subjects. However, conductivity, ammonia, pH standardized for CO2 and nitrite/nitrate were increased in LTX recipients compared to healthy controls (p < 0.05 each).
Conclusions: A panel of nonspecific easy-to-obtain exhaled breath markers could be reduced to 3 independent factors. The information content of conductivity, ammonia, and pH after CO2 equilibration appeared to be similar, while FENO was independent. The increased levels of these biomarkers in LTX might indicate a potential for their use in these patients.