Elevated exhalation of hydrogen peroxide and thiobarbituric acid reactive substances in patients with community acquired pneumonia

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• 作者：Edyta Majewska ; Marek Kasielski ; Rafal Luczynski ; Grzegorz Bartosz ; Piotr Bialasiewicz ; Dariusz Nowak
• 关键词：Pneumonia ; Exhaled breath condensate ; Exhaled air ; Hydrogen peroxide ; Thiobarbituric acid reactive substances ; Reactive oxygen species ; Oxidative stress
• 刊名：Respiratory Medicine
• 出版年：2004
• 出版时间：July 2004
• 年：2004
• 卷：98
• 期：7
• 页码：669-676
• 全文大小：218 K

文摘

Background: Bacterial pneumonia involves influx of activated phagocytes into distal airways. These cells release oxidants including H₂O₂, that may be exhaled or induce peroxidative damage to lung tissues with formation of thiobarbituric reactive substances (TBARs).

Study objectives: To determine whether concentrations of H₂O₂ and TBARs in exhaled breath condensate (EBC) is elevated and correlate with systemic response to pneumonia during 10 days of hospital treatment.

Design: The concentration of H₂O₂ and TBARs was measured in EBC of 43 inpatients with community acquired pneumonia (CAP) and 20 healthy never smoked subjects over 10 days and were accompanied by monitoring of WBC count, serum concentration of C-reactive protein (CRP) and peroxyl radical-trapping capacity.

Results: Patients with CAP exhaled 4.6-, 3.7-, 3.9-, 3.3-times more H₂O₂ than healthy controls at 1st, 3rd, 5th and 10th day of treatment (P<0.05), respectively. EBC concentrations of TBARs were elevated at 1st and 3rd day. H₂O₂ and TBARs levels decreased along with treatment course. Correlation (P<0.05) was found between H₂O₂ levels and CRP and WBC count (r=0.31) at 1st day and between TBARs and CRP at 5th (r=0.34) and 10th day (r=0.46). The mean H₂O₂ exhalation estimated over ten days of treatment correlated with pneumonic chest X-ray score (r=0.42), CRP levels (r=0.46) and WBC count (r=0.33) at admission (P<0.05).

Conclusions: Pneumonia is accompanied by oxidative stress in airways that moderately correlates with intensity of systemic inflammatory response. Determination of H₂O₂ in EBC may be helpful for non-invasive monitoring of oxidants production during lower respiratory tract infection.