Kostikas Konstantinos, Papatheodorou Georgios, Ganas Konstantinos, Psathakis Konstantinos, Panagou Panos, Loukides Stelios
Department of Pneumonology and Clinical Research Unit, Athens Army General Hospital, Athens, Greece.
Am J Respir Crit Care Med. 2002 May 15;165(10):1364-70. doi: 10.1164/rccm.200111-068OC.
Endogenous airway acidification, as assessed by pH in expired breath condensate, has been implicated in asthma pathophysiology. We measured pH in breath condensate of patients with inflammatory airway diseases in stable condition and examined its relationship with the inflammatory process (as assessed by differential cell counts in induced sputum), oxidative stress (as assessed by H(2)O(2) and 8-isoprostane), and nitric oxide metabolism (as assessed by total nitrate/nitrite). We studied 40 patients with bronchial asthma (20 with moderate disease, forced expiratory volume in 1 second 60 [10]% SD predicted), 20 patients with bronchiectasis, 20 patients with chronic obstructive pulmonary disease (COPD), and 10 normal subjects. Mean (95% confidence intervals) pH values were significantly lower in patients with COPD and bronchiectasis compared with patients with asthma and control subjects (7.16, 7.09-7.23 and 7.11, 7.04-7.19 versus 7.43, 7.35-7.52 and 7.57, 7.51-7.64, respectively, p < 0.0001). Patients with moderate asthma had significantly lower values compared with mild and control subjects. In patients with COPD and bronchiectasis, the values of pH were significantly correlated with both sputum neutrophilia and oxidative stress. Respectively, in patients with moderate asthma, a significant correlation was observed between pH and sputum eosinophilia, total nitrate/nitrite, and oxidative stress. The pH of the expired breath condensate might be a simple, noninvasive, inexpensive, and easily repeatable procedure for the evaluation of the inflammatory process in airway diseases.
通过呼出气体冷凝液中的pH值评估的内源性气道酸化与哮喘病理生理学有关。我们测量了病情稳定的炎症性气道疾病患者呼出气体冷凝液中的pH值，并研究了其与炎症过程（通过诱导痰中的细胞分类计数评估）、氧化应激（通过H₂O₂和8-异前列腺素评估）以及一氧化氮代谢（通过总硝酸盐/亚硝酸盐评估）之间的关系。我们研究了40例支气管哮喘患者（20例中度疾病患者，一秒用力呼气量为预测值的60[10]%标准差）、20例支气管扩张症患者、20例慢性阻塞性肺疾病（COPD）患者和10名正常受试者。与哮喘患者和对照组相比，COPD患者和支气管扩张症患者的平均（95%置信区间）pH值显著更低（分别为7.16, 7.09 - 7.23和7.11, 7.04 - 7.19，而哮喘患者和对照组分别为7.43, 7.35 - 7.52和7.57, 7.51 - 7.64，p < 0.0001）。中度哮喘患者的值与轻度哮喘患者和对照组相比显著更低。在COPD患者和支气管扩张症患者中，pH值与痰中嗜中性粒细胞增多和氧化应激均显著相关。在中度哮喘患者中，分别观察到pH值与痰中嗜酸性粒细胞增多、总硝酸盐/亚硝酸盐以及氧化应激之间存在显著相关性。呼出气体冷凝液的pH值可能是一种用于评估气道疾病炎症过程的简单、无创、廉价且易于重复的方法。
