Exhaled markers in the monitoring of airways inflammation and its response to steroid's treatment in mild persistent asthma

• Published in: European journal of pharmacology Vol. 519; no. 1-2; pp. 175 - 181
• Main Authors: Carpagnano, Giovanna E., Foschino Barbaro, Maria P., Resta, Onofrio, Gramiccioni, Enzo, Valerio, Nicola V., Bracciale, Paolo, Valerio, Giuseppe
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 05.09.2005; Elsevier
• Subjects: Administration, Inhalation; Adult; Airway inflammation; Androstadienes - administration & dosage; Androstadienes - therapeutic use; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - therapeutic use; Asthma; Asthma - drug therapy; Asthma - metabolism; Asthma - physiopathology; Biological and medical sciences; Biomarkers - analysis; Breath Tests; Chronic obstructive pulmonary disease, asthma; Female; Fluticasone; Humans; Hydrogen-Ion Concentration; IL-4; IL-6; Interleukin-4 - analysis; Interleukin-6 - analysis; Male; Medical sciences; Middle Aged; Monitoring, Physiologic - methods; Pharmacology. Drug treatments; Pneumology; Reproducibility of Results; IL-4; pH; Airway inflammation; IL-6; Asthma; Steroid; Lung disease; Respiratory disease; Cytokine; Inflammation; Respiratory system; Interleukin 6; Respiratory tract; Interleukin 4; Treatment; Bronchus disease; Obstructive pulmonary disease
• ISSN: 0014-2999; 1879-0712
• DOI: 10.1016/j.ejphar.2005.06.034

The measure of inflammatory cytokines in the exhaled breath condensate has been recently proposed for use in monitoring asthma and the therapeutic response to steroids. The aim of the present study was to investigate the usefulness of measuring exhaled IL-6, IL-4 and pH in mild persistent asthma. Furthermore the effects on these markers of inhaled steroids were assessed. The study enrolled 28 asthmatic (15 males, 38±12 years) and 15 healthy subjects (5 males, 35±6 years). IL-6, IL-4 and pH were measured in the exhaled breath condensate of the subjects studied. Significantly higher concentrations of IL-6 and IL-4 were observed in the breath condensate of asthmatic patients (7.1±1.1 and 64.4±8.3 pg/ml) compared to controls (2.7±0.6 and 31.7±3.5 pg/ml), p<0.001. Furthermore, exhaled IL-4 fell significantly after treatment with inhaled steroids for 6 months (47.9±3.2 pg/ml, p<0.001) while exhaled IL-6 did not (6.4±1.0 pg/ml, p=0.8). The exhaled pH turned out to be lower in asthmatic subjects than in controls (7.39±0.11 vs. 7.85±0.14; P<0.001) but trended towards control levels after steroid treatment (7.65±0.16, P<0.001). We conclude that the measurement of exhaled IL-4 and pH in mild asthmatic subjects could be a useful way of monitoring their airway inflammation as well as their response to the treatment.