期刊论文详细信息
BMC Pulmonary Medicine
Changes in PH in exhaled breath condensate after specific bronchial challenge test in patients with chronic hypersensitivity pneumonitis: a prospective study
X. Munoz3  F. Morell1  M. Sanchez-Ortiz2  A. Villar2  M J Cruz1  I. Ojanguren2 
[1] CIBER Enfermedades Respiratorias (Ciberes), Barcelona, Spain;Servicio de Neumología, Departamento de Medicina, Hospital Universitario Vall d´Hebron, Universidad Autónoma de Barcelona, Catalonia, Spain;Servei de Pneumologia, Hospital Universitari Vall d’Hebron, Passeig Vall d’Hebron, 119, Barcelona, 08035, Spain
关键词: Environmental exposure;    Pulmonary fibrosis;    Inflammation;   
Others  :  1228331
DOI  :  10.1186/s12890-015-0100-5
 received in 2014-12-11, accepted in 2015-09-10,  发布年份 2015
PDF
【 摘 要 】

Background

The aim of this study was to investigate the influence of the specific inhalation challenge (SIC) on changes of pH values in exhaled breath condensate (EBC) in patients with hypersensitivity pneumonitis (HP).

Methods

A prospective study of 85 patients with suspected HP, of whom 63 were diagnosed with HP due to exposure to avian or fungal antigens. In all cases, EBC samples were collected before and after completion of the SIC and pH values were determined.

Results

Taken as a whole, patients with HP did not present changes in EBC pH after SIC. However, considering only patients with exposure to molds, those diagnosed with HP had a significantly more acid pH post-SIC than those with another diagnosis (p = 0.011). This fact is not observed in patients exposed to bird’s antigens. A ROC curve showed that a reduction in EBC pH of 0.3 units or more after SIC in patients diagnosed with HP due to exposure to molds had a sensitivity of 30 % (CI: 12.8 to 54.3 %) and a specificity of 100 % (CI: 65.5 to 100 %).

Conclusion

EBC pH may be useful in interpreting SIC results in patients with HP, especially in those patients exposed to molds. Further studies are now required to test the validity of these proposals.

【 授权许可】

   
2015 Ojanguren et al.

【 预 览 】
附件列表
Files Size Format View
20151015020559534.pdf 593KB PDF download
Fig. 3. 25KB Image download
Fig. 2. 46KB Image download
Fig. 1. 16KB Image download
【 图 表 】

Fig. 1.

Fig. 2.

Fig. 3.

【 参考文献 】
  • [1]Fink JN, Ortega HG, Reynolds HY, Cormier YF, Fan LL, Franks TJ, Kreiss K, Kunkel S, Lynch D, Quirce S, Rose C, Schleimer RP, Schuyler MR, Selman M, Trout D, Yoshizawa Y. Needs and opportunities for research in hypersensitivity pneumonitis. Am J Respir Crit Care Med. 2005; 171(7):792-8.
  • [2]Schuyler M, Cormier Y. The diagnosis of Hypersensitivity Pneumonitis. Chest. 1997; 111:534-6.
  • [3]Munoz X, Morell F, Cruz MJ. The use of specific inhalation challenge in hypersensitivity pneumonitis. Curr Opin Allergy Clin Immunol. 2013; 13(2):151-8.
  • [4]Morell F, Roger A, Reyes L, Cruz MJ, Murio C, Muñoz X. Bird fancier´s lung. A series of 86 patients. Medicine (Baltimore). 2008; 87:110-30.
  • [5]Hendrick DJ, Marshall R, Faux JA, Krall JM. Positive “alveolar” response to antigen inhalation provocation tests: their validity and recognition. Thorax. 1980; 35:415-27.
  • [6]Ramirez-Venegas A, Sansores RH, Perez-Padilla R, Carrillo G, Selman M. Utility of a provocation test for diagnosis of chronic pigeon breeder`s disease. Am J Respir Crit Care Med. 1998; 158:862-9.
  • [7]Ohtani Y, Kojima K, Sumi Y, Sawada M, Inase N, Miyake S, Yoshizawa Y. Inhalation provocation tests in chronic bird fancier’s lung. Chest. 2000; 118:1382-9.
  • [8]Kharitonov SA, Barnes PJ. Exhaled biomarkers. Chest. 2006; 130(5):1541-6.
  • [9]Horváth I, Hunt J, Barnes PJ, Alving K, Antczak A, Baraldi E, Becher G, van Beurden WJ, Corradi M, Dekhuijzen R, Dweik RA, Dwyer T, Effros R, Erzurum S, Gaston B, Gessner C, Greening A, Ho LP, Hohlfeld J, Jöbsis Q, Laskowski D, Loukides S, Marlin D, Montuschi P, Olin AC, Redington AE, Reinhold P, van Rensen EL, Rubinstein I, Silkoff P, Toren K, Vass G, Vogelberg C. Exhaled breath condensate: methodological recommendations and unresolved questions. Eur Respir J. 2005; 26(3):523-48.
  • [10]Petsky HL, Cates CJ, Lasserson TJ, Li AM, Turner C, Kynaston JA, Chang AB. A systematic review and meta-analysis: tailoring asthma treatment on eosinophilic markers (exhaled nitric oxide or sputum eosinophils). Thorax. 2012; 67(3):199-208.
  • [11]Sobiecka M, Kus J, Demkow U, Filewska M, Jozwik A, Radwan-Rohrenschef P, Chorostowska-Wynimko J. Induced sputum in patients with interstitial lung disease: a non-invasive surrogate for certain parameters in bronchoalveolar lavage fluid. J Physiol Pharmacol. 2008; 6:645-57.
  • [12]D´Ippolito R, Chetta A, Foresi A, Marangio E, Castagnaro A, Merliniaft S, Zompatori M, Olivieri D. Induced sputum and bronchoalveolar lavage from patients with hypersensitivity pneumonitis. Respir Med. 2004; 98(10):977-83.
  • [13]Mroz RM, Chyczewska E, Korniluk M, Stasiak-Barmuta A, Ossolinska M. Comparison of cellular composition of induced sputum, bronchial washings and bronchoalveolar lavage fluid in sarcoidosis, hypersensitivity pneumonitis and COPD. Pneumonol Alergol Pol. 2002; 70(9–10):468-77.
  • [14]Villar A, Muñoz X, Sanchez-Vidaurre S, Gómez-Ollés S, Morell F, Cruz MJ. Bronchial inflammation in hypersensitivity pneumonitis after antigen-specific inhalation challenge. Respirology. 2014; 19(6):891-9.
  • [15]Morell F. Idiopathic pulmonary fibrosis: importance of accurate diagnosis and treatment. Arch Bronconeumol. 2013; 49(8):319-20.
  • [16]Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Enright P, van der Griten CPM, Sustafsson P, Jensen R, Johnson DC, Maclntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J. General considerations for lung function testing. Eur Respir J. 2005; 26:153-61.
  • [17]García-Río F, Calle M, Burgos F, Casan P, Del Campo F, Galdiz JB et al.. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Spirometry. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Arch Bronconeumol. 2013; 49(9):388-401.
  • [18]Morell F, Roger A, Cruz MJ, Muñoz X, Rodrigo MJ. Suberosis: Clinical Study and new etiologic agents in a series of eight patients. Chest. 2003; 124:1145-52.
  • [19]Klech H, Pohl W. Technical recommendations and guidelines for bronchoalveolar lavage (BAL). Report of the European Society of Pneumology Task Group. Eur Respir J. 1989; 2:561-85.
  • [20]Anders GT, Johnson JE, Bush BA, Matthews JI. Transbronchial biopsy without fluoroscopy. A seven-year perspective. Chest. 1988; 94:557-60.
  • [21]Hunt JF, Fang K, Malik R et al.. Endogenous airway acidification. Implications for asthma pathophysiology. Am J Respir Crit Care Med. 2000; 161(3 Pt 1):694-9.
  • [22]Deeks JJ, Altman DG. Diagnostic tests 4: Likelihood ratios. BMJ. 2004; 17; 329(7458):168-9.
  • [23]Wilson EB. Probable inference, the law of succession, and statistical inference. J Am Stat Assoc. 1927; 22:209-12.
  • [24]Altman DG, Bland JM. Diagnostic tests 3: receiver operating characteristic plots. BMJ. 1994; 309(6948):188.
  • [25]Morell F, Villar A, Montero MÁ, Muñoz X, Colby TV, Pipvath S, Cruz MJ, Raghu G. Chronic hypersensitivity pneumonitis in patients diagnosed with idiopathic pulmonary fibrosis: a prospective case-cohort study. Lancet Respir Med. 2013; 1(9):685-94.
  • [26]Muñoz X, Sánchez-Ortiz M, Torres F, Villar A, Morell F, Cruz MJ. Diagnostic yield of specific inhalation challenge in hypersensitivity pneumonitis. Eur Resp J. 2014; 44(6):1658-65.
  • [27]Corradi M, Gergelova P, Mutti A. Use of exhaled breath condensate to investigate occupational lung diseases. Curr Opin Allergy Clin Immunol. 2010; 10(2):93-8.
  • [28]Bikov A, Galffy G, Tamasi L, Bartusek D, Antus B, Losonczy G, Horvath I. Exhaled breath condensate pH decreases during exercise-induced bronchoconstriction. Respirology. 2014; 19(4):563-9.
  • [29]Liang Y, Yeligar SM, Brown LA. Exhaled breath condensate: a promising source for biomarkers of lung disease. ScientificWorldJournal. 2012; 2012:217518.
  • [30]Chow S, Thomas PS, Malouf M, Yates DH. Exhaled breath condensate (EBC) biomarkers in pulmonary fibrosis. J Breath Res. 2012; 6(1):016004.
  • [31]Chow S, Campbell C, Sandrini A, Thomas PS, Johnson AR, Yates DH. Exhaled breath condensate biomarkers in asbestos-related lung disorders. Respir Med. 2009; 103(8):1091-7.
  • [32]Vaughan J, Ngamtrakulpanit L, Pajewski TN, Turner R, Nguyen TA, Smith A, Urban P, Hom S, Gaston B, Hunt J. Exhaled breath condensate pH is a robust and reproducible assay of airway acidity. Eur Respir J. 2003; 22(6):889-94.
  • [33]Gaston B, Hunt JF. Measurement of exhaled breath condensate pH: Implications for pathophysiology and monitoring of inflammatory airway diseases. Montuschi P. New perspectives in monitoring lung inflammation. CRC Press, In; 2005.
  • [34]Gaston B, Hunt JF. Measurement of exhaled breath condensate pH: implications for pathophysiology and monitoring of inflammatory airway diseases. Analysis of exhaled breath condensate: methodological issues. In: New perspectives in monitoring lung inflammation. Analysis of exhaled breath condensate. Montuschi P, editor. CRC Press, London; 2005: p.73-80.
  • [35]Thomas RA, Green RH, Brightling CE, Birring SS, Parker D, Wardlaw AJ, Pavord ID. The influence of age on induced sputum differential cell counts in normal subjects. Chest. 2004; 126(6):1811-4.
  • [36]Montuschi P. Analysis of exhaled breath condensate: methodological issues. In: New perspectives in monitoring lung inflammation. Analysis of exhaled breath condensate. Montuschi P, editor. CRC Press, London; 2005: p.11-3.
  • [37]Caffarelli C, Dascola CP, Peroni D, Ricò S, Stringari G, Varini M, Folesani G, Corradi M. Airway acidification in childhood asthma exacerbations. Allergy Asthma Proc. 2014; 35:e51-6.
  • [38]Kostikas K, Papatheodorou G, Ganas K, Psathakis K, Panagou P, Loukides S. pH in expired breath condensate of patients with inflammatory airway diseases. Am J Respir Crit Care Med. 2002; 165:1364-70.
  • [39]Kostikas K, Minas M, Nikolaou E, Papaioannou AI, Liakos P, Gougoura S, Gourgoulianis KI, Dinas PC, Metsios GS, Jamurtas AZ, Flouris AD, Koutedakis Y. Secondhand smoke exposure induces acutely airway acidification and oxidative stress. Respir Med. 2013; 107(2):172-9.
  • [40]Garey KW, Neuhauser MM, Robbins RA, Danziger LH, Rubinstein I. Markers of inflammation in exhaled breath condensate of young healthy smokers. Chest. 2004; 125(1):22-6.
  • [41]Antus B, Barta I, Kullmann T, Lazar Z, Valyon M, Horvath I, Csiszer E. Assessment of exhaled breath condensate pH in exacerbations of asthma and chronic obstructive pulmonary disease: A longitudinal study. Am J Respir Crit Care Med. 2010; 182(12):1492-7.
  • [42]Vandenplas O, Suojalehto H, Aasen TB, Baur X, Burge PS, de Blay F, Fishwick D, Hoyle J, Maestrelli P, Muñoz X, Moscato G, Sastre J, Sigsgaard T, Suuronen K, Walusiak-Skorupa J, Cullinan P. pecific inhalation challenge in the diagnosis of occupational asthma: consensus statement. Eur Respir J. 2014; 43(6):1573-87.
  文献评价指标  
  下载次数:3次 浏览次数:8次