Advertisement
Regular Article| Volume 95, ISSUE 8, P649-654, August 2001

Total nitrite/nitrate in expired breath condensate of patients with asthma

Open ArchiveDOI:https://doi.org/10.1053/rmed.2001.1117
Total nitrite/nitrate in expired breath condensate of patients with asthma
Previous ArticleFlextube reflectometry for determination of sites of upper airway narrowing in sleeping obstructive sleep apnoea patients
Next ArticleThe clinical utility of arterialized earlobe capillary blood in the assessment of patients for long-term oxygen therapy
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Production of nitric oxide (NO) is generally increased during inflammatory diseases including asthma. The eventual fate of NO is oxidation to nitrite (NO2) and nitrate (NO3), both of which are end-products of NO metabolism. Hydrogen Peroxide (H2O2) is increased in exhaled breath condensate of asthmatic subjects and may be used as a non-invasive marker of oxidative stress. NO has in some cases been shown to attenuate oxidant-induced lung injury. Total NO2/NO3concentration and H2O2levels were measured in expired breath condensate in 50 clinically stable asthmatics [all males, all atopics, mean age 22 (3) Math Eq yrs, forced expiratory volume in 1 sec (FEV1) 91(10)% predicted, PD20to histamine 0·262 (0·16) mg 20 on inhaled steroids, 20 smokers, all steroid-naive] and in 10 normal, non-atopic subjects [all males, age 23 (4) yrs, FEV1101 (14)% predicted, PD20to histamine 1·3 (0·55) mg]. NO2/NO3levels were significantly higher in patients with asthma than in normal subjects (1·08, 95% CI 0·86–1·3 μMath Eqvs. 0·6; 95% CI 0·46–0·8,P <0·001). Patients who were on inhaled steroids had significantly lower values compared to steroid-naive (0·71, 95% CI 0·55–0·87 μMath Eqvs. 133, 95% CI 1–1·65 μMath Eq, P<0·001). Similar results were observed between smokers and non-smokers (1·11, 95% CI 0·74–1·47 μMath Eqvs. 1·77, 95% CI 1·1–2·4 μMath Eq,P <0·0001). There was a significant positive correlation between NO2/NO3levels and H2O2concentration in expired breath condensate (r=0·48, P<0·0001). No correlation was observed between NO2/NO3levels, airway obstruction and bronchial hyper-reactivity as assessed by PD20to histamine. Total NO2/NO3levels in expired breath condensate are raised in patients with stable asthma and are significantly related to oxidative stress as assessed by H2O2concentration. Measurement of expired breath NO2/NO3and H2O2levels may be clinically useful in the management of oxidation and inflammation mediated lung injury.

      Keywords

      References

      REFERENCES

        • Kharitonov SA
        • Yates D
        • Robbins RA
        • Logan-Sinclair R
        • Shinebourne EA
        • Barnes PJ
        Increased nitric oxide in exhaled air of asthmatic patients.
        Lancet. 1994; 343: 133-135
        • lchiropoulos H
        Biological tyrosine nitration: a pathophysiological function of nitric oxide and reactive oxygen species.
        Arch Biochem Biophys. 1998; 356: 1-11
        • Kroncke KD
        • Fehsel K
        • Kolb-Bachofen V
        Nitric oxide: cytotoxicity versus cytoprotection—how why when and where?.
        Nitric oxide Biol Chem. 1997; 1: 107-120
        • Gaston B
        • Drazen JM
        • Loscalzo J
        • Stamler JS
        The biology of nitrogen oxides in the airways.
        Am J Respir Crit Care Med. 1994; 149: 538-551
        • Dohlman AW
        • Black HR
        • Royal JA
        Expired breath hydrogen peroxide is a marker of acute airway inflammation in paediatric patients with asthma.
        Am Rev Respir Dis. 1993; 148: 955-960
        • Barnes PJ
        Reactive oxygen species and airway inflammation.
        Free Rad Biol Med. 1990; 9: 235-243
        • Kanazawa H
        • Shoji S
        • Yamada M
        Increased levels of nitric oxide derivatives in induced sputum in patients with asthma.
        J Allergy Clin Immunol. 1997; 99: 624-629
      8. Am Rev Respir Dis. 1987; 136: 225-244
        • Jobsis Q
        • Raatgeep HC
        • Schellekens SL
        Hydrogen peroxide in exhaled air of healthy children: reference values.
        Eur Respir J. 1998; 12: 483-485
        • Moshage H
        • Kok B
        • Huizeng R
        • Jansen P
        Nitrate and nitrite determination in plasma. A critical evaluation.
        Clin Chem. 1995; 41: 892-896
        • Green LC
        • Wagner DA
        • Glogowski J
        • Skipper PL
        • Wishnok JS
        • Tannenbaum SR
        Analysis of nitrate nitrite and [15N] nitrate in biological fluids.
        Anal Biochem. 1982; 126: 131-138
        • Dekhuijzen R PN
        • Aben K KH
        • Dekker I
        • Aarts L PHJ
        • Wielders P LML
        • Van Herwaarden C LA
        Increased exhalation of hydrogen peroxide in patients with stable and unstable chronic obstructive pulmonary disease.
        Am J Respir Crit Care Med. 1996; 154: 813-816
        • Gallati H
        • Pracht I
        Horseradish peroxidase: kinetic studies and optimization of peroxidase activity determination using the substrates H2O2and 3,3′,5,5′-tetramethylbenzidine.
        J Clin Chem Clin Biochem. 1985; 23: 453-460
        • Arias-Diaz J
        • Vara E
        • Torres-Melero J
        Nitrite/nitrate and cytokine levels in bronchoalveolar lavage fluid of lung cancer patients.
        Cancer. 1994; 74: 1546-1551
        • Pheng LH
        • Francoeur C
        • Denis M
        The involvement of nitric oxide in a mouse model of adult respiratory distress syndrome.
        Inflammation. 1995; 19: 559-610
        • Kanazawa H
        • Shoji S
        • Yoshikawa T
        • Hirata K
        • Yoshikawa J
        Increased production of endogenous nitric oxide in patients with bronchial asthma and chronic obstructive pulmonary disease.
        Clin Exp Allergy. 1998; 28: 1244-1250
        • Kharitonov SA
        • Barnes PJ
        Exhaled nitric oxide: a marker of airway inflammation?.
        Curr Opin Anaesthesiol. 1996; 9: 542-548
        • Kharitonov SA
        • Alving K
        • Barnes PJ
        Exhaled and nasal nitric oxide measurements: recommendations.
        Eur Respir J. 1997; 10: 1683-1693
        • Henriksen AH
        • Lingaus-Holmen T
        • Sue-Chue M
        • Brener L
        Combined use of exhaled nitric oxide and airway hyperresponsiveness in characterizing asthma in a large population survey.
        Eur Respir J. 2000; 15: 849-855
        • Jatakanon A
        • Lim S
        • Kharitonov SA
        • Chung FK
        • Barnes PJ
        Correlation between exhaled NO sputum EOS and bronchial responsiveness in patients with mild asthma.
        Thorax. 1998; 53: 91-95
        • Gratziou CH
        • Lignos M
        • Dassiou M
        • Roussos CH
        Influence of atopy on exhaled NO in patients with stable asthma and rhinitis.
        Eur Respir J. 1999; 14: 897-901
        • Mercer RR
        • Costa DL
        • Crapo JD
        Effects of prolonged exposure to low doses of nitric oxide or nitrogen dioxide on the alveolar septa of the adult rat lung.
        Lab Invest. 1995; 73: 20-28
        • Freeman B
        Free radical chemistry of nitric oxide. Looking at the dark side. Review.
        Chest. 1994; 105: 79S-84S
        • Hugod C
        Ultrastructural changes of the rabbit lung after a 5ppm nitric oxide exposure.
        Arch Environ Health. 1979; 34: 12-17
        • Weinberger B
        • Fakhrzadeh L
        • Heck DE
        • Laskin JD
        • Gardiner CR
        • Laskin D
        Inhaled nitric oxide primes lung macrophages to produce reactive oxygen and nitrogen intermediates.
        Am J Respir Crit Care Med. 1998; 158: 931-938
        • Wiseman H
        • Halliwell B
        Damage to DNA by reactive oxygen and reactive species: role in inflammatory disease and progression to cancer.
        Biochem J. 1996; 313: 17-29
        • Horvath I
        • Donnely LE
        • Kiss A
        Combined use of exhaled hydrogen peroxide and nitric oxide in monitoring asthma.
        Am J Respir Crit Care Med. 1998; 158: 1042-1046
        • Ho LP
        • Innes JA
        • Greening AP
        Nitrite levels in breath condensate of patients with cystic fibrosis is elevated in contrast to exhaled nitric oxide.
        Thorax. 1998; 53: 680-684

      Article info

      Publication history

      Accepted: April 4, 2001
      Received: October 2, 2000

      Identification

      DOI: https://doi.org/10.1053/rmed.2001.1117

      Copyright

      © 2001 Harcourt Publishers Ltd. Published by Elsevier Inc.

      User license

      Elsevier user license |
      How you can reuse Information Icon
      Elsevier user license

      Permitted

      For non-commercial purposes:

      • Read, print & download
      • Text & data mine
      • Translate the article

      Not Permitted

      • Reuse portions or extracts from the article in other works
      • Redistribute or republish the final article
      • Sell or re-use for commercial purposes

      Elsevier's open access license policy

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX