dinoprost and Asthma

Isoprostanes are physiopathologic mediators of oxidative stress, resulting in lipid peroxidation. 8-isoprostane seems particularly useful for measuring oxidative stress damage. However, no reference range values are available for 8-isoprosante in exhaled breath condensate (EBC) of healthy adults, enabling its meaningful interpretation as a biomarker. We conducted this systematic review and meta-analysis according to the protocol following PROSPERO (CRD42020146623). After searching and analyzing the literature, we included 86 studies. After their qualitative synthesis and risk of bias assessment, 52 studies were included in meta-analysis. The latter focused on studies using immunological analytical methods and investigated how the concentrations of 8-isoprostane differ based on gender. We found that gender had no significant effect in 8-isoprostane concentration. Among other studied factors, such as individual characteristics and factors related to EBC collection, only the device used for EBC collection significantly affected measured 8-isoprostane concentrations. However, adjustment for the factors related to EBC collection, yielded uncertainty whether this effect is due to the device itself or to the other factors. Given this uncertainty, we estimated the reference range values of 8-isoprostane stratified by gender and EBC collection device. A better standardization of EBC collection seems necessary; as well more studies using chemical analytical methods to extend this investigation.

Topics: Asthma; Biomarkers; Breath Tests; Dinoprost; Exhalation; Female; Healthy Volunteers; Humans; Inflammation; Lung; Male; Nitric Oxide; Oxidative Stress; Reference Values; Sex Factors

We aimed to assess the evidence for the use of 8-isoprostane in exhaled breath condensate (EBC) as a biomarker in adult asthma.. A systematic review and meta-analysis of EBC 8-isoprostane.. We searched a number of online databases (including PubMed, Embase and Scopus) in January 2016. We included studies of adult non-smokers with EBC collection and asthma diagnosis conducted according to recognised guidelines. We aimed to pool data using random effects meta-analysis and assess heterogeneity using I. The clinical value of EBC 8-isoprostane as a quantitative assessment of oxidative stress in asthma remains unclear due to variability in results and methodological heterogeneity. It is essential to develop a robust and standardised methodology if the use of EBC 8-isoprostane in asthma is to be properly evaluated.

Topics: Adult; Asthma; Biomarkers; Breath Tests; Case-Control Studies; Dinoprost; Exhalation; Humans

Asthma represents the most common chronic respiratory disease of childhood. Its current standard diagnosis relies on patient history of symptoms and confirmed expiratory airflow limitation. Nevertheless, the spectrum of asthma in clinical presentation is broad, and both symptoms and lung function may not always reflect the underlying airway inflammation, which can be determined by different pathogenetic mechanisms. For these reasons, the identification of objective biomarkers of asthma, which may guide diagnosis, phenotyping, management and treatment is of great clinical utility and might have a role in the development of personalized therapy. The availability of non-invasive methods to study and monitor disease inflammation is of relevance especially in childhood asthma. In this sense, a promising role might be played by the measurement of exhaled biomarkers, such as exhaled nitric oxide (FE(NO)) and molecules in exhaled breath condensate (EBC). Furthermore, recent studies have shown encouraging results with the application of the novel metabolomic approach to the study of exhaled biomarkers. In this paper the existing knowledge in the field of asthma biomarkers, with a special focus on exhaled biomarkers, will be highlighted.

Topics: Aldehydes; Asthma; Biomarkers; Breath Tests; Child; Dinoprost; Humans; Hydrogen Peroxide; Hydrogen-Ion Concentration; Inflammation; Leukotrienes; Nitrates; Nitric Oxide; Nitrites; Oxidative Stress

Epidemiological data has established increasing adiposity as a risk factor for incident asthma. However, the mechanisms underlying the association between obesity and asthma are incompletely understood. In the present paper, we review current knowledge of possible mechanisms mediating the observed association between obesity and asthma.. Systematic literature review.. Obesity and asthma share some etiological factors, such as a common genetic predisposition and effects of in utero conditions, and may also have common predisposing factors such as physical activity and diet. Obesity results in important changes in the mechanical properties of the respiratory system which could explain the occurrence of asthma. However, there are also plausible biological mechanisms whereby obesity could be expected to either cause or worsen asthma. These include co-morbidities such as gastro-oesophageal reflux, complications from sleep-disordered breathing, breathing at low lung volumes, chronic systemic inflammation, and endocrine factors, including adipokines and reproductive hormones. Obesity related asthma is in general not associated with eosinophilic airway inflammation, and adipokines are likely to play important roles in the inflammatory pathogenesis of asthma in obese individuals.. The association between obesity and asthma is not straightforward, and further knowledge is clearly needed, as understanding the underlying mechanisms may lead to new therapeutic options for this high-risk part of the asthma population.

Topics: Adipokines; Adiposity; Adolescent; Adult; Aged; Asthma; Biomarkers; Body Mass Index; Dinoprost; Environment; Epigenesis, Genetic; Female; Genetic Predisposition to Disease; Humans; Life Style; Lung; Male; Middle Aged; Obesity; Oxidative Stress; Respiratory Function Tests; Sex Factors; Young Adult

The need for non-invasive assessment of airway inflammation is imperative, since inflammatory airway diseases, such as asthma and COPD, are characterized by variation in their clinical presentation throughout their course. Exhaled breath condensate (EBC) collection represents a rather appealing method that can be used to conveniently and noninvasively collect a wide range of volatile and non-volatile molecules from the respiratory tract, without affecting airway function or inflammation. Although promising, EBC is currently used only as a research tool, due to the lack of appropriate standardization and the absence of reference values. A large number of mediators of inflammation, oxidative and nitrosative stress, including adenosine, ammonia, hydrogen peroxide, isoprostanes, leukotrienes, prostanoids, nitrogen oxides, peptides and cytokines, have been studied in EBC. This review focuses mainly on the presentation of the above biomarkers in asthma as well as on the effect of various factors on their concentrations. Concentrations of such mediators have been shown to be related to the underlying asthma and its severity and to be modulated by therapeutic interventions. Despite the encouraging positive results up-to-date, the introduction of EBC in everyday clinical practice requires the work-out of some methodological pitfalls, the standardization of EBC collection, and finally the identification of a reliable biomarker which is reproducible, has normal values and provides information for the underlying inflammatory process and the response to treatment. So far none of the parameters studied in EBC fulfils the aforementioned requirements.

Topics: Asthma; Biomarkers; Breath Tests; Dinoprost; Eicosanoids; Humans; Hydrogen Peroxide; Leukotrienes; Nitrogen Oxides; Oxidative Stress

Obesity is associated with increased systemic and airway oxidative stress, which may result from a combination of adipokine imbalance, comorbidities, and reduced antioxidant defenses. While obesity-mediated increased oxidative stress plays an important role in the pathogenesis of vascular disease and nonalcoholic hepatic steatosis, little is known of how it may affect the lung. Contrary to what has previously been thought, the combination of obesity and asthma, both chronic inflammatory diseases, does not necessarily result in a synergistic effect, leading to even greater oxidative stress. However, most available studies have compared the levels of oxidative stress biomarkers on stable asthma patients, and it is possible that the interaction of oxidative stress between obesity and asthma is not readily detectable under basal conditions. We propose that obesity-mediated oxidative stress, which may affect the lung function of asthmatic subjects by increasing airway inflammation and reducing the effectiveness of inhaled corticosteroids, may become evident during exposure to an aggravating factor or during periods of asthma exacerbation. Understanding whether obesity-mediated oxidative stress has a mechanistic role in the association between obesity and asthma will help in the formation of public health policies and increase our capacity to develop therapeutic interventions that improve the life of obese asthmatic subjects.

Topics: Adipokines; Animals; Asthma; Dinoprost; Humans; Inflammation Mediators; Lung; Obesity; Oxidative Stress; Risk Factors

Avoiding oxidative stress in the airways is important for the treatment of respiratory disease associated with gastroesophageal reflux disease (GERD). It is often difficult to decide whether GERD is causing airway inflammation or whether an airway disease is complicated by GERD. Measurement of exhaled breath condensate (EBC) is performed by cooling and collecting the airway lining fluid contained in exhaled air. A decrease of pH and an increase of the 8-isoprostane concentration in EBC have been observed in patients with mild to moderate asthma accompanied by GERD. There are still problems to be overcome before EBC can be used clinically, but pH and 8-isoprostane may be promising objective markers of airway inflammation due to GERD. The disease concept and diagnosis of GERD are constantly advancing, including the development of impedance methods. It is expected that treatment will be based on the latest diagnostic knowledge of GERD associated with respiratory disease and on monitoring of airway inflammation.

Topics: Asthma; Biomarkers; Body Composition; Breath Tests; Cytokines; Dinoprost; Electric Impedance; Esophagus; Gastroesophageal Reflux; Humans; Hydrogen-Ion Concentration; Inflammation; Inflammation Mediators; Oxidative Stress; Respiratory Mucosa

The lungs of asthmatic patients are exposed to oxidative stress due to the generation of reactive oxygen and nitrogen species as a consequence of chronic airway inflammation. Increased concentrations of NO*, H2O2 and 8-isoprostane have been measured in exhaled breath and induced sputum of asthmatic patients. O2*-, NO*, and halides interact to form highly reactive species such as peroxynitrite and HOBr, which in turn cause nitration and bromination of protein tyrosine residues. Oxidative stress may also reduce glutathione levels and cause inactivation of antioxidant enzymes such as superoxide dismutase, with a consequent increase in apoptosis, shedding of airway epithelial cells and airway remodelling. The oxidant/antioxidant equilibrium in asthmatic patients may be further perturbed by low dietary intakes of the antioxidant vitamins C and E, selenium and flavonoids, with a consequent lowering of the concentrations of these and other non-dietary antioxidants such as bilirubin and albumin in plasma and airway epithelial lining fluid. Although supplementation with vitamins C and E appears to offer protection against the adverse effects of ozone, recent randomised, placebo-controlled trials of vitamin C or E supplements for patients with mild asthma have not shown significant benefits over standard therapy. However, genetic variation in glutathione S-transferase may influence the susceptibility of asthmatic individuals to oxidative stress and the extent to which they are likely to benefit from antioxidant supplementation. Long-term prospective trials are required to determine whether modification of dietary intake will benefit asthma patients and reduce the socio-economic burden of asthma in the community.

Topics: Animals; Antioxidants; Apoptosis; Asthma; Dinoprost; Glutathione Transferase; Humans; Hydrogen Peroxide; Inflammation; Models, Biological; Nitric Oxide; Oxidants; Oxidative Stress; Reactive Nitrogen Species; Reactive Oxygen Species

In the middle of the nineties a new, non-invasive method for investigation of the lung aroused the interest of many researchers: the exhaled breath condensate. It shows the extent of the interest that in the last five years more than 80 original articles have been published in this theme. Many substances are found in the expired breath which are detectable in the liquid that we obtain by cooling (= condensing) the exhaled breath. The advantages of this method are that it is non-invasive, convenient, it could be performed with mechanically ventilated patients as well as with children. The most studied substance is the hydrogen-peroxide, which is the marker of oxidative stress, and its level in condensate is elevated in numerous inflammatory diseases. 8-isoprostane was also studied a lot, which is another marker of oxidative stress. Numerous substances could be even measured in condensate, so the decay-product of nitric-oxide (nitrite, nitrate, nitrotyrosine), further nitrosothiol, adenosine, ammonia, different ions, leukotrienes, cytokines; recently even other feature of condensate is examined, such as its pH. The different mediators could help us to know better the diseases, support the diagnosis, follow the treatment or the disease. In this study the authors attempt to present the most important knowledge till now.

Topics: Asthma; Biomarkers; Breath Tests; Bronchiectasis; Cystic Fibrosis; Dinoprost; F2-Isoprostanes; Humans; Hydrogen Peroxide; Oxidative Stress; Pulmonary Disease, Chronic Obstructive; Respiratory Distress Syndrome; Respiratory Tract Diseases; Smoking

The actions of prostanoids in various physiological and pathophysiological conditions have been being examined using mice lacking different prostanoid receptors. Prostaglandin (PG) I2 worked not only as a mediator of inflammation but also as an antithrombotic agent. PGF2alpha was found to be an essential inducer of labor. Several important actions of PGE2 are exerted via each of the four PGE2 receptor subtypes: EP1, EP2, EP3 and EP4. PGE2 participated in colon carcinogenesis via the EP1. PGE2 also participates in ovulation and fertilization and contributes to the control of blood pressure under high-salt intake via the EP2. PGE2 worked as a mediator of febrile responses to both endogenous and exogenous pyrogens and as a regulator of bicarbonate secretion induced by acid-stimulation in the duodenum via the EP3. It regulated the closure of ductus arteriosus and showed bone resorbing action via the EP4. PGD2 was found to be a mediator of allergic asthma. These studies have revealed important roles of prostanoids, some of which had not previously been known.

Topics: Animals; Asthma; Bicarbonates; Colonic Neoplasms; Dinoprost; Dinoprostone; Female; Fever; Hypertension; Inflammation; Labor, Obstetric; Mice; Mice, Knockout; Pregnancy; Prostaglandins; Receptors, Prostaglandin; Reproduction; Thrombosis; Thromboxane A2

Topics: Anaphylaxis; Animals; Asthma; Bronchi; Dinoprost; Dinoprostone; Dogs; Epoprostenol; Guinea Pigs; Humans; In Vitro Techniques; Lung; Lung Diseases; Models, Biological; Muscle, Smooth; Prostaglandin D2; Prostaglandins; Prostaglandins D; Prostaglandins E; Prostaglandins F; SRS-A; Thromboxane A2

The Intrinsic Sympathetic Activity (ISA) of the beta-1-adrenoceptor blocker celiprolol was tested in a series of pharmacological and clinical investigations. Celiprolol shows much more pronounced positive chronotropic effects in spontaneously beating atria of cats than in those of guinea-pigs and rats. Positive inotropic effects of celiprolol are much pronounced in the left kitten atrium, but scarcely demonstrable in the kitten papillary muscle. Celiprolol has no influence on the adenylyl cyclase activity of the dog heart. In reserpinized rats and reserpinized, adrenalectomized, vagotomized cats celiprolol increases the heart rate to the same extent as the beta-blocker pindolol. In ganglion-blocked dogs celiprolol distinctly increases heart rate and left ventricular contraction force. Celiprolol relaxes isolated human arterial and venous strips and induces a transient increase of the femoral arterial blood flow in anaesthetized dogs. Celiprolol relaxes isolated bovine tracheal muscle preparations and reduces the airway resistance in anaesthetized cats infused with serotonin. The intrinsic chronotropic effects of celiprolol in cat atria in vitro and in reserpinized rats in vivo and the relaxing effects of celiprolol in isolated bovine tracheal muscles are antagonized by propranolol, and therefore these actions may be explained by the ISA of celiprolol. However the vascular relaxing effects of celiprolol in vitro and in vivo and the bronchodilating effects in the serotonin-infused cat are not blocked by propranolol. In order to obtain a more precise characterization of these surprising effects, further pharmacological investigations were done. In the isolated femoral artery of the dog the concentration-response curve of calcium chloride is not influenced by celiprolol while it is antagonized by verapamil. A serotonin antagonistic effect cannot be demonstrated for celiprolol either in receptor binding studies or on the blood pressure of anaesthetized dogs. Celiprolol inhibits the methacholine bronchospasm in rats and the prostaglandin F2 alpha-induced bronchoconstriction in cats. The histamine-induced bronchoconstriction in dogs is scarcely affected by celiprolol while it is enhanced by propranolol. In radioligand studies celiprolol shows a tenfold higher affinity for alpha-2 in comparison to alpha-1 receptors. Celiprolol enhances the inhibitory effect of clonidine in the electrically stimulated vas deferens of the rat in vitro.(ABSTRACT TRUNCATED AT 400 WOR

Topics: Adrenergic beta-Antagonists; Animals; Asthma; Blood Coagulation; Bronchi; Bronchial Spasm; Calcium Channel Blockers; Celiprolol; Dinoprost; Heart; Hemodynamics; Histamine; Humans; Myocardial Infarction; Propanolamines; Prostaglandins F; Receptors, Adrenergic, alpha; Respiration; Serotonin Antagonists; Sympathomimetics

Topics: Animals; Arachidonic Acid; Arachidonic Acids; Aspirin; Asthma; Bronchitis; Dinoprost; Dinoprostone; Epoprostenol; Humans; Leukotriene B4; Lung; Lung Diseases; Prostaglandin D2; Prostaglandin Endoperoxides, Synthetic; Prostaglandin H2; Prostaglandins D; Prostaglandins E; Prostaglandins F; Prostaglandins G; Prostaglandins H; Pulmonary Circulation; Pulmonary Ventilation; SRS-A

Topics: Adrenergic beta-Agonists; Alcohol Drinking; Anti-Anxiety Agents; Anti-Bacterial Agents; Anti-Infective Agents; Aspirin; Asthma; Barbiturates; Coffee; Cromolyn Sodium; Dinoprost; Drug Interactions; Female; Fetal Alcohol Spectrum Disorders; Histamine H1 Antagonists; Humans; Iodine; Lung Diseases; Maternal-Fetal Exchange; Nasal Decongestants; Parasympatholytics; Prednisone; Pregnancy; Pregnancy Complications; Prostaglandins F; Smoking; Theophylline

Topics: Adenylyl Cyclases; Anaphylaxis; Animals; Asthma; Bronchi; Chemical Phenomena; Chemistry; Dinoprost; Guinea Pigs; Lung; Lung Diseases; Prostaglandin-Endoperoxide Synthases; Prostaglandins; Prostaglandins E; Prostaglandins F; Structure-Activity Relationship; Trachea

Numerous open trials have demonstrated the beneficial clinical effects of aspirin desensitization (AD) in patients with aspirin-induced asthma (AIA). These beneficial effects might be attributable to aspirin's potent anti-inflammatory properties, but that supposition requires further corroboration.. We sought to compare the clinical and biochemical responses to chronic oral AD in 20 patients with AIA and 14 patients with aspirin-tolerant asthma (ATA). All of the patients had chronic rhinosinusitis and nasal polyposis, and these responses were investigated in a pilot, double-blind, placebo-controlled study.. Twelve patients with AIA and 6 patients with ATA were randomly assigned to receive 624 mg of aspirin, and 8 patients with AIA and 8 patients with ATA received placebo. Both aspirin and placebo were administered once daily for 6 months. Nasal symptoms, Sino-Nasal Outcome Test (SNOT20) scores, peak nasal inspiratory flows, Asthma Control Questionnaire scores, spirometric parameters, peak expiratory flows, blood eosinophilia, and corticosteroid doses were assessed on a monthly basis. Levels of urinary leukotriene E4 and the stable plasma prostaglandin (PG) D2 metabolite 9α,11β-PGF2 were evaluated at baseline and after 1, 3, 5, and 6 months.. Only the patients with AIA subjected to AD reported improvements in smell and reductions in sneezing and nasal blockade. The SNOT20 and Asthma Control Questionnaire scores of these patients decreased, and their peak nasal inspiratory flows increased. The dosages of inhaled corticosteroids were reduced. There were no changes in leukotriene E(4) or 9α,11β-PGF(2) levels after AD.. The clinically beneficial effects of AD on nasal and bronchial symptoms occurred only in the patients with AIA.

Topics: Administration, Oral; Adult; Aged; Allergens; Aspirin; Asthma; Asthma, Aspirin-Induced; Chronic Disease; Desensitization, Immunologic; Dinoprost; Double-Blind Method; Eosinophils; Female; Follow-Up Studies; Humans; Leukotriene E4; Male; Middle Aged; Nasal Polyps; Pilot Projects; Prostaglandin D2; Rhinitis; Sinusitis; Spirometry; Treatment Outcome

Evaluate the effect of the marine lipid fraction of the New Zealand green-lipped mussel (Perna canaliculus) PCSO-524 (Lyprinol/Omega XL), rich in omega-3 fatty acids, on airway inflammation and the bronchoconstrictor response to eucapnic voluntary hyperpnea (EVH) in asthmatics.. Twenty asthmatic subjects, with documented HIB, participated in a placebo controlled double-blind randomized crossover trial. Subjects entered the study on their usual diet and were then placed on 3 weeks of PCSO-524 or placebo supplementation, followed by a 2 week washout period, before crossing over to the alternative diet. Pre- and post-eucapnic voluntary hyperpnea (EVH) pulmonary function, fraction of exhaled nitric oxide (FENO), asthma symptom scores, medication use, exhaled breath condensate (EBC) pH, cysteinyl leukotrienes (cyst-LT), 8-isoprostane and urinary 9α, 11β-prostaglandin (PG)F2 and Clara (CC16) protein concentrations were assessed at the beginning of the trial and at the end of each treatment period.. The PCSO-524 diet significantly reduced (p < 0.05) the maximum fall in post-EVH FEV1 (-8.4 ± 3.2%) compared to usual (-19.3 ± 5.4%) and placebo diet (-22.5 ± 13.7%). Pre- and post- EVH EBC cyst-LT and 8-isoprostane, and urinary 9α, 11β-PGF2 and CC16 concentrations were significantly reduced (p < 0.05) on the PCSO-524 diet compared to the usual and placebo diet. EBC pH and asthma symptom scores were significantly improved (p < 0.05) and rescue medication use significantly reduced (p < 0.05) on the PCSO-524 diet compared to the usual and placebo diet.. PCSO-524 (Lyprinol)/Omega XL) may have beneficial effects in HIB and asthma by serving as a pro-resolving agonist and/or inflammatory antagonist.

Topics: Adrenergic beta-Agonists; Animals; Anti-Asthmatic Agents; Asthma; Biological Products; Biomarkers; Bivalvia; Breath Tests; Bronchitis; Bronchoconstriction; Bronchodilator Agents; Constriction, Pathologic; Cross-Over Studies; Dietary Supplements; Dinoprost; Double-Blind Method; Fatty Acids, Omega-3; Female; Forced Expiratory Volume; Humans; Hyperventilation; Lipids; Male; Medication Adherence; Nitric Oxide; Uteroglobin; Young Adult

Asthmatic airways are characterised by enhanced oxidative stress, which can be studied by measuring biomarkers, such as 8-isoprostane. The aims of the present study were: 1) to measure the concentrations of 8-isoprostane in exhaled breath condensate (EBC) and urine of children with problematic and well-controlled asthma; 2) to compare the concentrations of 8-isoprostane measured by gas chromatographic/negative ion chemical ionisation mass spectrometry (GC/NICI-MS) and by an enzymatic immunoassay (EIA). We recruited 20 asthmatic allergic children, 13 with well-controlled asthma and seven with problematic asthma. They underwent exhaled nitric oxide measurements and spirometry, and both EBC and urine samples were collected. 8-isoprostane was measured in EBC by GC/NICI-MS and EIA. 8-isoprostane concentrations in EBC were significantly higher in children with problematic asthma than in children with well-controlled asthma (p = 0.01). An acceptable reproducibility emerged between GC/NICI-MS and EIA (coefficient of reproducibility 11.5 pg x mL(-1)). 8-isoprostane levels measured in urine did not correlate with those measured in EBC. We showed that 8-isoprostane in EBC was significantly increased in children with problematic asthma, suggesting a role for oxidative stress in this asthma phenotype. In addition we found an acceptable reproducibility of EIA compared to GC/NICI-MS, even if the latter method had higher accuracy.

Topics: Anti-Asthmatic Agents; Asthma; Biomarkers; Breath Tests; Child; Dinoprost; Gas Chromatography-Mass Spectrometry; Humans; Immunoenzyme Techniques; Nitric Oxide; Oxidative Stress; Reproducibility of Results; Spirometry

Exercise-induced bronchoconstriction (EIB) in the asthmatic child is associated with persistent airway inflammation and poor disease control. EIB could arise partly from airway oxidative stress. Exhaled breath condensate (EBC) levels of 8-isoprostane (IsoP), which is a known marker of oxidative stress, might therefore be helpful for monitoring asthma noninvasively.. We recruited 46 asthmatic children and adolescents 6 to 17 years of age (29 boys), all of whom underwent lung function testing, measurement of the fractional concentration of exhaled nitric oxide (FENO), and collection of EBCs for 8-IsoP measurement before and after exercise challenge. FENO was measured before exercise and 5 min and 20 min after exercise. Spirometry was repeated 1, 5, 10, 15, and 20 min after exercise.. Baseline 8-IsoP levels (but not baseline FENO levels) correlated with the fall in FEV(1) 5 min after exercise (r = - 0.47; p = 0.002). 8-IsoP levels measured after exercise remained unchanged from baseline levels; conversely, FENO levels decreased in parallel with the decline in FEV(1) at 5 min (r = 0.44; p = 0.002). The mean baseline 8-IsoP concentrations were higher in patients with EIB (n = 12) than in those without EIB (n = 34; 44.9 pg/mL [95% confidence interval (CI), 38.3 to 51.5] vs 32.3 pg/mL [95% CI, 27.6 to 37.0], respectively; p < 0.01). No difference was found in the mean baseline FENO between groups (with EIB group: 38.7 ppb; 95% CI, 24.5 to 61.1; without EIB group: 29.1 ppb; 95% CI, 22.0 to 38.4).. Increased 8-IsoP concentrations in EBC samples of asthmatic children and adolescents with EIB suggest a role for oxidative stress in bronchial hyperreactivity.

Topics: Adolescent; Asthma; Biomarkers; Breath Tests; Bronchial Hyperreactivity; Child; Constriction, Pathologic; Dinoprost; Exercise; Exhalation; Female; Humans; Male; Oxidative Stress; Reproducibility of Results; Spirometry

Wine-induced asthmatic symptoms may be caused by sulphite additives. Prostaglandin (PG)D2 and cysteinyl leukotrienes (cysLT) are important mediators of asthmatic responses. To determine whether the sulphite additives in wine alter the production of PGD2 and cysLT, asthmatic patients with compelling histories of wine sensitivity were challenged with high- and low-sulphite wines; the urinary metabolites of PGD2 and cysLT were measured before and after challenge.. Eight self-reporting wine-sensitive asthmatic patients completed double-blind challenges with high- and low-sulphite wines on separate days. Urine samples were collected before and after consumption of 150 ml of wine. Urinary concentrations of 9alpha,11beta-PGF2 and leukotriene (LT)E4 were measured by enzyme immunoassay.. Urinary 9alpha,11beta-PGF2 concentrations increased in all subjects following challenge with high-sulphite wine, and the median concentration increased 1.6-fold (p < 0.01). Urinary 9alpha,11beta-PGF2 also increased 1.5-fold after low-sulphite wine challenge, although this did not reach statistical significance (p = 0.08). The median difference in 9alpha,11beta-PGF2 concentration after high-sulphite wine challenge was not significantly different compared with that after low-sulphite wine challenge. Median urinary LTE4 concentrations did not change significantly after either wine challenge.. Increased urinary 9alpha,11beta-PGF2 concentrations following wine challenge suggest mast cell activation as a possible mechanism for wine-induced asthma, although this did not appear to be related to the sulphite additives in wine. Urinary 9alpha,11beta-PGF2 may warrant further assessment as a potential biomarker of reactivity to wine in asthmatic subjects.

Topics: Adult; Allergens; Asthma; Cross-Over Studies; Dinoprost; Double-Blind Method; Female; Humans; Leukotriene E4; Male; Mast Cells; Middle Aged; Skin Tests; Sulfites; Wine

There is a substantial body of evidence on the efficacy of yoga in the management of bronchial asthma. Many studies have reported, as the effects of yoga on bronchial asthma, significant improvements in pulmonary functions, quality of life and reduction in airway hyper-reactivity, frequency of attacks and medication use. In addition, a few studies have attempted to understand the effects of yoga on exercise-induced bronchoconstriction (EIB) or exercise tolerance capacity. However, none of these studies has investigated any immunological mechanisms by which yoga improves these variables in bronchial asthma.. The present randomized controlled trial (RCT) was conducted on 57 adult subjects with mild or moderate bronchial asthma who were allocated randomly to either the yoga (intervention) group (n = 29) or the wait-listed control group (n = 28). The control group received only conventional care and the yoga group received an intervention based on yoga, in addition to the conventional care. The intervention consisted of 2-wk supervised training in lifestyle modification and stress management based on yoga followed by closely monitored continuation of the practices at home for 6-wk. The outcome measures were assessed in both the groups at 0 wk (baseline), 2, 4 and 8 wk by using Generalized Linear Model (GLM) repeated measures followed by post-hoc analysis.. In the yoga group, there was a steady and progressive improvement in pulmonary function, the change being statistically significant in case of the first second of forced expiratory volume (FEV1) at 8 wk, and peak expiratory flow rate (PEFR) at 2, 4 and 8 wk as compared to the corresponding baseline values. There was a significant reduction in EIB in the yoga group. However, there was no corresponding reduction in the urinary prostaglandin D2 metabolite (11beta prostaglandin F2alpha) levels in response to the exercise challenge. There was also no significant change in serum eosinophilic cationic protein levels during the 8-wk study period in either group. There was a significant improvement in Asthma Quality of Life (AQOL) scores in both groups over the 8-wk study period. But the improvement was achieved earlier and was more complete in the yoga group. The number-needed-to-treat worked out to be 1.82 for the total AQOL score. An improvement in total AQOL score was greater than the minimal important difference and the same outcome was achieved for the sub-domains of the AQOL. The frequency of rescue medication use showed a significant decrease over the study period in both the groups. However, the decrease was achieved relatively earlier and was more marked in the yoga group than in the control group.. The present RCT has demonstrated that adding the mind-body approach of yoga to the predominantly physical approach of conventional care results in measurable improvement in subjective as well as objective outcomes in bronchial asthma. The trial supports the efficacy of yoga in the management of bronchial asthma. However, the preliminary efforts made towards working out the mechanism of action of the intervention have not thrown much light on how yoga works in bronchial asthma.. Current Controlled Trials ISRCTN00815962.

Topics: Adrenal Cortex Hormones; Adult; Anti-Asthmatic Agents; Asthma; Dinoprost; Female; Forced Expiratory Volume; Humans; Life Style; Linear Models; Lung; Male; Outcome Assessment, Health Care; Peak Expiratory Flow Rate; Quality of Life; Severity of Illness Index; Stress, Psychological; Yoga

Extra-fine hydrofluoroalkane-beclomethasone differs from other inhaled corticosteroids by its fine aerosol characteristics. Therefore, extra-fine hydrofluoroalkane-beclomethasone may be particularly useful for treating peripheral airway inflammation in asthma.. To analyze the anti-inflammatory effects of extra-fine hydrofluoroalkane-beclomethasone vs fluticasone dry powder inhaler (DPI) in asthmatic children by measuring bronchial and alveolar nitric oxide (NO) and inflammatory markers in exhaled breath condensate (EBC).. In a 6-month crossover study, 33 children aged 6 to 12 years with moderate persistent asthma were randomly treated with extra-fine hydrofluoroalkane-beclomethasone (200 microg daily via an Autohaler) and fluticasone DPI (200 microg daily via a Diskus). The primary outcome variables were alveolar NO concentration and bronchial NO flux. The secondary outcome variables were levels of inflammatory markers in EBC, lung function indices, symptoms, exacerbations, and adverse effects. All the variables were recorded at baseline and after each treatment period.. Mean +/- SE alveolar NO concentration and bronchial NO flux were comparable after treatment with hydrofluoroalkane-beclomethasone vs fluticasone DPI (4.7 +/- 0.5 vs 4.3 +/- 0.5 ppb, P = .55, and 1,124.3 +/- 253.6 vs 1,029.1 +/- 195.5 pL/s, P = .70, respectively). In addition, levels of inflammatory markers in EBC, lung function indices, and symptoms did not differ between treatments. Patients used fewer beta2-agonists during the last 2 weeks of hydrofluoroalkane-beclomethasone treatment.. The anti-inflammatory effects of hydrofluoroalkane-beclomethasone are similar to those of fluticasone DPI in children with moderate persistent asthma.

Topics: Administration, Inhalation; Androstadienes; Anti-Inflammatory Agents; Asthma; Beclomethasone; Biomarkers; Breath Tests; Child; Cross-Over Studies; Dinoprost; Female; Fluticasone; Forced Expiratory Volume; Humans; Hydrocarbons, Fluorinated; Hydrogen Peroxide; Inflammation; Interleukins; Male; Nitrates; Nitric Oxide; Nitrites; Prospective Studies; Treatment Outcome; Vital Capacity

Leukotriene (LT) E(4) and 8-isoprostane concentrations are elevated in exhaled breath condensate in children with asthma. The effects of leukotriene receptor antagonists (LTRAs) on exhaled leukotriene and prostanoids in children with asthma are unknown.. (1) To study the effect of montelukast, a LTRA, on exhaled LTE(4), 8-isoprostane, and prostaglandin E(2) in children with asthma and atopic children; (2) to measure exhaled nitric oxide.. An open-label study with oral montelukast (5 mg once daily for 4 weeks) was undertaken in 17 atopic children with asthma and 16 atopic children without asthma.. Pretreatment exhaled LTE(4) (P < .0001) and 8-isoprostane (P < .0001) values were higher in atopic children with asthma than in atopic children without asthma. In atopic children with asthma, montelukast reduced exhaled LTE(4) by 33% (P < .001), and this reduction was correlated with pretreatment LTE(4) values (r = -0.90; P = .0001). Posttreatment exhaled LTE(4) levels in children with asthma were higher than pretreatment LTE(4) values in atopic children without asthma (P < .004). Montelukast had no effect on exhaled LTE(4) in atopic children without asthma (P = .74), or on exhaled 8-isoprostane (atopic children with asthma, P = .94; atopic children without asthma, P = .55) and PGE(2) (atopic children with asthma, P = .56; atopic children without asthma, P = .93) in both groups. In atopic children with asthma, exhaled nitric oxide concentrations were reduced by 27% (P < .05) after montelukast.. Leukotriene receptor antagonists decrease exhaled LTE(4) in atopic children with asthma. This reduction is dependent on baseline exhaled LTE(4) values.. Measurement of exhaled LTE(4) might help identify children with asthma most likely to benefit from LTRAs.

Topics: Acetates; Allergens; Anti-Asthmatic Agents; Asthma; Biomarkers; Breath Tests; Child; Cross-Sectional Studies; Cyclopropanes; Dinoprost; Dinoprostone; Humans; Hypersensitivity; Leukotriene Antagonists; Leukotriene E4; Nitric Oxide; Quinolines; Skin Tests; Spirometry; Sulfides

Induced sputum 8-iso-prostaglandin F(2alpha) (PGF(2alpha)) concentrations may be a useful marker of oxidative stress in airways disease. This study examines oxidative stress (measured by 8-iso-PGF(2alpha)) in airway disease according to disease type (asthma and bronchiectasis), disease activity (stable and acute asthma), and disease pattern (intermittent, mild, moderate, and severe persistent asthma). We compared subjects with stable asthma (n = 71) and bronchiectasis (n = 23) with healthy control subjects (n = 29). Another group of patients with asthma (n = 39) were assessed during and after acute exacerbation. Induced sputum 8-iso-PGF(2alpha) concentrations were validated and found to be elevated in subjects with stable asthma and bronchiectasis versus control subjects (median [interquartile range] 216 [103-389] and 698 [264-1,613] ng/L vs. 123 [41-290] ng/L, p < 0.001) and increased as clinical asthma pattern worsened (intermittent 115 [42-153], mild persistent 116 [89-229] ng/L, moderate persistent 183 [110-317] ng/L, severe persistent 387 [102-587] ng/L; p = 0.010). Sputum 8-iso-PGF(2alpha) concentrations were elevated during acute asthma and decreased with recovery (458 [227-950] ng/L vs. 214 [148-304] ng/L, p = 0.0002). We conclude that 8-iso-PGF(2alpha) is involved in the pathophysiology of inflammatory airway diseases, being related to disease type, pattern, and activity. Analysis of 8-iso-PGF(2alpha) concentrations in induced sputum provides a useful tool for monitoring oxidative stress and investigating strategies aimed at reducing oxidative stress in airways disease.

Topics: Adult; Age Factors; Asthma; Biomarkers; Bronchiectasis; Dinoprost; Eosinophils; Female; Humans; Leukocyte Count; Male; Middle Aged; Multivariate Analysis; Neutrophils; Oxidative Stress; Pneumonia; Respiratory Function Tests; Sex Factors; Sputum

Exhaled breath condensate (EBC) is a non-invasive method to assess airway inflammation and oxidative stress and may be useful in the assessment of childhood asthma.. Exhaled 8-isoprostane, a stable marker of oxidative stress, was measured in EBC, in children (5-17 years) with asthma (13 steroid-naïve and 12 inhaled steroid-treated) and 11 healthy control.. Mean exhaled 8-isoprostane concentration was significantly elevated in steroid-naïve asthmatic children compared to healthy children 9.3 (SEM 1.7) vs. 3.8 (0.6) pg/ml, p < 0.01. Children on inhaled steroids also had significantly higher 8-isoprostane levels than those of normal subjects 6.7 (0.7) vs. 3.8 (0.6) pg/ml, p < 0.01. Steroid-naïve asthmatics had higher exhaled nitric oxide (eNO) than those of controls 28.5 (4.7) vs. 12.6 (1.5) ppb, p < 0.01. eNO in steroid-treated asthmatics was similar to control subjects 27.5(8.8) vs. 12.6(1.5) ppb. Exhaled 8-isoprostane did not correlate with duration of asthma, dose of inhaled steroids or eNO.. We conclude that 8-isoprostane is elevated in asthmatic children, indicating increased oxidative stress, and that this does not appear to be normalized by inhaled steroid therapy. This suggests that 8-isoprostane is a useful non-invasive measurement of oxidative stress in children and that antioxidant therapy may be useful in the future.

Topics: Adolescent; Asthma; Biomarkers; Breath Tests; Child; Child, Preschool; Dinoprost; Exhalation; Female; Humans; Lung; Male; Nitric Oxide; Reproducibility of Results; Sensitivity and Specificity

Cysteinyl-leukotrienes (cys-LTs) and 8-isoprostane are biomarkers of airway inflammation and oxidative stress.. The aim of this study was to evaluate cys-LT and 8-isoprostane levels in exhaled breath condensate (EBC) of children with different degrees of asthma severity.. EBC was collected from 14 steroid-naive children with mild persistent asthma, 13 children with stable mild- to-moderate persistent asthma treated with inhaled corticosteroids (ICS), 9 ICS-treated children with unstable asthma, and 19 healthy children.. In the three groups of asthmatic children, EBC concentrations of cys-LTs and 8-isoprostane were significantly higher than in control children (steroid-naive asthmatic children: cys-LTs median, 10.8 pg/mL, P <.001, 8-isoprostane, 16.2 pg/mL, P <.001; ICS-treated stable asthmatic children: cys-LTs, 12.7 pg/mL, P <.001, 8-isoprostane, 18.1 pg/mL, P <.001; children with unstable asthma: cys-LTs, 106.0 pg/mL, P <.01, 8-isoprostane, 29.7 pg/mL, P <.01; control children: cys-LTs, 4.3 pg/mL, 8-isoprostane, 3.5 pg/mL). Cys-LT levels were higher in children with unstable asthma than in the other two asthmatic groups (P <.05). FE(NO) levels were significantly higher in steroid-naive and in children with unstable asthma compared with ICS-treated children with stable asthma (P <.01).. Our study shows that EBC cys-LTs and 8-isoprostane concentrations are higher in asthmatic children than in healthy control children, with scattered values in patients with unstable asthma. These findings suggest that EBC eicosanoid measurement may have useful clinical implications for investigating phenotype differences among asthmatic patients.

Topics: Adolescent; Androstadienes; Anti-Asthmatic Agents; Asthma; Biomarkers; Breath Tests; Budesonide; Child; Cysteine; Dinoprost; F2-Isoprostanes; Female; Fluticasone; Forced Expiratory Volume; Humans; Leukotrienes; Male; Nitric Oxide; Oxidative Stress; Severity of Illness Index

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can precipitate adverse reactions in two apparently different clinical conditions: bronchial asthma and chronic idiopathic urticaria (CIU). Recent evidence indicates that the reactions are triggered by the drugs that inhibit cyclooxygenase-1 but not cyclooxygenase-2.. To assess whether patients with CIU and aspirin sensitivity share common eicosanoid alterations with patients who have aspirin-sensitive asthma.. Seventy-four patients with CIU and a history of sensitivity to aspirin and NSAIDs underwent placebo-controlled oral aspirin challenge tests. Concentrations of urinary leukotriene E4 (uLTE4) were measured by ELISA and plasma stable prostaglandin D2 metabolite, 9alpha,11beta prostaglandin F(2) by GC/MS. All measurements were carried out at baseline and after aspirin dosing. Patients were genotyped for the leukotriene C4 synthase (LTC4S) promoter single nucleotide polymorphism.. In 30 of 74 patients, the aspirin challenge was positive, resulting in urticaria/angioedema. In these 30 patients, baseline uLTE4 levels were higher than in nonresponders and the healthy control subjects and increased further (significantly) after the onset of clinical reaction. No such increase occurred in subjects with negative aspirin challenge. Baseline uLTE4 levels correlated with severity of skin reactions. Plasma 9alpha,11beta prostaglandin F(2) levels rose significantly in both aspirin responders and nonresponders, although in the latter group the increase occurred later than in the former. In patients who reacted to aspirin, frequency of (-444)C allele of LTC4S was significantly higher than in patients who did not react.. CIU with aspirin sensitivity is characterized by the eicosanoid alterations, which are similar to those present in aspirin-induced asthma.

Topics: Adult; Alleles; Aspirin; Asthma; Dinoprost; Drug Hypersensitivity; Eicosanoids; Female; Genotype; Glutathione Transferase; Humans; Leukotriene E4; Male; Middle Aged; Polymorphism, Single Nucleotide; Single-Blind Method; Urticaria

Aspirin-induced asthma/rhinitis (AIAR) is characterized by the altered metabolism of leukotrienes and proinflammatory prostaglandins. The basal and postchallenge levels of eicosanoids might reflect the clinical and biochemical characteristics of patients with distinct types of hypersensitive responses to aspirin.. We compared clinical and eicosanoid profiles of patients with AIAR showing both bronchial and nasal versus isolated nasal responses to aspirin challenge.. Twenty-three patients with AIAR underwent the single-blind, oral, placebo-controlled aspirin challenge. The bronchial response (BR) was evidenced by dyspnea and spirometry, whereas the nasal response (NR) was evidenced by nasal symptoms and acoustic rhinometry and/or rhinomanometry. Urinary leukotriene E4 (uLTE4), serum and urinary stable prostaglandin D2 metabolite, and 9alpha,11beta-prostaglandin F2 (9alpha,11beta-PGF2), were determined at baseline and after the aspirin challenge.. Fifteen subjects showed BR and NR (BNR), whereas 8 showed NR only. Basal uLTE4 in the BNR group was significantly higher than in the NR group. After aspirin challenge, it increased significantly in both groups. Serum 9alpha,11beta-PGF2 increased after aspirin challenge in the BNR group only. The patients with BNR had more severe AIAR.. BNR to aspirin in AIAR indicates a more advanced disease and more profound underlying eicosanoid metabolism disturbances.

Topics: Administration, Oral; Adult; Aspirin; Asthma; Bronchi; Dinoprost; Female; Humans; Leukotriene E4; Male; Nasal Cavity; Rhinitis; Severity of Illness Index; Single-Blind Method

Prostaglandin (PG)D2 is a major product of arachidonic acid metabolism in pulmonary mast cells. We therefore attempted to determine whether measurement of the stable urinary metabolite of PGD2, 9 alpha, 11 beta-PGF2, could serve as a marker of mast cell activation in the lungs. A commercially available enzyme immunoassay was validated and found to be specific and sensitive when applied to unpurified urine. There was no diurnal variation in the levels of 9 alpha, 11 beta-PGF2 in healthy volunteers. Morning baseline values of urinary 9 alpha, 11 beta-PGF2 were measured in three groups--healthy volunteers (n = 9), patients with atopic asthma (n = 14), and aspirin-intolerant patients with asthma (n = 12)--and found to be very similar, 54 +/- 9, 62 +/- 6, and 71 +/- 15 ng/mmol creatinine, respectively (means +/- SEM). Urinary excretion of 9 alpha, 11 beta-PGF2 was increased threefold immediately after allergen-induced bronchoconstriction in nine patients with atopic asthma. Bronchial challenge with inhaled lysine aspirin in eight aspirin-intolerant patients with asthma produced bronchoconstriction without extrapulmonary symptoms and was also followed by a significant increase in the urinary excretion of 9 alpha, 11 beta-PGF2. In addition, challenge with a higher dose of aspirin produced an even greater increase in urinary 9 alpha, 11 beta-PGF2, supporting dose-dependent release of PGD2 during aspirin-induced bronchoconstriction. In contrast, the postchallenge levels of urinary 9 alpha, 11 beta-PGF2 were not increased when bronchoconstriction was induced by histamine challenge in the aspirin-intolerant patients with asthma. The study confirms mast cell involvement in allergen-induced bronchoconstriction and provides novel data, which strongly support the hypothesis that pulmonary mast cells are activated during aspirin-induced airway obstruction. It is finally suggested that measurement of urinary 9 alpha, 11 beta-PGF2 with enzyme immunoassay may be used as a new noninvasive strategy to monitor mast cell activation in vivo.

Topics: Adult; Airway Obstruction; Allergens; Aspirin; Asthma; Bronchial Provocation Tests; Chromatography, High Pressure Liquid; Cross-Over Studies; Dinoprost; Double-Blind Method; Histamine; Humans; Immunoenzyme Techniques; Lysine; Mast Cells; Middle Aged; Prostaglandin D2

Although the mechanism of aspirin-induced asthma and rhinitis is unknown, it has been suggested that adverse nasal and bronchial reactions are caused by an increased production of lipoxygenase products. In examining this hypothesis we have measured the release of peptide leukotrienes (PeptLTs), 15-HETE, and prostaglandins in nasal fluids obtained by nasal lavages after instillation of acetylsalycilic acid (ASA) and placebo (saline). Ten ASA-sensitive asthmatics, 10 ASA-insensitive asthmatics, and seven healthy subjects were challenged in a double-blind study with normal saline and 12 mg of ASA. Twelve mg were administered based on the results of a previous study that showed that this dose caused minor to moderate symptoms in ASA-sensitive patients. PeptLTs, LTB4, 15-HETE, PGE2, PGF2 alpha, and PGD2 were measured by radioimmunoassay methods. Significant levels of PeptLTs were detected in sensitive asthmatic patients 60 min after nasal challenge. This change was associated with a significant increase in symptoms. No increase in PeptLTs levels were found, however, in either insensitive patients or healthy subjects. Inhibition of PGE2 and PGF2 alpha release was detected in the three groups after ASA administration. ASA also inhibited PGD2 release in insensitive asthmatic patients but not in both sensitive patients and healthy subjects. These results suggest that an abnormal release of PeptLTs in ASA-sensitive asthmatic patients contributes to nasal and bronchial adverse reactions. The lack of effects on PGD2 release suggests that mast cells from ASA-insensitive patients are more sensitive to ASA than those from sensitive asthmatic patients and healthy subjects.

Topics: Administration, Intranasal; Adult; Albumins; Aspirin; Asthma; Dinoprost; Dinoprostone; Drug Hypersensitivity; Female; Humans; Hydroxyeicosatetraenoic Acids; Leukotriene B4; Leukotrienes; Male; Middle Aged; Nasal Mucosa; Prostaglandin D2

We studied the effects of salbutamol, ipratropium bromide and cromolyn sodium on PGF2 alpha-induced bronchospasm in ten patients with asthma. Initially, the bronchial reactivity to IC-PGF2 alpha and the DP20-PGF2 alpha were determined. Recalculations were made two days later and again 1 h after administration of various drugs given on different days. Salbutamol and ipratropium bromide induced significant bronchodilation and of similar magnitude 1 h after administration. On the day salbutamol was given, surface area under the dose-response curve to PGF2 alpha was significantly higher and the final drop of FEV1 significantly lower than those observed on days when placebo, ipratropium bromide and cromolyn sodium were given. No differences among these values were found for placebo, ipratropium bromide and cromolyn sodium. Thus, beta 2 stimulants attenuate significantly PGF2 alpha-induced bronchospasm, while ipratropium bromide and cromolyn sodium do not have protective effect.

Topics: Adolescent; Adult; Albuterol; Asthma; Atropine Derivatives; Bronchial Provocation Tests; Bronchial Spasm; Cromolyn Sodium; Dinoprost; Dose-Response Relationship, Drug; Female; Humans; Ipratropium; Male

In order to evaluate whether adverse reactions to a nonsteroidal antiinflammatory agent (NSAIA) were related to variations in prostaglandin levels during the menstrual cycle, we measured 13-14-diOH-15-keto-prostaglandin F2 alpha in serum and the effect on airways of a single dose of 100 mg oral meclofenamate and 1.5 mg inhaled metaproterenol during the early (follicular phase) and late (luteal phase) menstrual cycle. Among 24 women with premenstrual asthma (PMA), four women with regular asthma (REA), and four healthy women, the 13-14-diOH-15-keto-PGF2 alpha averaged 140.9 +/- 68.4 pg/0.1 ml during the follicular phase but only 14.4 +/- 2.2 pg/0.1 ml during the luteal phase (p less than 0.0001). Acute asthma reactions to the meclofenamate occurred during the follicular phase in six women with PMA but were never observed during the luteal phase (p = 0.016). These reactions occurred preferentially in patients on corticosteroids (p = 0.004). Conversely, one patient with PMA had 18% improvement in FEV1 with meclofenamate during the luteal phase. A placebo-controlled, double-blind evaluation of the healthy women and the women with REA revealed a trend toward improvement in FEV1 during the luteal phase (0.15 less than p less than 0.10) but no change during the follicular phase. The effect of metaproterenol did not vary with the menstrual cycle, and there was no interaction between the effects of meclofenamate and those of metaproterenol. It appears that meclofenamate causes adverse effects on pulmonary function in asthmatic women primarily during the follicular phase of the menstrual cycle. This effect is associated with corticosteroid treatment and may be related to monthly variation in serum 13-14-diOH-15-keto-PGF2 alpha.

Topics: Adult; Asthma; Clinical Trials as Topic; Dinoprost; Double-Blind Method; Female; Humans; Meclofenamic Acid; Menstrual Cycle; Metaproterenol; ortho-Aminobenzoates; Premenstrual Syndrome; Prohibitins; Prostaglandins F; Respiration

Adverse reactions to aspirin in asthmatic patients have been widely described in the past. In contrast to this more frequent complication, several authors have published reports suggesting that aspirin and other nonsteroidal anti-inflammatory drugs can improve asthma. We studied the effect of long-term aspirin administration in children with moderately severe asthma. Ten children who showed no immediate effect of aspirin challenge (either adverse or beneficial) were placed in a 9 wk, double-blind crossover study, receiving aspirin (10 gr twice daily) or placebo for 4 wk, then a 1 wk washout period, followed by aspirin or placebo for 4 wk. There was no difference between aspirin and placebo periods in number of wheezing episodes, frequency of additional bronchodilator or prednisone use, or daily spirometric measurements. Serum thromboxane B2 levels were significantly reduced during aspirin therapy (p less than 0.001), indicating that the patients had complied with the aspirin therapy. Thus long-term administration of aspirin to asthmatics who show no immediate beneficial or adverse response to aspirin challenge appeared not to influence the clinical course of asthma. In addition, inhibition of the platelet prostaglandin cyclooxygenase pathway in these patients did not modify the clinical course of their asthma.

Topics: Adolescent; Aspirin; Asthma; Child; Clinical Trials as Topic; Dinoprost; Dinoprostone; Double-Blind Method; Humans; Patient Compliance; Prostaglandins E; Prostaglandins F; Spirometry

A new method of challenge with H2O is described after summarizing the results of previous studies concerning the pharmacological prevention of bronchoconstriction induced by PGF2 alpha and by ultrasonic mist of distilled water (H2O). This provides a simple, rapid and reproducible way of obtaining linear dose-response curves by plotting times of exposures against absolute or percent increases in sRaw. The preventive activity of several drugs against this type of bronchospasm has been tested. Beta 2-stimulants (fenoterol) were the most effective, both in terms of intensity and duration of action (more than 6 hours). DSCG, tiaramide and nifedipine were also efficient. Oxitropium bromide was almost ineffective, in spite of the comparatively high doses used. The H1 and H2 antihistamines chlorpheniramine and ranitidine were ineffective. The possible implications of these results are discussed, mainly in order to try to understand the mechanism of H2O bronchospasms, for which airways cooling does not seem at work.

Topics: Albuterol; Asthma; Benzothiazoles; Bronchi; Bronchial Provocation Tests; Bronchodilator Agents; Clinical Trials as Topic; Dinoprost; Double-Blind Method; Fenoterol; Humans; Piperazines; Prostaglandins F; Water

The global burden of chronic airway diseases represents an important public health concern. The role of oxidative stress and inflammation in the pathogenesis of these diseases is well known. The aim of this study is to evaluate the behavior of both inflammatory and oxidative stress biomarkers in patients with chronic bronchitis, current asthma and past asthma in the frame of a population-based study.. For this purpose, data collected from the Gene Environment Interactions in Respiratory Diseases (GEIRD) Study, an Italian multicentre, multicase-control study, was evaluated. Cases and controls were identified through a two-stage screening process of individuals aged 20-65 years from the general population. Out of 16,569 subjects selected from the general population in the first stage of the survey, 2259 participated in the clinical evaluation. Oxidative stress biomarkers such as 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), 8-isoprostane and glutathione and inflammatory biomarkers such as Fractional Exhaled Nitric Oxide (FENO) and white blood cells were evaluated in 1878 subjects.. Current asthmatics presented higher levels of FENO (23.05 ppm), leucocytes (6770 n/µL), basophils (30.75 n/µL) and eosinophils (177.80 n/µL), while subjects with chronic bronchitis showed higher levels of GSH (0.29 mg/mL) and lymphocytes (2101.6 n/µL). The multivariable multinomial logistic regression confirmed high levels of leucocytes (RRR = 1.33), basophils (RRR = 1.48), eosinophils (RRR = 2.39), lymphocytes (RRR = 1.26) and FENO (RRR = 1.42) in subjects with current asthma. Subjects with past asthma had a statistically significant higher level of eosinophils (RRR = 1.78) with respect to controls. Subjects with chronic bronchitis were characterized by increased levels of eosinophils (RRR = 2.15), lymphocytes (RRR = 1.58), GSH (RRR = 2.23) and 8-isoprostane (RRR = 1.23).. In our study, current asthmatics show a greater expression of the inflammatory profile compared to subjects who have had asthma in the past and chronic bronchitis. On the other hand, chronic bronchitis subjects showed a higher rate of expression of oxidative stress biomarkers compared to asthmatic subjects. In particular, inflammatory markers such as circulating inflammatory cells and FENO seem to be more specific for current asthma, while oxidative stress biomarkers such as glutathione and 8-isoprostane appear to be more specific and applicable to patients with chronic bronchitis.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Adult; Aged; Asthma; Biomarkers; Bronchitis, Chronic; Case-Control Studies; Dinoprost; Female; Glutathione; Humans; Leukocyte Count; Male; Middle Aged; Oxidative Stress; Young Adult

　Prostaglandin F2α (PGF2α) analog formulations are the most commonly used drugs for glaucoma treatment. They are known to be superior to β-blockers for reducing intraocular pressure and can be effective all through the day. Because of the action, topical β-blockers are contraindicated for patients with bronchial asthma. PGF2α is also known to act as a constrictor of the respiratory tract. The present study aims to analyze the relationship between PGF2α analogs and asthma. In addition, we utilized β-blockers and combined formulations of both contents to evaluate for comparison with PGF2α analogs. Data from Japanese adverse drug event reports (JADERs) from April 2004 to January 2016 were used for analysis. The drugs of interest were 4 PGF2α analogs, 4 β-blockers, and 2 combined formulations of both. For quantitative signal detection, the reporting odds ratios (RORs) with Haldane-Anscombe 1/2 correction were calculated. The corrected RORs (95%CI) were detected to be 4.73 (2.30-9.75) for PGF2α analogs, 4.61 (1.82-11.7) for β-blockers, and 28.7 (12.1-68.1) for combined formulations. Our results suggest that not only topical β-blockers but also PGF2α analogs are associated with asthma, and the combined formulations have stronger associations with asthma than when administered alone. Therefore, further clinical research will be necessary, and careful attention should be paid to any glaucoma patient using PGF2α analogs for asthma symptoms.

Topics: Adrenergic beta-Antagonists; Adverse Drug Reaction Reporting Systems; Asthma; Contraindications, Drug; Databases, Pharmaceutical; Dinoprost; Drug Combinations; Glaucoma; Humans

Associations between outdoor air pollution and asthma in adults are still scarce, and the underlying biological mechanisms are poorly understood. Our aim was to study the associations between 1) long-term exposure to outdoor air pollution and current asthma, 2) exhaled 8-isoprostane (8-iso; a biomarker related to oxidative stress) and current asthma, and 3) outdoor air pollution and exhaled 8-iso.Cross-sectional analyses were conducted in 608 adults (39% with current asthma) from the first follow-up of the French case-control and family study on asthma (EGEA; the Epidemiological study of the Genetic and Environmental factors of Asthma). Data on nitrogen dioxide, nitrogen oxides, particulate matter with a diameter ≤10 and ≤2.5 µm (PM

Topics: Adult; Aged; Air Pollutants; Asthma; Biomarkers; Breath Tests; Case-Control Studies; Cross-Sectional Studies; Dinoprost; Environmental Exposure; Exhalation; Female; France; Humans; Linear Models; Male; Middle Aged; Oxidative Stress; Particulate Matter; Young Adult

Asthma is an oxidative stress related disease, but associations with asthma outcomes are poorly studied in adults. We aimed to study the associations between several biomarkers related to oxidative stress and various asthma outcomes.Cross-sectional analyses were conducted in 1388 adults (mean age 43 years, 44% with asthma) from the Epidemiological Study of the Genetics and Environment of Asthma (EGEA2). Three blood antioxidant enzyme activities (biomarkers of response to oxidative stress) and exhaled breath condensate 8-isoprostanes and plasma fluorescent oxidation products (FlOPs) levels (two biomarkers of damage) were measured. Associations between biomarkers and 1) ever asthma and 2) asthma attacks, asthma control and lung function in participants with asthma were evaluated using regression models adjusted for age, sex and smoking.Biomarkers of response were unrelated to asthma outcomes. Higher 8-isoprostane levels were significantly associated with ever asthma (odds ratio for one interquartile range increase 1.28 (95% CI 1.06-1.67). Among participants with asthma, 8-isoprostane levels were negatively associated with adult-onset asthma (0.63, 0.41-0.97) and FlOPs levels were positively associated with asthma attacks (1.33, 1.07-1.65), poor asthma control (1.30, 1.02-1.66) and poor lung function (1.34, 1.04-1.74).Our results suggest that 8-isoprostanes are involved in childhood-onset asthma and FlOPs are linked to asthma expression.

Topics: Adult; Age of Onset; Asthma; Biomarkers; Breath Tests; Cohort Studies; Cross-Sectional Studies; Dinoprost; Exhalation; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Nitric Oxide; Oxidative Stress; Oxygen; Regression Analysis

To investigate the effect of chloroquine on airway hyperresponsiveness in asthmatic mice and explore the possible mechanism.. Balb/c mouse models of asthma established using OVA received intraperitoneal injections of chloroquine, dexamethasone, or both prior to OVA challenge. Within 24 h after the final challenge, airway hyper- responsiveness (AHR) of the mice was assessed, and the total cell count and the counts of different cell populations in the bronchoalveolar lavage fluid (BALF) were determined under light microscopy. The severity of lung inflammation was evaluated using HE staining, and the concentrations of IL-6 and PGF2α in the BALF were detected by enzyme-linked immunosorbent assay (ELISA).. Chloroquine pretreatment significantly decreased AHR (P<0.001) in the asthmatic mice and reduced the total cell count (P<0.01), eosinophils (P<0.001), neutrophils (P<0.01), and PGF2α levels in the BALF. Chloroquine combined with low-dose dexamethasone significantly lessened inflammations around the bronchioles (P<0.05) and blood vessels (P<0.01) in the lung tissue, and obviously lowered IL-6 (P<0.05) and PGF2α (P<0.001) in the BALF in the asthmatic mice.. Chloroquine can inhibit AHR in asthmatic mice and produce better anti-inflammatory effect when combined with dexamethasone for treatment of neutrophilic asthma.

Topics: Animals; Asthma; Bronchoalveolar Lavage Fluid; Chloroquine; Dexamethasone; Dinoprost; Disease Models, Animal; Enzyme-Linked Immunosorbent Assay; Eosinophils; Inflammation; Interleukin-6; Leukocyte Count; Lung; Mice; Mice, Inbred BALB C; Neutrophils

Mast cell (MC) mediators, among them prostaglandin D2 (PGD2) and 9α,11β-PGF2, PGD2's metabolite, play a key role in allergic reactions, including bee venom anaphylaxis (BVA). Assessment of these mediators has never been performed in BVA. The aim of the study was to assess the activation of MC during in vivo provocation with bee venom (BV) and to measure PGD2 and 9α,11β-PGF2 in the course of an allergen challenge. The second aim was to determine if assessment of these mediators could be useful for predicting adverse events during venom immunotherapy (VIT). In 16 BV-VIT patients and 12 healthy subjects, levels of PGD2 and 9α,11β-PGF2 were assessed during BV provocation by means of the skin chamber method. Chamber fluids, collected at 5 and 15 min, were analyzed for both mediators by gas chromatography mass spectrometry negative ion chemical ionization. BVA in comparison to non-allergic patients had a significantly higher ratio of 9α,11β-PGF2 in allergen-challenged chambers to 9α,11β-PGF2 in allergen-free chambers after 15 min of provocation (p = 0.039). Allergen challenge resulted in a significant increase of 9α,11β-PGF2 levels between 5 and 15 min after provocation only in BVA patients (p < 0.05). Analysis of log-transformed PGD2 levels showed significant difference between changes in PGD2 concentration between BVA and healthy subjects. No study patient developed adverse reactions during. 9α,11β-PGF2 is actively generated during the early allergic response to BV. Skin chamber seems to be a promising, non-invasive and safe model of in vivo allergen provocation in BV-allergic patients. High or low levels of both mediators do not predict occurrence of adverse events during VIT.

Topics: Adolescent; Adult; Aged; Allergens; Asthma; Bee Venoms; Biomarkers; Dinoprost; Female; Gas Chromatography-Mass Spectrometry; Humans; Hypersensitivity; Immunotherapy; Male; Mast Cells; Middle Aged; Multivariate Analysis; Prostaglandin D2; ROC Curve; Skin Tests; Young Adult

Inhaled prostaglandin (PG) E2 might inhibit asthmatic responses, but the mechanisms involved remain undefined.. We sought to characterize the direct and indirect effects of PGE2 on human small airways with particular reference to the receptors mediating the responses.. Contraction and relaxation were studied in isolated human bronchi with an inner diameter of 1 mm or less.. Low concentrations of PGE2 (0.01-1 μmol/L) relaxed the bronchi precontracted by histamine. The bronchodilator response was inhibited by the E prostanoid (EP) subtype 4 receptor antagonist ONO-AE3-208 but unaffected by the EP2 receptor antagonist PF-04418948. Higher concentrations of PGE2 (10-100 μmol/L) contracted the small airways. However, the TP receptor agonists U-46,619, PGF2α, and PGD2 were more potent than PGE2. Moreover, the bronchoconstrictor responses to PGE2 and all other tested prostanoids, including the EP1/EP3 receptor agonist 17-phenyl trinor PGE2 and the partial FP receptor agonist AL-8810, were uniformly abolished by the TP receptor antagonist SQ-29,548. In the presence of TP and EP4 antagonists, PGE2 inhibited the mast cell-mediated bronchoconstriction resulting from anti-IgE challenge. Measurement of the release of histamine and cysteinyl leukotrienes documented that this bronchoprotective action of PGE2 was mediated by the EP2 receptor, unrelated to bronchodilation, and increased with time of exposure.. The pharmacology of PGE2 in isolated human small airways was different from its profile in animal models. This first demonstration of powerful EP2 receptor-mediated inhibition of IgE-dependent contractions in human airways introduces a new selective target for the treatment of asthma. This EP2 control of mast cell-mediated bronchoconstriction is presumably exaggerated in patients with aspirin-exacerbated respiratory disease.

Topics: 15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid; Asthma; Azetidines; Bridged Bicyclo Compounds, Heterocyclic; Bronchi; Bronchoconstriction; Cells, Cultured; Dinoprost; Dinoprostone; Fatty Acids, Unsaturated; Histamine; Humans; Hydrazines; Immunoglobulin E; In Vitro Techniques; Mast Cells; Molecular Targeted Therapy; Naphthalenes; Phenylbutyrates; Prostaglandin D2; Receptors, Prostaglandin; Receptors, Prostaglandin E, EP1 Subtype; Receptors, Prostaglandin E, EP2 Subtype; Receptors, Prostaglandin E, EP4 Subtype; Receptors, Thromboxane

In addition to lung volume restriction, individuals with chronic tetraplegia exhibit reduced airway caliber and bronchodilator responsiveness similar to persons with asthma. In asthma, airflow obstruction is closely linked to airway inflammation. Conversely, little is known regarding the airway inflammatory response in tetraplegia. To compare levels of biomarkers of inflammation in exhaled breath condensate (EBC) and serum in subjects with chronic tetraplegia, mild asthma, and able-bodied controls.Prospective, observational pilot study. Thirty-four subjects participated: tetraplegia (n = 12), asthma (n = 12), controls (n = 10). Biomarkers in EBC [8-isoprostane (8-IP), leukotriene B4 (LT-B4), prostaglandin E2 (PG-E2), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6)] and serum (8-IP, LT-B4, TNF-α, IL-6) were determined using commercially available EIA kits (Cayman Chemical Company, Ann Arbor, MI). Separate, one-way ANOVA with Bonferroni's post-hoc analyses were performed to determine group differences in demographic and dependent variables [EBC and serum biomarkers, fractional exhaled nitric oxide (FeNO), pulmonary function parameters, and specific airway conductance (sGaw)]. The tetraplegia group had significantly elevated 8-IP levels in EBC compared to the asthma (68 ± 38 versus 21 ± 13 pg ml(-1); p < 0.001) and control groups (22 ± 13 pg ml(-1); p < 0.01), respectively. FeNO levels were significantly elevated in the asthma compared to the control group (26 ± 18 versus 11 ± 4 ppb; p < 0.05), and trended higher than levels in the tetraplegia group (15 ± 6; p = 0.08). Levels of serum biomarkers did not differ significantly among groups. Through analysis of EBC, levels of 8-IP were significantly elevated compared to levels found in individuals with mild asthma and healthy controls. Further studies are needed to extend upon these preliminary findings that suggest the presence of airway inflammation in subjects with chronic tetraplegia, and how this relates to pulmonary dysfunction in this population.

Topics: Asthma; Biomarkers; Breath Tests; Case-Control Studies; Dinoprost; Exhalation; Female; Humans; Inflammation; Interleukin-6; Leukotriene B4; Male; Middle Aged; Nitric Oxide; Pilot Projects; Prospective Studies; Quadriplegia; Tumor Necrosis Factor-alpha

The ″in situ burning" of trapped crude oil on the surface of Gulf waters during the 2010 Deepwater Horizon (DWH) oil spill released numerous pollutants, including combustion-generated particulate matter (PM). Limited information is available on the respiratory impact of inhaled in situ burned oil sail particulate matter (OSPM). Here we utilized PM collected from in situ burn plumes of the DWH oil spill to study the acute effects of exposure to OSPM on pulmonary health. OSPM caused dose-and time-dependent cytotoxicity and generated reactive oxygen species and superoxide radicals in vitro. Additionally, mice exposed to OSPM exhibited significant decreases in body weight gain, systemic oxidative stress in the form of increased serum 8-isoprostane (8-IP) levels, and airway inflammation in the form of increased macrophages and eosinophils in bronchoalveolar lavage fluid. Further, in a mouse model of allergic asthma, OSPM caused increased T helper 2 cells (Th2), peribronchiolar inflammation, and increased airway mucus production. These findings demonstrate that acute exposure to OSPM results in pulmonary inflammation and alteration of innate/adaptive immune responses in mice and highlight potential respiratory effects associated with cleaning up an oil spill.

Topics: Adaptive Immunity; Animals; Asthma; Cell Death; Cell Line; Cell Survival; Dinoprost; Disease Models, Animal; Electron Spin Resonance Spectroscopy; Environmental Exposure; Female; Mice, Inbred BALB C; Mucus; Oxidative Stress; Particulate Matter; Petroleum; Petroleum Pollution; Pneumonia; Superoxides; Time Factors

Breath analysis and exhaled breath condensate (EBC) collection are simple and noninvasive processes whereby inflammatory mediators and other biomarkers can be assessed in diseases that affect the lung. It was hypothesised that markers of epithelial dysfunction and secretion, such as a low pH, 8-isoprostane, and release of epithelial factors such as trefoil factor 2 (TFF2) and mucin, would be elevated in the breath of those with inflammatory bowel disease (IBD). The aim was to compare the levels of these biomarkers in EBC and the fraction of expired nitric oxide (FENO) in children with Crohn disease (CD), in those with asthma, and in normal individuals in a pilot study.. EBC was collected from patients in the 3 groups mentioned above in a cross-sectional design. pH, 8-isoprostane, TFF2, and mucin levels were measured in the EBC. Spirometry was performed in asthmatic patients and patients with IBD, whereas FENO and skin prick tests were performed in patients with IBD.. Breath samples including EBC were collected from 80 patients (30 CD, 30 asthma, 20 controls). Compared with controls, EBC pH was lower in children with IBD (P < 0.0001) or asthma (P = 0.0041). 8-Isoprostane levels differed between the 3 groups (P < 0.05). EBC TFF2 was mainly less than the limit of detection, whereas mucin levels did not differ significantly between the 3 groups. FENO was measurable in children with IBD, but did not correlate with disease activity or serum markers of inflammation.. A lower EBC pH may reflect inflammatory events either in the lung or systemically. 8-Isoprostane, FENO, and mucin were detected for the first time in the EBC of children with IBD. Further studies are required to assess the value of these assessments.

Topics: Adolescent; Asthma; Biomarkers; Breath Tests; Child; Crohn Disease; Cross-Sectional Studies; Dinoprost; Exhalation; Female; Humans; Hydrogen-Ion Concentration; Inflammation; Inflammation Mediators; Isoprostanes; Lung; Male; Mucins; Nitric Oxide; Peptides; Pilot Projects; Reference Values; Trefoil Factor-2

Respiratory allergic disease is an inflammatory condition accompanied by oxidative stress. Supplementation of an anti-inflammatory agent with antioxidants may have a therapeutic effect. In this study, the effects of choline chloride in combination with antioxidants were evaluated via the intranasal route in a mouse model of allergic airway disease. Balb/c mice were sensitized on days 0, 7, and 14 and challenged on days 25-30 with cockroach extract (CE) and with a booster challenge on day 38. They were treated with choline chloride (ChCl; 1mg/kg), vitamin C (Vit C; 308.33 mg/kg), and selenium (Se; 1mg/kg) alone or in combination via the intranasal route on days 31, 33, 35, 37, and 39. The mice were sacrificed on day 40 to collect blood, bronchoalveolar lavage fluid, lungs, and spleen. Mice immunized with CE showed a significant increase in airway hyperresponsiveness (AHR), lung inflammation, Th2 cytokines, and the oxidative stress markers intracellular reactive oxygen species and 8-isoprostanes compared to the phosphate-buffered saline control group. A significant decrease was observed in these parameters with all the treatments (p<0.01). The highest decrease was noticed in the ChCl+Vit C+Se-treated group, with AHR decreased to the normal level. This group also showed the highest decrease in airway inflammation (p<0.001), IL-4 and IL-5 (p<0.001), IgE and IgG1 (p<0.001), NF-κB (p<0.001), and 8-isoprostane levels (p<0.001). Glutathione peroxidase activity, which was decreased significantly in CE-immunized mice, was restored to normal levels in this group (p<0.001). IL-10 level was decreased in CE-immunized mice and was restored to normal by combination treatment. The combination treatment induced FOXP3(+) cells in splenocyte culture, responsible for the upregulation of IL-10. In conclusion, the combination of choline chloride, vitamin C, and selenium via the intranasal route reduces AHR, inflammation, and oxidative stress, probably by causing IL-10 production by FOXP3(+) cells, and possesses therapeutic potential against allergic airway disease.

Topics: Administration, Intranasal; Animals; Anti-Inflammatory Agents; Antioxidants; Ascorbic Acid; Asthma; Bronchoalveolar Lavage Fluid; Choline; Cockroaches; Dinoprost; Drug Combinations; Eosinophil Peroxidase; Glutathione Peroxidase; Immunoglobulin E; Immunoglobulin G; Inflammation; Interleukin-10; Interleukin-4; Interleukin-5; Lipotropic Agents; Lung; Mice; Mice, Inbred BALB C; Oxidative Stress; Reactive Oxygen Species; Respiratory Hypersensitivity; Selenium; Spleen; Th2 Cells; Transcription Factor RelA

Exposure to airborne black carbon (BC) has been associated with asthma development, respiratory symptoms and decrements in lung function. However, the mechanism through which BC may lead to respiratory symptoms has not been completely elucidated. Oxidative stress has been suggested as a potential mechanism through which BC might lead to adverse health outcomes. Exhaled breath condensate (EBC) allows for the non-invasive collection of airway lining fluid containing biomarkers of oxidative stress like 8-isoprostane, a stable by-product of lipid peroxidation. Therefore, we sought to characterize the association between domestic airborne BC concentrations and 8-isoprostane in EBC.. Seven- and eight-year-old children participated in an asthma case-control study in New York City. During home visits, air samples and EBC were collected. Seven day averages of domestic levels of particulate matter <2.5μm (PM2.5), BC and environmental tobacco smoke (ETS) were measured. Urea and 8-isoprostane were measured by liquid chromatography tandem mass spectrometry (LC/MS/MS) in EBC.. In univariate models, PM2.5 and BC, but not ETS, were significantly associated with increases in 8-isoprostane in the EBC (β=0.006 and β=0.106 respectively, p<0.05 for both). These associations remained statistically significant for both PM2.5 and BC after adjustment for covariates. In a co-pollutant model including PM2.5, BC and ETS, only BC remained a statistically significant predictor of 8-isoprostane (p<0.05).. Our findings suggest the BC fraction of PM might contain exposure relevant to increased oxidative stress in the airways.

Topics: Air Pollutants; Asthma; Breath Tests; Child; Chromatography, Liquid; Cohort Studies; Dinoprost; Exhalation; Humans; New York City; Particulate Matter; Soot; Tandem Mass Spectrometry; Tobacco Smoke Pollution

Exhaled breath condensate (EBC) 8-isoprostane concentrations are increased in asthma, but it is not known if they acutely change following bronchoprovocation. The objective of this study was to evaluate EBC 8-isoprostane concentrations following allergen-induced bronchoprovocation in asthma.. This comparison study included eight mild atopic asthmatics and six controls. Asthmatics were challenged with inhaled specific allergen, methacholine, and irrelevant allergen in random order. Controls were challenged with irrelevant allergen. EBCs collected at 0, 3, 6, 9, and 23 hours by the R-tube method were measured for 8-isoprostanes by ELISA technique. Repeated measures ANOVA technique was used for analysis.. EBC 8-isoprostane concentrations did not change following any inhalational challenge, as compared to baseline, in either asthmatics or controls.. EBC 8-isoprostane concentrations do not acutely change following bronchoprovocation in subjects with mild asthma.

Topics: Administration, Inhalation; Adult; Allergens; Asthma; Breath Tests; Bronchi; Dinoprost; Enzyme-Linked Immunosorbent Assay; Female; Humans; Middle Aged; Oxidative Stress; Radioimmunoassay

Epidemiological studies suggest that maternal exposure to environmental hazards, such as particulate matter, is associated with increased incidence of asthma in childhood. We hypothesized that maternal exposure to combustion derived ultrafine particles containing persistent free radicals (MCP230) disrupts the development of the infant immune system and results in aberrant immune responses to allergens and enhances asthma severity.. Pregnant C57/BL6 mice received MCP230 or saline by oropharyngeal aspiration on gestational days 10 and 17. Three days after the second administration, blood was collected from MCP230 or saline treated dams and 8-isoprostanes in the serum were measured to assess maternal oxidative stress. Pulmonary T cell populations were assayed in the infant mice at six days, three and six weeks of postnatal age. When the infant mice matured to adults (i.e. six weeks of age), an asthma model was established with ovalbumin (OVA). Airway inflammation, mucus production and airway hyperresponsiveness were then examined.. Maternal exposure to MCP230 induced systemic oxidative stress. The development of pulmonary T helper (Th1/Th2/Th17) and T regulatory (Treg) cells were inhibited in the infant offspring from MCP230-exposed dams. As the offspring matured, the development of Th2 and Treg cells recovered and eventually became equivalent to that of offspring from non-exposed dams. However, Th1 and Th17 cells remained attenuated through 6 weeks of age. Following OVA sensitization and challenge, mice from MCP230-exposed dams exhibited greater airway hyperresponsiveness, eosinophilia and pulmonary Th2 responses compared to offspring from non-exposed dams.. Our data suggest that maternal exposure to MCP230 enhances postnatal asthma development in mice, which might be related to the inhibition of pulmonary Th1 maturation and systemic oxidative stress in the dams.

Topics: Age Factors; Animals; Asthma; Bronchial Hyperreactivity; Cytokines; Dinoprost; Female; Gestational Age; Inflammation Mediators; Inhalation Exposure; Lung; Maternal Exposure; Mice, Inbred C57BL; Ovalbumin; Oxidative Stress; Particulate Matter; Pregnancy; Prenatal Exposure Delayed Effects; Pulmonary Eosinophilia; Severity of Illness Index; T-Lymphocytes, Regulatory; Th1 Cells; Th17 Cells; Th2 Cells

Exposures to ambient diesel exhaust particles have been associated with respiratory symptoms and asthma exacerbations in children; however, epidemiologic evidence linking short-term exposure to ambient diesel exhaust particles with airway inflammation is limited. We conducted a panel study with asthmatic and nonasthmatic adolescents to characterize associations between ambient diesel exhaust particle exposures and exhaled biological markers of airway inflammation and oxidative stress. Over four weeks, exhaled breath condensate was collected twice a week from 18 asthmatics and 18 nonasthmatics (ages 14-19 years) attending two New York City schools and analyzed for pH and 8-isoprostane as indicators of airway inflammation and oxidative stress, respectively. Air concentrations of black carbon, a diesel exhaust particle indicator, were measured outside schools. Air measurements of nitrogen dioxide, ozone, and fine particulate matter were obtained for the closest central monitoring sites. Relationships between ambient pollutants and exhaled biomarkers were characterized using mixed effects models. Among all subjects, increases in 1- to 5-day averages of black carbon were associated with decreases in exhaled breath condensate pH, indicating increased airway inflammation, and increases in 8-isoprostane, indicating increased oxidative stress. Increases in 1- to 5-day averages of nitrogen dioxide were associated with increases in 8-isoprostane. Ozone and fine particulate matter were inconsistently associated with exhaled biomarkers. Associations did not differ between asthmatics and nonasthmatics. The findings indicate that short-term exposure to traffic-related air pollutants may increase airway inflammation and/or oxidative stress in urban youth and provide mechanistic support for associations documented between traffic-related pollutant exposures and respiratory morbidity.

Topics: Adolescent; Air Pollutants; Air Pollution; Asthma; Biomarkers; Breath Tests; Dinoprost; Environmental Exposure; Female; Humans; Hydrogen-Ion Concentration; Inflammation; Male; New York City; Nitrogen Dioxide; Oxidative Stress; Ozone; Particulate Matter; Soot; Urban Population; Vehicle Emissions; Young Adult

TGF-β1 is thought to play a role in airway remodeling in asthmatic subjects. TGF-β1 expression might be mediated by an excessive burden of reactive oxygen species and oxidant stress.. Given the profound airway oxidant stress we have previously observed in children with severe asthma, we sought to (1) quantify TGF-β1 protein and mRNA gene expression in the airways of children with mild-to-moderate and severe atopic asthma and (2) determine the relationship of airway TGF-β1 concentrations to oxidant burden (ie, lipid peroxidation), T(H)2-mediated eosinophilic inflammation, and airflow limitation.. Bronchoalveolar lavage fluid was collected from 68 atopic children with asthma (severe asthma, n = 28) and 12 atopic adult control subjects. Airway TGF-β1 expression and activation were assessed in relation to airway IL-13, 8-isoprostane, and malondialdehyde concentrations. The relationship of airway TGF-β1 expression to airflow limitation in children with asthma was also assessed.. Children with severe asthma had higher total airway concentrations of TGF-β1 that were associated with increased protein and mRNA expression of TGF-β1 in airway macrophages and an increase in concentrations of the lipid peroxidation biomarkers 8-isoprostanes and malondialdehyde. TGF-β1 activation was also greater in children with severe asthma and was associated with higher airway 8-isoprostane, malondialdehyde, and IL-13 concentrations. Total airway TGF-β1 concentrations were further associated with airflow limitation.. Children with severe asthma have increased airway TGF-β1 expression and activation associated with an increased airway oxidant burden. Oxidant stress might mediate the effects of TGF-β1 and promote airway remodeling in children with severe asthma.

Topics: Adolescent; Asthma; Bronchi; Bronchoalveolar Lavage; Bronchoscopy; Child; Dinoprost; Gene Expression; Humans; Interleukin-13; Macrophages, Alveolar; Malondialdehyde; Oxidative Stress; RNA, Messenger; Spirometry; Transforming Growth Factor beta1

The mechanisms of cough in asthma are unclear. Asthma is associated with an oxidative stress. Many reactive oxygen species sensitize or activate sensory C-fibers which are capable to induce cough. It was hypothesized that oxidative stress in the airways might contribute to the cough severity in asthma. Exhaled breath condensate samples were collected in ten healthy and 26 asthmatic subjects. The concentration of 8-isoprostane was measured. In addition, the subjects filled in Leicester Cough Questionnaire and underwent cough provocation tests with dry air hyperpnoea and hypertonic saline, among other measurements. Among the asthmatic subjects, high 8-isoprostane was associated with severe cough response to hyperpnoea (p=0.001), low Leicester Cough Questionnaire values (indicating severe subjective cough, p=0.02), and usage of combination asthma drugs (p=0.03-0.04). However, the 8-isoprostane concentrations did not differ significantly between the healthy and the asthmatic subjects. Airway oxidative stress may be associated with experienced cough severity and measured cough sensitivity in asthma.

Topics: Adult; Asthma; Breath Tests; Bronchial Provocation Tests; Case-Control Studies; Chronic Disease; Cohort Studies; Cough; Dinoprost; Exhalation; Female; Humans; Hyperventilation; Male; Middle Aged; Oxidative Stress; Reference Values; Severity of Illness Index; Spirometry; Statistics, Nonparametric

Several studies have demonstrated the importance of Rho-kinase in the modulation of smooth muscle contraction, airway hyperresponsiveness, and inflammation. However, the effects of repeated treatment with a specific inhibitor of this pathway have not been previously investigated. We evaluated the effects of repeated treatment with Y-27632, a highly selective Rho-kinase inhibitor, on airway hyperresponsiveness, oxidative stress activation, extracellular matrix remodeling, eosinophilic inflammation, and cytokine expression in an animal model of chronic airway inflammation. Guinea pigs were subjected to seven ovalbumin or saline exposures. The treatment with Y-27632 (1 mM) started at the fifth inhalation. Seventy-two hours after the seventh inhalation, the animals' pulmonary mechanics were evaluated, and exhaled nitric oxide (E(NO)) was collected. The lungs were removed, and histological analysis was performed using morphometry. Treatment with Y-27632 in sensitized animals reduced E(NO) concentrations, maximal responses of resistance, elastance of the respiratory system, eosinophil counts, collagen and elastic fiber contents, the numbers of cells positive for IL-2, IL-4, IL-5, IL-13, inducible nitric oxide synthase, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, transforming growth factor-β, NF-κB, IFN-γ, and 8-iso-prostaglandin F2α contents compared with the untreated group (P < 0.05). We observed positive correlations among the functional responses and inflammation, remodeling, and oxidative stress pathway activation markers evaluated. In conclusion, Rho-kinase pathway activation contributes to the potentiation of the hyperresponsiveness, inflammation, the extracellular matrix remodeling process, and oxidative stress activation. These results suggest that Rho-kinase inhibitors represent potential pharmacological tools for the control of asthma.

Topics: Airway Remodeling; Airway Resistance; Amides; Animals; Anti-Asthmatic Agents; Asthma; Collagen; Dinoprost; Drug Evaluation, Preclinical; Elastic Tissue; Elasticity; Eosinophils; Extracellular Matrix; Guinea Pigs; Inhalation; Interleukin-2; Lung; Male; Matrix Metalloproteinase 9; Nitric Oxide; Nitric Oxide Synthase Type II; Oxidative Stress; Pyridines; rho-Associated Kinases

For several hours after exercise-induced bronchoconstriction, there is diminished responsiveness to repeated challenge. The mechanism causing this refractoriness is unclear. Inhalation of dry powder mannitol is a new bronchial provocation test that has been suggested as a surrogate for an exercise challenge. Refractoriness to repeated mannitol challenge has however not been established. Our objective was to investigate if repeated challenge with mannitol is associated with refractoriness and diminished release of mast cell mediators of bronchoconstriction. Sixteen subjects with asthma underwent repeated inhalation of mannitol 90 min apart. Lung function was assessed by forced expiratory volume in 1 s (FEV₁). The urinary excretion (ng/mmol creatinine) of the mediators 9α,11β-prostaglandin (PG) F₂ and leukotriene (LT) E₄ were measured. The group mean fall in FEV₁ after the second challenge was 48.5 ± 5.8% of the first (P < 0.001). The protection afforded by the initial challenge, however, varied considerably between subjects (range 88-0%). Furthermore, the urinary excretion of the two mediators was increased after both challenges. The average excretion of mediators after the challenges was significantly higher for the six most refractory subjects. This was observed both for LTE₄ (95.6 ± 5.2 vs. 58.0 ± 2.4 for the 6 least refractory) (P < 0.001) and for 9α,11β-PGF₂ (137.6 ± 6.7 vs. 50.1 ± 1.1 for the 6 least refractory) (P = 0.002). As occurs with exercise-induced bronchoconstriction, repeated inhalation of mannitol induced refractoriness. We propose that refractoriness is due to tachyphylaxis at the level of the airway smooth muscle responsiveness to mediators of bronchoconstriction rather than due to fatigue of their release from mast cells.

Topics: Administration, Inhalation; Adult; Asthma; Bronchoconstriction; Dinoprost; Exercise; Female; Forced Expiratory Volume; Humans; Leukotriene E4; Male; Mannitol; Mast Cells

Acute exposure to cigarette smoke is related to airway and systemic inflammation and oxidative stress. Little is known about the acute effect of cigarette smoking in smoking asthmatics. The aim of this study was to evaluate the acute effect of smoking in airway and systemic inflammation and oxidative stress in normal smokers and patients with properly treated well-controlled persistent asthma.. Ten normal smokers and 10 smokers with moderate persistent asthma controlled with LABA and ICS were recruited. Subjects refrained from smoking for at least 12 h prior to their inclusion. We compared the effects of smoking of two cigarettes on airway obstruction, airway inflammation and oxidative stress [by measuring fraction of exhaled nitric oxide (FeNO), plus pH and 8-isoprostane in exhaled breath condensate (EBC)] before and 30, 90 and 180 min after smoking. Furthermore, we evaluated systemic oxidative stress, C-reactive protein (CRP) and serum amyloid A (SAA) and urine leukotriene E(4) (LTE(4)) before and 180 min after smoking.. No differences were observed in EBC pH and 8-isoprostane, FeNO and systemic oxidative stress between the groups at baseline. In asthmatics, EBC pH decreased 30 min and EBC 8-isoprostane increased 90 min after smoking (P = 0.039 and P = 0.029 respectively), which was not evident in smoking controls. Serum oxidative stress increased only in asthmatic smokers at 180 min (P = 0.001). No differences were observed in SAA, CRP and urine LTE(4) levels before and after smoking.. Acute smoking has more deleterious effects in well-controlled properly treated asthmatic smokers compared with matched normal smokers.

Topics: Adult; Asthma; Biomarkers; Breath Tests; C-Reactive Protein; Dinoprost; Exhalation; Female; Humans; Hydrogen-Ion Concentration; Leukotriene E4; Male; Middle Aged; Nitric Oxide; Oxidative Stress; Respiratory Function Tests; Serum Amyloid A Protein; Smoking; Sputum; Time Factors

Potential bacterial pathogens are found in the airways in several diseases that are associated with neutrophilic inflammation. The aim of this study was to characterize subjects with stable asthma, with no symptoms of respiratory infection, to assess whether key potentially pathogenic bacteria were present in significant quantities in the airways and to correlate this with the pattern of airway inflammation and oxidative stress. Subjects with stable asthma (n = 115) and healthy controls (n = 8) underwent clinical assessment, including hypertonic saline challenge combined with sputum induction. A significant load of potentially pathogenic bacteria (> 10(6) cfu/mL) was cultured from the sputum of 17 (15%) subjects with stable asthma and was associated with higher total cell counts, proportion and number of neutrophils, sputum IL-8 and 8-isoprostane concentrations. The role of bacteria in potentiating neutrophilic asthma warrants further investigation. Therapies such as antibiotic and antioxidant treatment may be most effective in this sub-group of patients.

Topics: Adult; Aged; Asthma; Bacteria; Dinoprost; Female; Humans; Inflammation; Interleukin-8; Male; Middle Aged; Neutrophils; Oxidative Stress; Sputum

It has recently demonstrated that a free radical-mediated pathway generates prostaglandins (PGs) and the corresponding prostaglandin enantiomers (ent-PGs). Aspirin-intolerant asthma and anaphylaxis accompany PGD(2) overproduction, possibly associated with mast cell activation via the COX pathway. However, free radical-mediated PG generation in the pathophysiology of these diseases, which can be demonstrated by measuring urinary ent-PGF(2)alpha, has not been reported.. To evaluate the characteristic profile of eicosanoid generation via the COX and/or free radical-mediated pathway underlying aspirin-intolerant asthma and anaphylaxis.. A comparative group analysis consisted of asthma (n = 17) and anaphylaxis (n = 8, none with aspirin-induced anaphylaxis) cases. Urinary eicosanoid concentrations were quantified as follows: 2,3-dinor-9alpha,11beta-PGF(2) by gas chromatography-mass spectrometry; leukotriene E(4), 9alpha,11beta-PGF(2), and PGs by enzyme immunoassay.. 2,3-Dinor-9alpha,11beta-PGF(2) is a more predominant PGD(2) metabolite in urine than 9alpha,11beta-PGF(2). At baseline, the aspirin-intolerant asthma group (n = 10) had significantly higher leukotriene E(4) and lower PGE(2) concentrations in urine than the aspirin-tolerant asthma group. During the reaction, the urinary concentrations of leukotriene E(4) and PGD(2) metabolites correlatively increased, but with markedly different patterns of the mediator release, in the aspirin-intolerant asthma group and the anaphylaxis group, respectively. The urinary PGD(2) metabolites and primary PGs were significantly decreased in the aspirin-tolerant asthma group. Urinary ent-PGF(2)alpha concentrations were significantly increased in the anaphylaxis group but not the aspirin-intolerant asthma group.. When assessed by urinary 2,3-dinor-9alpha,11beta-PGF(2), PGD(2) overproduction during aspirin-intolerant bronchoconstriction was clearly identified, regardless of COX inhibition. It is evident that free radical-mediated PG generation is involved in the pathophysiology of anaphylaxis.

Topics: Adult; Aged; Anaphylaxis; Aspirin; Asthma; Biomarkers; Bleeding Time; Cysteine; Dinoprost; Eicosanoids; Female; Humans; Leukotrienes; Male; Middle Aged; Young Adult

Leukotrienes and isoprostanes are biomarkers of airway inflammation and oxidative stress that can be detected in exhaled breath condensate (EBC). The aim of this study was to evaluate leukotriene B4 (LTB4) and 8-isoprostane levels in EBC of healthy and asthmatic children with episodic and moderate persistent asthma.. EBC was collected from 62 children aged 6 to 14 years: 22 healthy children, 30 patients with episodic asthma, and 10 patients with moderate persistent asthma, without preventive treatment at the time of enrolment.. LTB concentrations were higher in children with asthma than in healthy controls (50.7 pg/mL vs. 13.68 pg/mL, P < .011). The same was true for children with moderate persistent asthma compared to children with episodic asthma (146.9 pg/mL vs. 18.85 pg/mL, P < .0001), children with moderate persistent asthma compared to healthy controls (146.9 pg/mL vs. 13.68 pg/mL, P < .0001), and children with episodic asthma compared to healthy controls (P, nonsignificant). EBC concentrations of 8-isoprostane were higher in asthmatic than in healthy children (18.3 pg/mL vs. 6.59 pg/mL, P < .026). They were also increased in children with moderate persistent asthma compared to those with episodic asthma (36.25 pg/mL and 12.28 pg/mL, P < .012), and in children with moderate persistent asthma and episodic asthma compared to healthy controls (36.25 pg/mL vs. 6.59 pg/mL [P < .0001] and 12.28 pg/mL versus 6.59 pg/mL [P < .0001], respectively).. LTB4 and 8-isoprostane concentrations were increased in asthmatic children compared to healthy individuals, with differences detected for 2 degrees of asthma severity. Our findings suggest that EBC is a noninvasive method for airway inflammation and oxidative stress assessment.

Topics: Adolescent; Asthma; Breath Tests; Child; Dinoprost; Female; Humans; Leukotriene B4; Male; Nitric Oxide; Oxidative Stress; Respiratory Function Tests; Statistics, Nonparametric

Allergen exposure may increase airway oxidative stress, which causes lipid membrane peroxidation and an increased formation of 8-isoprostane.. The aim of the study was to investigate oxidative stress induced by allergen challenge in mild asthmatics, by measuring 8-isoprostane in exhaled breath condensate (EBC), and to examine their relationship with mediators derived from arachidonic acid. Methods 8-isoprostane, cysteinyl leukotrienes (cys-LTs) and prostaglandin E2 (PGE(2) ) concentrations in EBC were measured at baseline and after allergen challenge in 12 patients with mild allergic asthma sensitized to cat allergen.. At 24 h after allergen challenge, compared with baseline values, EBC 8-isoprostane increased [48.64 pg/mL (44.14-53.61) vs. 21.56 pg/mL (19.92, 23.35), P<0.001], cys-LTs increased [27.37 pg/mL (24.09-31.10) vs. 13.28 pg/mL (11.32, 15.57), P<0.001] and PGE(2) decreased [18.69 pg/mL (12.26, 28.50) vs. 39.95 pg/mL (34.37, 46.43), P<0.001]. The trend of increasing 8-isoprostane after allergen challenge was significantly correlated with the trend of increasing cys-LTs (R(2) =0.85, P<0.001) whereas the trend of decreasing PGE(2) after allergen challenge was significantly correlated with the trend of increasing cys-LTs (R(2) =0.52, P=0.001).. The increase in EBC 8-isoprostane observed after allergen challenge indicates that allergen exposure increases airway oxidative stress in allergic asthma. The strict correlation between cys-LTs and 8-isoprostane underlines the relationship between allergic inflammation and oxidative stress. A shift of arachidonic acid metabolism towards lipoxygenase pathway is induced by the allergen challenge. Airway oxidative stress occurs after allergen challenge even in patients with mild intermittent allergic asthma.

Topics: Administration, Inhalation; Adult; Allergens; Animals; Asthma; Biomarkers; Breath Tests; Case-Control Studies; Cats; Dinoprost; Dinoprostone; Exhalation; Female; Forced Expiratory Volume; Humans; Leukotrienes; Lipid Peroxidation; Lung; Male; Middle Aged; Nitric Oxide; Oxidative Stress; Severity of Illness Index; Time Factors; Young Adult

Collection of exhaled breath condensate (EBC) is a safe, non-invasive method to collect droplets of the airway surface liquid and measure mediators of airway inflammation and oxidative stress, such as cysteinyl-leukotrienes (cys-LTs) and 8-isoprostane.. The aim of our study was to investigate baseline values of inflammatory lipid mediators in EBC and their relation to asthma severity.. Nineteen healthy subjects, 16 mild, 12 moderate and 15 severe asthmatics were studied. All subjects attended a clinic visit for spirometry and EBC collection. The concentrations of exhaled cys-LTs and 8-isoprostane were measured by means of specific enzyme immunoassays.. 8-isoprostane levels were significantly increased in mild (49.1+/-5.2 pg/mL, p<0.001), moderate (49.7+/-5.2 pg/mL, p<0.001) and severe asthmatics (77.7+/-7.3 pg/mL, p<0.001), compared to healthy controls (16.4+/-1.6 pg/mL). Moreover, 8-isoprostane levels were significantly higher in severe compared to mild and moderate asthmatics (p<0.01). Cys-LT levels were significantly higher in moderate (34.6+/-4.4 pg/mL, p<0.05) and severe asthmatics (47.9+/-6.0 pg/mL, p<0.001), while no significant difference was found between healthy controls and mild asthmatics. 8-isoprostane levels in EBC of asthmatics strongly correlated with cys-LT levels (r=0.61, p<0.0001).. 8-isoprostane and cys-LT are detectable in EBC of healthy subjects and their levels progressively increase in asthmatic patients according to disease severity. The correlation found between these two lipid mediators indicating a link between oxidative stress and airway inflammation.

Topics: Adult; Asthma; Breath Tests; Case-Control Studies; Cross-Sectional Studies; Cysteine; Dinoprost; Female; Forced Expiratory Volume; Greece; Humans; Immunoenzyme Techniques; Leukotrienes; Male; Middle Aged; Oxidative Stress; Spirometry

Anaphylaxis is a life-threatening syndrome resulting from the sudden release of mast cell- and basophil-derived mediators into the circulation. However, pathological evidence of the association between inflammatory mediators and human anaphylaxis is insufficient.. The aim of this study was to better understand the relationship between in vivo production of inflammatory mediators and the pathogenesis of anaphylaxis. We also sought to evaluate mast cell activation in anaphylaxis.. We measured the concentrations of various inflammatory mediators in urine samples, which were collected from 32 anaphylactic patients during the onset of anaphylaxis and during clinical remission, 21 patients with asthma on acute exacerbation and 15 healthy control subjects. Blood and urine specimens were collected from the patients after provocation test. Urinary leukotriene E4 (LTE4), 9alpha, 11beta-prostaglandin F2 (9alpha, 11beta-PGF2), eosinophil-derived neurotoxin (EDN) and leukotriene B4 glucuronide (LTBG) concentrations were determined by enzyme immunoassay, and the activity of plasma platelet-activating factor acetylhydrolase and serum tryptase concentration were measured using commercially available kits.. Significantly higher concentrations of urinary LTE4 and 9alpha, 11beta-PGF2, which immediately decreased during clinical remission, were observed in the anaphylactic patients than in asthmatic patients on acute exacerbation and healthy control subjects. Concentrations of EDN and LTBG were not significantly different among the anaphylactic patients, asthmatic patients on acute exacerbation and healthy subjects. There was a significant correlation between urinary LTE4 and 9alpha, 11beta-PGF2 concentrations in the anaphylactic patients (r=0.672, P=0.005, n=32). In addition, LTE4 concentration in patients with anaphylactic shock is significantly elevated compared with that in patients without anaphylactic shock.. This is a report on the significant increase in urinary LTE4 and 9alpha, 11beta-PGF2 concentrations during anaphylaxis. Urinary LTE4 and 9alpha, 11beta-PGF2 concentrations may be a reliable marker of endogenous production of inflammatory mediators associated with anaphylaxis.

Topics: Adolescent; Adult; Anaphylaxis; Asthma; Cysteine; Dinoprost; Female; Humans; Inflammation Mediators; Leukotriene E4; Leukotrienes; Male; Mast Cells; Middle Aged; Prostaglandin D2; Young Adult

Severe asthma is characterized by persistent airway inflammation and increased formation of reactive oxygen species.. Glutathione (GSH) is an important antioxidant in the epithelial lining fluid (ELF). We hypothesized that airway GSH homeostasis was altered in children with severe asthma and was characterized by decreased GSH and increased glutathione disulfide (GSSG) concentrations.. Bronchoalveolar lavage was obtained from 65 children with severe asthma, including 35 children with baseline airway obstruction evidenced by FEV(1) <80%. Control data were obtained from 6 children with psychogenic (habit) cough or vocal cord dysfunction undergoing diagnostic bronchoscopy and 35 healthy adult controls. GSH, GSSG, and other determinants of airway oxidative stress including glutathione S-transferase (GST), glutathione reductase (GR), glutathione peroxidase (GPx), malondialdehyde, 8-isoprostane, and H(2)O(2) were measured in the ELF. The ELF redox potential was calculated from GSH and GSSG by using the Nernst equation.. Compared with controls, subjects with severe asthma had lower airway GSH with increased GSSG despite no differences in GST, GR, and GPx activities between groups. This was accompanied by increased malondialdehyde, 8-isoprostane, and H(2)O(2) concentrations in the ELF. GSH oxidation was most apparent in subjects with severe asthma with airway obstruction and was supported by an upward shift in the ELF GSH redox potential.. Children with severe asthma have increased biomarkers of oxidant stress in the ELF that are associated with increased formation of GSSG and a shift in the GSH redox potential toward the more oxidized state.

Topics: Adolescent; Adult; Antioxidants; Asthma; Biomarkers; Bronchoalveolar Lavage Fluid; Child; Child, Preschool; Cough; Dinoprost; Female; Glutathione; Glutathione Peroxidase; Glutathione Reductase; Glutathione Transferase; Homeostasis; Humans; Hydrogen Peroxide; Lung; Male; Malondialdehyde; Oxidation-Reduction; Oxidative Stress; Voice Disorders

Enhanced oxidative stress has been described in adults who suffer from symptoms of asthma and poor lung function. This study assessed the relation between markers of oxidative stress and antioxidant status and lung function, symptoms of asthma, atopy and bronchial hyperresponsiveness (BHR) in young adults.. A sub-sample of 589 individuals aged 22-28 years, selected from a total of 1232 included in a survey assessing early and current risk factors for chronic diseases, participated in the study. Participants were from an agricultural area of Chile, responded to a Spanish version of the European Community Respiratory Health Survey questionnaire, were skin tested to eight allergens, and challenged with methacholine to assess BHR. Five hundred and eighty-five individuals had measures of plasma biomarkers ferric reducing ability of plasma, uric acid, protein carbonyls and 564 had 8-iso-prostaglandin F(2alpha) (8-iso-PGF(2alpha)) assessed.. All participants had detectable plasma 8-iso-PGF(2alpha) and carbonyl levels. There was no indication for an association between markers of antioxidant status or oxidative stress with any of the outcomes studied.. The levels of oxidative stress-related biomarkers and antioxidant status in plasma may not be related to asthma in the general population in the absence of more severe symptoms or exacerbations.

Topics: Adult; Allergens; Antioxidants; Asthma; Biomarkers; Blood Proteins; Body Mass Index; Dinoprost; Female; Ferric Compounds; Forced Expiratory Volume; Humans; Hypersensitivity; Male; Oxidation-Reduction; Oxidative Stress; Protein Carbonylation; Respiratory Function Tests; Respiratory Sounds; Uric Acid; Vital Capacity; Young Adult

Exhaled breath condensate (EBC) pH has been proposed as a biomarker of airway inflammation and oxidative stress in asthma. Cigarette smoking reduces EBC pH in mild asthma. The effects of smoking on EBC pH in more symptomatic asthmatic patients using inhaled corticosteroids (ICS) are unknown. We aimed to compare EBC pH in asthmatic smokers (AS) and non-smokers (ANS) with moderate to severe disease, who were taking ICS. We also investigated the relationship between EBC pH and biomarkers of airway inflammation and oxidative stress.. AS (n = 18) and ANS (n = 17), who were using ICS, were recruited and EBC pH, sputum inflammatory cell counts and sputum supernatant 8-isoprostane concentrations were measured. Full lung function testing was performed.. EBC pH was significantly lower in AS than in ANS (6.91 vs 7.41). In AS there was a significant inverse correlation between EBC pH and 8-isoprostane levels (r = -0.54, P = 0.03). There was no correlation between EBC pH and sputum neutrophil counts.. EBC pH appears to be a biomarker of the level of oxidative stress in smokers with moderate to severe asthma. EBC pH may have applications for the longitudinal monitoring of the effects of smoking on the airways of asthmatic patients.

Topics: Administration, Inhalation; Adrenal Cortex Hormones; Adult; Aged; Asthma; Biomarkers; Breath Tests; Case-Control Studies; Dinoprost; Exhalation; Female; Humans; Hydrogen-Ion Concentration; Middle Aged; Oxidative Stress; Respiratory Function Tests; Severity of Illness Index; Smoking; Sputum

Oxidative stress is associated with the pathogenesis of cigarette smoke related lung diseases, but longitudinal effects of smoking cessation on oxidant markers in the airways are unknown.. This study included 61 smokers; 21 with chronic bronchitis or COPD, 15 asthmatics and 25 asymptomatic smokers followed up for 3 months after smoking cessation. Fractional exhaled nitric oxide (FeNO), sputum neutrophil counts, sputum 8-isoprostane, nitrotyrosine and matrix metalloproteinase-8 (MMP-8) were investigated at baseline and 1 and 3 months after smoking cessation.. After 3 months 15 subjects had succeeded in quitting of smoking and in these subjects symptoms improved significantly. Unexpectedly, however, sputum neutrophils increased (p = 0.046) after smoking cessation in patients with chronic bronchitis/COPD. At baseline, the other markers did not differ between the three groups so these results were combined for further analysis. Sputum 8-isoprostane declined significantly during the follow-up at 3 months (p = 0.035), but levels still remained significantly higher than in non-smokers. The levels of FeNO, nitrotyrosine and MMP-8 did not change significantly during the 3 months after smoking cessation.. Whilst symptoms improve after smoking cessation, the oxidant and protease burden in the airways continues for months.

Topics: Adolescent; Adult; Aged; Asthma; Bronchitis, Chronic; Dinoprost; Female; Humans; Longitudinal Studies; Lung; Male; Matrix Metalloproteinase 8; Middle Aged; Neutrophils; Nitric Oxide; Oxidants; Oxidative Stress; Peptide Hydrolases; Prospective Studies; Smoking; Smoking Cessation; Spirometry; Sputum; Young Adult

Children with atopic eczema (AE) are at risk of developing asthma. Airway inflammation has been shown to be present before the onset of clinical asthma. Increased exhalation (forced expiration; FE) of nitric oxide (FE(NO)) and 8-isoprostane seems to be a feature of bronchial inflammation in people with asthma.. To determine whether the exhalation of these two molecules is increased in children with eczema, even in the absence of overt asthma.. In total, 21 children with AE were recruited and compared with healthy controls. A questionnaire was completed to identify respiratory symptoms compatible with asthma. The severity of AE was graded clinically. Spirometry, FE(NO) measurements and exhaled breath condensate collection for 8-isoprostane were performed.. The mean level of 8-isoprostane was similar for children with AE (2.33 +/- 4.76 pg/mL) and controls (3.37 +/- 3.43). FE(NO) was increased in children with AE (mean 64.97 parts per billion) compared with the normal range, even in the absence of respiratory symptoms and in the presence of normal lung function.. FE(NO) but not 8-isoprostane levels in exhaled breath condensate are higher in children with AE without asthma. Our finding may indicate a predictive role for FE(NO) for the development of asthma.

Topics: Adolescent; Asthma; Biomarkers; Breath Tests; Child; Dermatitis, Atopic; Dinoprost; Female; Humans; Male; Nitric Oxide; Predictive Value of Tests; Pulmonary Ventilation

Oxidative stress has an important role in the pathophysiology of asthma. But oxidative stress of airway has not been assessed in patients with nonasthmatic eosinophilic bronchitis (EB). 8-epi-prostaglandin F2alpha (8-isoprostane) is a biomarker of oxidative stress.. We sought to determine whether oxidative stress (measured by 8-isoprostane) occurs in EB and whether 8-isoprostane is associated with airway function in EB and asthma.. We measured 8-isoprostane concentrations in the bronchoalveolar lavage (BAL) fluid from 11 subjects with EB, 10 subjects with asthma, and 9 healthy control subjects. 8-isoprostane was measured by enzyme immunoassays.. We found that BAL fluid 8-isoprostane concentrations were raised both in EB and asthma. The median concentrations of 8-isoprostane in BAL fluid were significantly higher in subjects with asthma (12.78 pg/mL) when compared with EB (8.34 pg/mL) and healthy control subjects (5.07 pg/mL).. Our study shows that oxidative stress is increased significantly in asthmatic subjects and the degree of oxidative stress in EB subjects is milder than that in asthma, as reflected by 8-isoprostane concentrations in the BAL fluid. The difference in airway function observed in subjects with EB and asthma could be associated with different elevation in 8-isoprostane concentration in the airways.

Topics: Adult; Asthma; Bronchitis; Bronchoalveolar Lavage Fluid; Dinoprost; Eosinophilia; Eosinophils; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Neutrophils; Oxidative Stress; Sputum

A diagnosis of aspirin-intolerant asthma requires aspirin provocation in specialist clinics. Urinary leukotriene E(4) (LTE(4)) is increased in aspirin-intolerant asthma. A study was undertaken to investigate new biomarkers of aspirin intolerance by comparing basal levels of cysteinyl-leukotrienes (CysLTs) and leukotriene B(4) (LTB(4)) in saliva, sputum and ex vivo stimulated blood in subjects with aspirin-intolerant and aspirin-tolerant asthma. The effects of aspirin- and allergen-induced bronchoconstriction on leukotriene levels in saliva and ex vivo stimulated blood were also compared with the effects of the provocations on urinary mediators.. Induced sputum, saliva, urine and blood were obtained at baseline from 21 subjects with asthma. At a separate visit, 11 subjects showed a positive response to lysine-aspirin inhalation and 10 were aspirin tolerant. Saliva, blood and urine were also collected on the provocation day. Analyses of CysLTs and LTB(4) and the prostaglandin D(2) metabolite 9alpha,11beta-prostaglandin F(2) were performed and the fraction of exhaled nitric oxide was measured.. Subjects with aspirin-intolerant asthma had higher exhaled nitric oxide levels and higher baseline levels of CysLTs in saliva, sputum, blood ex vivo and urine than subjects with aspirin-tolerant asthma. There were no differences in LTB(4) levels between the groups. Levels of urinary LTE(4) and 9alpha,11beta-prostaglandin F(2) increased after aspirin provocation whereas leukotriene levels in saliva and ex vivo stimulated blood did not increase.. These findings support a global and specific increase in CysLT production in aspirin-intolerant asthma. Measurement of CysLTs in saliva has the potential to be a new and convenient non-invasive biomarker of aspirin-intolerant asthma.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Asthma; Biomarkers; Cysteine; Dinoprost; Drug Hypersensitivity; Female; Humans; Leukotriene B4; Leukotrienes; Male; Middle Aged; Saliva; Sputum; Uteroglobin

Topics: Adenosine; Asthma; Bronchial Provocation Tests; Bronchoconstriction; Case-Control Studies; Dinoprost; Female; Humans; Inflammation Mediators; Male; Mast Cells; Reference Values; Sensitivity and Specificity

Exhaled nitric oxide and induced sputum eosinophils are well established as direct markers of inflammation/oxidative stress in asthma. Recently, it has been proposed that sputum 8-isoprostane concentrations may present a reliable index for measuring oxidative stress in asthmatic patients. We assessed the value of sputum 8-isoprostane in mild asthma in children and adolescents.. Patients with newly diagnosed asthma (children, n = 23; adults, n = 14) and age-matched healthy controls (children, n = 13; adults, n = 15) were studied. Lung function was measured by spirometry, sputum was induced by hypertonic saline, and fractional exhaled nitric oxide (FeNO) was measured with standard methods. Cell differential counts were obtained from sputum slides and the concentration of 8-isoprostane was measured with an enzyme immunoassay from sputum supernatants.. High-quality sputum specimens could be obtained from 10 children and 10 adults, and the sputum analyses were conducted only for the representative specimens. Asthmatics had increased FeNO (children 35.5 vs. 11.9 ppb; adults 81.1 vs. 16.6 ppb; p < 0.001) and sputum eosinophils (children 2.4% vs. 1.4%; adults 10.4% vs. 0.2%; p = 0.005) compared to healthy controls. There was a significant correlation between FeNO and eosinophils (R = 0.65; p < 0.0001). Sputum 8-isoprostane was not elevated in asthmatics compared to healthy subjects (children 81.1 vs. 89.9 and adults 76.9 vs. 73.4 pg/mL) and did not correlate with lung function or other measurements of airway inflammation. However, increased 8-isoprostane levels were detected in patients with chronic obstructive pulmonary disease (n = 11, 184.7 pg/mL, used as controls for assays).. In agreement with earlier studies, FeNo is sensitive in detecting oxidative/nitrosative stress in asthmatic airways. However, our results suggest that 8-isoprostane may not be sensitive in reflecting oxidant burden in mild asthma.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asthma; Biomarkers; Breath Tests; Case-Control Studies; Child; Dinoprost; Exhalation; Female; Humans; Male; Middle Aged; Nitric Oxide; Oxidative Stress; Sensitivity and Specificity; Severity of Illness Index; Spirometry; Sputum

Oxidative stress plays an important role in the pathogenesis of asthma. Interestingly, a low airway pH and a high concentration of 8-isoprostane, a marker of oxidative stress, has been reported to cause inflammatory airway diseases. However, the relationship between these 2 markers and pulmonary function has not been determined in mild asthma patients.. pH and 8-isoprostane concentration were measured in exhaled breath condensate (EBC) from patients with mild asthma (n = 44) and healthy subjects (n = 20). The relationship between acid stress (pH) and oxidative stress (8-isoprostane) was then analyzed, along with the relationships between these 2 markers and lung function.. The median (interquartile range [IQR]) pH of EBC was significantly lower in asthma patients than in control subjects (7.53 [7.41-7.68] vs 7.70 [7.62-7.74], P < .05), while the median (IQR) 8-isoprostane concentration of EBC was significantly higher in asthma patients than control subjects (16.2 [11.7-19.1] vs 3.5 [2.6-7.9] pg/mL, P < .05). There was no correlation between pH and 8-isoprostane concentration. Furthermore, lung function was not correlated with either pH or 8-isoprostane concentrations in EBC.. Acid stress and oxidative stress assessed by pH and 8-isoprostane concentration, respectively, in EBC did not show parallel changes associated with asthma and were not correlated with lung function in asthma patients. These 2 stress factors may have different roles in the pathogenesis of asthma.

Topics: Adult; Asthma; Breath Tests; Dinoprost; Female; Humans; Hydrogen-Ion Concentration; Male; Oxidative Stress

Gastroesophageal reflux disease (GERD) influences the symptoms of asthma with acid and oxidative stress.. The purpose of this study was to determine the usefulness of measurement of the acid stress marker pH and the oxidative stress marker 8-isoprostane by exhaled breath condensate in proton pump inhibitor (PPI) therapy effect on moderate asthma patients with GERD.. The pH and the concentration of 8-isoprostane were measured in the exhaled breath condensate of patients with moderate asthma (n = 36) and healthy subjects (n = 26). Two months of PPI therapy (lansoprazole at 30 mg/day) were done in the asthma patients with (n = 13) or without (n = 13) GERD according to a questionnaire for the diagnosis of reflux disease, and exhaled markers were measured.. The pH was lower (7.3 +/- 0.3) and the 8-isoprostane level was higher (27.7 +/- 2.3) in the asthma patients than in the healthy control subjects (pH 7.5 +/- 0.2 and 8-isoprostane 6.6 +/- 1.2). Two months of PPI therapy improved the pH (from 7.2 +/- 0.1 to 7.3 +/- 0.1) and the 8-isoprostane concentration (from 32.7 +/- 3.4 to 19.2 +/- 3.4) in the asthma patients with GERD, along with improvement of GERD symptoms. However, these markers did not change in the asthma patients without GERD.. Measurement of the pH and 8-isoprostane level of exhaled breath condensate may be useful to evaluate the influence of GERD on asthma, as well as to determine the timing of intermittent PPI therapy.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Asthma; Biomarkers; Breath Tests; Comorbidity; Dinoprost; Female; Gastroesophageal Reflux; Humans; Hydrogen-Ion Concentration; Lansoprazole; Male; Middle Aged; Oxidative Stress; Proton Pump Inhibitors

To investigate changes in oxidant stress during and following acute asthma exacerbations, this study measured 2,3-dinor-5,6-dihydro-15-F(2t)-IsoP (F(2)-IsoP-M), the major urinary metabolite of 15-F(2t)-IsoP, in eight asthmatic adults, during and following an asthma hospitalization. F(2)-IsoP-M concentrations at admission and follow-up were significantly higher than discharge (admission median: 4.12 ng/Cr mg, range 1.89-7.8; follow-up: 2.47 ng/Cr mg (1.56-6.86); discharge: 1.42 ng/Cr mg (0.7-4.44); both p<0.01), but not significantly different between admission and follow-up. F(2)-IsoP-M concentrations at follow-up were higher than a control group with stable asthma (0.68 ng/Cr mg (0.31-1.5), p=0.0008). In conclusion, asthma exacerbations requiring hospitalization are associated with 6-fold higher urinary F(2)-IsoP-M concentrations compared to stable asthmatics. F(2)-IsoP-M concentrations decreased significantly during hospitalization, but significant elevations 3 months following hospitalization suggest ongoing oxidative stress despite clinical improvement. Urinary F(2)-IsoP-M may be a clinically useful, simple non-invasive systemic measure of oxidative stress in asthmatics, providing information not captured by spirometry or symptoms.

Topics: Adult; Asthma; Biomarkers; Case-Control Studies; Dinoprost; Female; Humans; Male; Middle Aged; Oxidative Stress

The effective microorganism fermentation extract (EM-X) is an antioxidant cocktail derived from the fermentation of plant material with effective microorganisms, and its clinical application is being increasingly scrutinized. In the current study, the antiasthmatic effect of EM-X was investigated using a mouse model. Inhalation of EM-X during OVA challenge resulted in a significant reduction in airway hyperreactivity (AHR) and airway recruitment of leukocytes including eosinophils. However, the level of 8-isoprostane in bronchoalveolar lavage fluid (BALF), a marker of oxidative stress in asthmatic patients, was unaltered by EM-X inhalation. Instead, ELISA data showed that levels of IL-4, IL-5 and IL-13 in BALF or lung tissues were significantly lower in EM-X-inhaling mice than in the control mice, but not the IFN-gamma level. A considerably lower amount of Ag-specific IgE and IgG1 was detected in the serum of EM-X-inhaling mice than in the serum of the controls, whereas their IgG2a secretion was similar. In addition, Ag-specific ex vivo IL-4, IL-5 and IL-13 production of draining lymph node cells was markedly diminished by EM-X inhalation, but not IFN-gamma. These data clearly show that inhaled EM-X suppresses type 2 helper T (TH2), but not type 1 helper T (TH1), response. In conclusion, inhalation of EM-X attenuates AHR and airway inflammation which results from selective inhibition of the TH2 response to allergen, but independently of antioxidant activity. Our data also suggest that EM-X may be effectively applied for control of allergic asthma.

Topics: Administration, Inhalation; Animals; Anti-Asthmatic Agents; Antigens; Antioxidants; Asthma; Bronchial Hyperreactivity; Bronchoalveolar Lavage Fluid; Dinoprost; Disease Models, Animal; Female; Immunoglobulins; Inflammation; Lung; Lymph Nodes; Mice; Mice, Inbred BALB C; Plant Extracts; Th2 Cells

Exhaled nitric oxide and inflammatory biomarkers in exhaled breath condensate may be useful to diagnose and monitor childhood asthma. Their ability to indicate an asthma diagnosis, and to assess asthma severity and control, is largely unknown.. To study (1) the ability of exhaled nitric oxide and inflammatory markers in exhaled breath condensate (nitrite, nitrate, hydrogen peroxide, 8-isoprostane, IFN-gamma, TNF-alpha, IL-2, -4, -5, -10 and acidity) to discriminate between childhood asthma and controls. (2) The ability of these biomarkers to indicate asthma severity and control.. One-hundred and fourteen children were included: 64 asthmatics (10.7+/-3.0 years, 67.2% atopic) and 50 controls (10.0+/-0.4 years). Condensate was collected using a glass condenser.. Exhaled nitric oxide, IFN-gamma and IL-4 in exhaled breath condensate differed significantly between asthma and controls. Multivariate backward logistic regression models demonstrated that IL-4 (odds ratio 7.9, 95% confidence interval 1.2-51.0) was the only significant indicator of an asthma diagnosis. Asthma control was best assessed by exhaled nitric oxide, 8-isoprostane, IFN-gamma and IL-4 (sensitivity 82%, specificity 80%, P<0.05), whereas exhaled nitric oxide, 8-isoprostane, nitrate and nitrite in condensate were the best indicators of asthma severity (sensitivity 89%, specificity 72%, P<0.05).. Different markers in condensate are of an additional value to exhaled nitric oxide, and are needed in non-invasive inflammometry. They could be useful to diagnose asthma and to indicate asthma control and severity in childhood.

Topics: Adolescent; Asthma; Biomarkers; Breath Tests; Case-Control Studies; Child; Child, Preschool; Dinoprost; Exhalation; Female; Humans; Interferon-gamma; Interleukin-4; Male; Nitrates; Nitric Oxide; Nitrites; Sensitivity and Specificity; Severity of Illness Index

Topics: Albumins; Aluminum; Asthma; Biomarkers; Breath Tests; Dinoprost; Equipment Design; Glass; Humans; Hydrogen-Ion Concentration; Ions; Materials Testing; Mucins; Nitric Oxide; Polypropylenes; Polytetrafluoroethylene; Time Factors

Exhaled breath condensate (EBC) pH appears to be a robust measure of asthma. However, the association between EBC pH and clinical factors and airway inflammatory markers remains unclear. The objectives of this study were to investigate the factors determining EBC pH in asthmatic children, and the reproducibility and effects of collection devices on EBC pH in nine healthy, nonsmoking adults. EBC was collected once from asthmatic children using EcoScreen, and from adults over 3 consecutive days using both RTubes and EcoScreen. EBC pH was measured immediately in non-deaerated samples by microelectrode pH meter. Concentrations of 8-isoprostane, cysteinyl leukotrienes (cys-LT), and leukotriene B4 (LTB4) were measured using enzyme immunoassay. Exhaled nitric oxide concentration (FeNO) was measured by chemiluminescence. Fifty-eight asthmatics (16 intermittent, 12 mild persistent, and 30 moderate-to-severe persistent) were recruited. EBC pH was lower among patients with moderate-to-severe persistent than intermittent asthma (P = 0.046). This marker correlated inversely with disease severity score (rho = -0.276, P = 0.036), but not FeNO or other EBC biomarkers. Bland-Altman analyses found pH but not other EBC biomarkers to be reproducible, which were confirmed by its low coefficient of variation (2.7%; range, 0.4-5.2%). There was poor correlation between pH in EBC collected by RTube and EcoScreen (rho = 0.059, P = 0.784). Factor analysis selected four factors that explained 67.5% of the total variance, and EBC pH clustered with both cys-LT and LTB4. In conclusion, our results suggest that pH in non-deaerated EBC is influenced by asthma severity in children. EBC pH measurement is reproducible, but is dependent on the collection devices used.

Topics: Adolescent; Adult; Asthma; Biomarkers; Breath Tests; Child; Cysteine; Dinoprost; Factor Analysis, Statistical; Female; Forced Expiratory Volume; Humans; Hydrogen-Ion Concentration; Immunoenzyme Techniques; Leukotriene B4; Leukotrienes; Luminescent Measurements; Male; Nitric Oxide; Reproducibility of Results; Severity of Illness Index

Airway hyperresponsiveness is a cardinal feature of asthma. Lung C-fiber activation induces central and local defense reflexes that may contribute to airway hyperresponsiveness. Initial studies show that substance P (SP) activates C fibers even though it is produced and released by these same C fibers. SP may induce release of other endogenous mediators. Bradykinin (BK) is an endogenous mediator that activates C fibers. The hypothesis was tested that SP activates C fibers via BK release. Guinea pigs were anesthetized, and C-fiber activity (FA), pulmonary insufflation pressure (PIP), heart rate, and arterial blood pressure were monitored before and after intravenous injection of capsaicin (Cap), SP, and BK. Identical agonist challenges were repeated after infusion of an antagonist cocktail of des-Arg9-[Leu8]-BK (10(-3) M, B1 antagonist), and HOE-140 (10(-4) M, B2 antagonist). After antagonist administration, BK increased neither PIP nor FA. Increases in neither PIP nor FA were attenuated after Cap or SP challenge. In a second series of experiments, Cap and SP were injected before and after infusion of indomethacin (1 mg/kg iv) to determine whether either agent activates C fibers through release of arachidonic acid metabolites. Indomethacin administration decreased the effect of SP challenge on FA but not PIP. The effect of Cap on FA or PIP was not altered by indomethacin. In subsequent experiments, C fibers were activated by prostaglandin E2 and F2alpha. Therefore, exogenously applied SP stimulates an indomethacin-sensitive pathway leading to C-fiber activation.

Topics: Action Potentials; Adrenergic beta-Antagonists; Animals; Asthma; Blood Pressure; Bradykinin; Capsaicin; Cyclooxygenase Inhibitors; Dinoprost; Dinoprostone; Guinea Pigs; Heart Rate; Indomethacin; Lung; Nerve Fibers, Unmyelinated; Prostaglandins; Respiratory Hypersensitivity; Substance P

Asthma and gastro-oesophageal reflux (GER) are both characterized by airway inflammation.. The purposes of this work were (i) to study airway inflammation in patients troubled by gastro-oesophageal reflux (GER) and GER associated with asthma, (ii) to ascertain whether GER can aggravate asthma by exacerbating the pre-existing airway inflammation and oxidative stress and (iii) to establish the validity of analysing breath condensate and induced sputum when studying the airways of subjects affected by GER. PATIENT S AND METHODS: We enrolled 14 patients affected by mild asthma associated with GER (40 +/-12 years), nine with mild but persistent asthma (39 +/- 13 years), eight with GER (35 +/- 11 years) and 17 healthy subjects (37 +/- 9 years). Sputum cell counts and concentrations of interleukin-4 (IL-4), IL-6 and 8-isoprostane were measured in breath condensate and supernatant.. GER-related asthma is characterized by an eosinophilic inflammation, as determined by elevated concentrations of IL-4 in breath condensate and sputum supernatant, and by sputum cell analysis. GER alone presents a neutrophilic pattern of inflammation when determined by elevated concentrations of IL-6 in sputum cell analysis. A concomitant increase has been found in 8-isoprostane in GER associated (or not associated) with asthma.. We conclude that GER is characterized by a neutrophilic airway inflammation and by increased oxidative stress. GER does not however aggravate pre-existing airway inflammation in asthma patients. Determinations of inflammatory and oxidant markers in the breath condensate of subjects with GER reflect these measured in the induced sputum.

Topics: Adult; Asthma; Biomarkers; Breath Tests; Cross-Sectional Studies; Dinoprost; Female; Forced Expiratory Volume; Gastroesophageal Reflux; Humans; Hydrogen-Ion Concentration; Inflammation Mediators; Interleukin-4; Interleukin-6; Male; Middle Aged; Oxidative Stress; Sputum; Vital Capacity

Exhaled breath condensate collection is not yet standardised and biomarker measurements are often close to lower detection limits. In the current study, it was hypothesised that adhesive properties of different condenser coatings interfere with measurements of eicosanoids and proteins in breath condensate. In vitro, condensate was derived from a collection model using two test solutions (8-isoprostane and albumin) and five condenser coatings (silicone, glass, aluminium, polypropylene and Teflon). In vivo, condensate was collected using these five coatings and the EcoScreen condenser to measure 8-isoprostane, and three coatings (silicone, glass, EcoScreen) to measure albumin. In vitro, silicone and glass coatings had significantly higher albumin recovery compared with the other coatings. A similar trend was observed for 8-isoprostane recovery. In vivo, median (interquartile range) 8-isoprostane concentrations were significantly higher using silicone (9.2 (18.8) pg.mL(-1)) or glass (3.0 (4.5) pg.mL(-1)) coating, compared with aluminium (0.5 (2.4) pg.mL(-1)), polypropylene (0.5 (0.5) pg.mL(-1)), Teflon (0.5 (0.0) pg.mL(-1)), and EcoScreen (0.5 (2.0) pg.mL(-1)). Albumin in vivo was mainly detectable using glass coating. In conclusion, a condenser with silicone or glass coating is more efficient for measurement of 8-isoprostane or albumin in exhaled breath condensate, than EcoScreen, aluminium, polypropylene or Teflon. Guidelines for exhaled breath condensate standardisation should include the most valid condenser coating to measure a specific biomarker.

Topics: Adolescent; Adult; Albumins; Asthma; Biomarkers; Breath Tests; Child; Child, Preschool; Dinoprost; Equipment Design; Female; Glass; Humans; Male; Materials Testing; Middle Aged; Silicones

We investigated the role of antioxidants in airway hyperresponsiveness to acetylcholine using young asthma model mice, which were sensitized and stimulated with ovalbumin.. The mice had been fed either a normal diet, an alpha-tocopherol-supplemented diet or a probucol-supplemented diet 14 days before the first sensitization. They were immunized with antigen at intervals of 12 days and, starting from 10 days after the second immunization, they were exposed to antigen 3 times every 4th day using an ultrasonic nebulizer. Twenty-four hours after the last antigen inhalation, airway responsiveness to acetylcholine was measured and bronchoalveolar lavage fluid (BALF) was collected. A blood and lung tissue study was also carried out.. Twenty-four hours after the last antigen challenge, both IL-4 and IL-5 in the BALF of alpha-tocopherol-supplemented mice were significantly decreased. The IL-5 level in probucol-supplemented mice was also decreased, but there was no difference in IL-4 levels. The serum IgE level was decreased in probucol-supplemented mice. Differential cell rates of the fluid revealed a significant decrease in eosinophils due to antioxidant supplementation. Airway hyperresponsiveness to acetylcholine was also repressed in antioxidant-supplemented mice. In histological sections of lung tissue, inflammatory cells and mucus secretion were markedly reduced in antioxidant-supplemented mice. We investigated the antioxidant effect on our model mice by examining 8-isoprostane in BALF and lung tissue, and acrolein in BALF; however, our experiment gave us no evidence of the antioxidant properties of either alpha-tocopherol or probucol contributing to the reduction of airway inflammation.. These findings indicate that alpha-tocopherol and probucol suppress allergic responses in asthma model mice, although these two drugs cause suppression in different ways that are unrelated to antioxidation.

Topics: Acrolein; Allergens; alpha-Tocopherol; Animals; Antioxidants; Asthma; Bronchial Hyperreactivity; Bronchial Provocation Tests; Bronchoalveolar Lavage Fluid; Dietary Supplements; Dinoprost; Disease Models, Animal; Eosinophils; Female; Hypersensitivity; Immunoglobulin E; Interleukin-4; Interleukin-5; Mice; Mice, Inbred BALB C; Ovalbumin; Oxidative Stress; Probucol

To evaluate the role of Chlamydia pneumoniae respiratory tract infection on pediatric asthma, allergic rhinitis or atopic eczema initiation, children of three age groups (n=1211) were prospectively studied for a C. pneumoniae infection using throat swabs and polymerase chain reaction (PCR) with enzyme immunoassay (EIA) detection. Infected children (study group, SG) were examined monthly until the agent could not be detected, quantifying persistent infection. They were compared with randomly selected, non-infected children without asthma matched for age, gender and origin (control group, CG) regarding lung function and inflammatory parameters as well as initiation of allergic diseases judged by family doctor diagnosis after, in median, 22 months. At the first follow-up examination, SG children revealed a higher leukotriene B4 (median 36 pg/ml vs. 19, p=0.04) and 8-isoprostane (median 15 pg/ml vs. 12, p=0.04) in breath condensate characterizing neutrophil, agent-related inflammation and oxidative stress in the lower airways. Cysteinyl leukotrienes, important in acute allergic inflammation, were without difference. Local, anti C. pneumoniae secretory immunoglobulin A antibodies were higher in children after C. pneumoniae infection (optical density median 0.7 vs. 0.4, p=0.001) confirming PCR-EIA results. At the final examination, there was no difference in pathological lung function tests, parameters of exhaled breath condensate or eosinophilia of the nasal mucosa. Incidence of asthma (0/55 vs. 5/54, p=0.03) and allergic rhinitis [3/53 vs. 10/52, p=0.04, odds ratio and 95% confidence interval-OR 0.25 (0.06;0.98)] as well as prevalence of asthma [1/56 vs. 9/58, p=0.02, OR 0.1 (0.01;0.81)] and allergic rhinitis [6/56 vs. 16/58, p=0.03, OR 0.32 (0.11;0.88)] were lower in the SG children. There was no association in atopic eczema. Three children with persistent infection revealed a slightly higher incidence in allergic rhinitis without significance than those with single C. pneumoniae detection (1/3 vs. 2/50), however, not to the CG. In conclusion a C. pneumoniae upper respiratory tract infection may be regarded as a protective factor for childhood asthma or allergic rhinitis in a population of kindergarten and school-age children.

Topics: Adolescent; Animals; Asthma; Child; Child, Preschool; Chlamydophila Infections; Chlamydophila pneumoniae; Cohort Studies; Dermatitis, Atopic; Dinoprost; Female; Humans; Immunoenzyme Techniques; Immunoglobulin A; Leukotriene B4; Male; Pneumonia, Bacterial; Polymerase Chain Reaction; Respiratory Function Tests; Rhinitis

Several studies suggest that the periphery of the lung is the major site of inflammation in asthma. Fractional exhaled nitric oxide (Feno) and 8-isoprostane have been proposed as biomarkers of inflammation and oxidative stress. We therefore hypothesised that small airway dysfunction in asthma is of inflammatory origin that can be detected by molecular markers in exhaled air. To test this hypothesis, we examined the relationship of Feno and 8-isoprostane in exhaled air with small airways function as assessed by the single breath nitrogen test.. Sixteen patients (14 women) with mild atopic asthma (forced expiratory volume in 1 second >80% predicted) of mean (SD) age 23.0 (5.5) years participated in a cross sectional study. Feno was recorded by chemiluminescence and 8-isoprostane was measured by ELISA in concentrated exhaled breath condensate. The slope of phase III (deltaN2) and the closing volume (CV) were assessed from the single breath washout curve.. The median Feno level was 30.4 ppb (range 10.1-82.8), the median 8-isoprostane concentration in exhaled breath condensate was 2.2 pg/ml (range 1.6-2.7), and the mean (SD) deltaN2 value was 1.1 (0.4)% N2/l. Feno was positively associated with deltaN2 (r(s) = 0.54, p = 0.032) while 8-isoprostane was inversely correlated with FEV1% predicted (rs= -0.58; p = 0.017) and CV as a percentage of vital capacity (rs= 0.58; p = 0.019).. Feno and 8-isoprostane in exhaled air are associated with small airways function in mild asthma. This suggests that these markers reflect small airway inflammation and favours a role for them as disease markers that is complementary to spirometry in the monitoring of patients with asthma.

Topics: Adult; Asthma; Biomarkers; Bronchitis; Cross-Sectional Studies; Dinoprost; Enzyme-Linked Immunosorbent Assay; Female; Forced Expiratory Volume; Humans; Male; Nitric Oxide; Vital Capacity

Airway inflammation is assessed to monitor progression, control and treatment of asthma. The collection of exhaled breath condensate (EBC) provides a non-invasive alternative to induced sputum samples for the monitoring of airway inflammation. Both samples can be confounded by salivary contamination. The aim of this study was to compare the levels of inflammatory mediators in samples of EBC, induced sputum and saliva samples from subjects with asthma.. EBC, saliva and induced sputum samples were collected from subjects with asthma (n=10). Total protein, IL-8, 8-isoprostane and surfactant protein A (SPA) were assessed in each sample.. Total protein, IL-8, 8-isoprostane and SPA were detected in all sputum samples. Only total protein and SPA were consistently measured in EBC, with levels at least 100-fold lower than those measured in induced sputum. In saliva, total protein, SPA and 8-isoprostane were detected in all samples, with IL-8 detected in 60% of samples.. Induced sputum is a reliable technique that can be used to assess markers of airway inflammation. While EBC is a simple and inexpensive technique to collect lower airway secretions, the detection of inflammatory mediators is variable, and further work is required to validate this technique to assess inflammatory mediators.

Topics: Adult; Aged; Asthma; Breath Tests; Bronchial Provocation Tests; Dinoprost; Female; Humans; Interleukin-8; Male; Middle Aged; Predictive Value of Tests; Pulmonary Surfactant-Associated Protein A; Saliva; Sputum; Statistics, Nonparametric

Through the establishment of mouse' ovalbumin- sensitized asthmatic model and the observation of the 8-Isoprostane of plasm, to evaluate the therapeutic effects of arsenolite on asthmatic mice.. Forty-two healthy Kunming male mice were randomly divided into control group and experience groups, the latter were treated with dexamethasone, arsenolite. Lung function were tested, 8-isoprostane of plasm and WBC of BALF were measured.. Lung function improved after treating with dexamethasone or arsenolite. The WBC of asthmatic mice were significantly higher than those in control group, and decreased after treating with dexamethasone or arsenolite; 8-Isoprostane of plasm in asthmatic mice was higher than that of control group, and decreased after treating with dexamethasone or arsenolite.. There is oxidant stress status in asthmatic mice. Arsenolite could lighten airway obstruction, reduce airway high response and redress oxidant stress status in asthmatic mice.

Topics: Animals; Anti-Asthmatic Agents; Arsenic Trioxide; Arsenicals; Asthma; Bronchoalveolar Lavage Fluid; Dinoprost; Leukocyte Count; Male; Materia Medica; Mice; Ovalbumin; Oxides; Random Allocation; Respiratory Function Tests

Airway inflammation in asthma is associated with cysteinyl leukotriene and prostaglandin D(2) production. Measurement of urinary metabolites of these eicosanoids may be useful for monitoring asthma patients. However, the influence of asthma phenotype and severity on basal urinary excretion of these metabolites is unknown.. To compare urinary leukotriene (LT)E(4) and 9 alpha, 11 beta-prostaglandin (PG)F(2) concentrations in large groups of mild, moderate and severe asthmatic patients and healthy control subjects.. Asthma severity, treatment and aspirin sensitivity were assessed by questionnaire in 168 asthmatic patients. Basal LTE(4) and 9 alpha, 11 beta-PGF(2) concentrations were measured in urine samples from these patients and from 175 control subjects using enzyme immunoassays.. Urinary LTE(4) was correlated with 9 alpha, 11 beta-PGF(2) in both control subjects and asthmatic patients (P<0.002). Median LTE(4) and 9 alpha, 11 beta-PGF(2) concentrations in patients with severe asthma were significantly reduced compared with mild asthmatic patients (P<0.05 and <0.001, respectively). Urinary 9 alpha, 11 beta-PGF(2), but not LTE(4) was lower in asthmatic patients using inhaled corticosteroids (P<0.02). Multiple regression analysis indicated that urinary 9 alpha, 11 beta-PGF(2) concentration was negatively correlated with asthma severity (P=0.003) and also with % predicted FEV(1) (forced expiratory volume in 1 s) (P=0.005).. Baseline urinary LTE(4) and 9 alpha, 11 beta-PGF(2) concentrations are of limited value in discriminating between patients with different severities of asthma. Reduced urinary LTE(4) and 9 alpha, 11 beta-PGF(2) in patients with severe asthma suggest that direct or indirect effects of high-dose corticosteroid therapy combined with other factors associated with severe asthma may influence eicosanoid production. However, the negative association of urinary 9 alpha, 11 beta-PGF(2) with lung function suggests an adverse effect of chronic PGD(2) production on lung function in asthma, irrespective of severity.

Topics: Adult; Aged; Asthma; Biomarkers; Dinoprost; Female; Glucocorticoids; Humans; Leukotriene E4; Male; Middle Aged; Regression Analysis; Severity of Illness Index

Prostaglandin D(2) (PGD(2)) is a major cyclooxygenase product generated by activated mast cells during an allergic response. Assessment of PGD(2) and its metabolites in patients with asthma has mostly been performed in urine, bronchoalveolar lavage fluid and induced sputum, whereas human plasma determinations have been performed only sporadically.. In 32 patients with allergic asthma and 50 healthy non-allergic controls, baseline plasma and urinary levels of 9alpha,11beta-PGF(2), a primary PGD(2) metabolite, were assessed by gas chromatography/mass spectrometry. Serum tryptase levels were measured by fluoroenzyme immunoassay and urinary leukotriene E(4) (LTE(4)) by ELISA. In a subgroup of 10 asthmatics (randomly selected from the 32 study patients) in whom bronchial allergen challenges with specific allergens (Dermatophagoides pteronyssinus, n = 4, mixed grass pollens, n = 6) were carried out, measurements were taken both before and after provocation.. At baseline no significant differences between mean plasma and urinary levels of the PGD(2) metabolite and serum tryptase levels were found in asthmatics or controls. Asthmatic patients had significantly higher urinary LTE(4) levels. Allergen challenge resulted in a significant early increase in the mean plasma 9alpha,11beta-PGF(2) level and only a borderline but significant increase in the urinary 9alpha,11beta-PGF(2) level within 2 hours after provocation. The challenge did not produce statistically significant changes in serum tryptase levels. Urinary LTE(4) levels remained significantly increased 4 hours after provocation.. PGD(2) is actively involved in the early asthmatic response to allergens. Measurement of 9alpha,11beta-PGF(2) release into plasma rather than urine following allergen challenge is a sensitive marker of enhanced PGD(2) synthesis, most probably due to mast cell activation.

Topics: Adolescent; Adult; Allergens; Asthma; Biomarkers; Dinoprost; Enzyme-Linked Immunosorbent Assay; Female; Humans; Leukotriene E4; Male; Mast Cells; Prostaglandin D2; Serine Endopeptidases; Time Factors; Tryptases

Biochemical analysis of expiratory breath condensate is an emerging non-invasive technique for assessment of airway inflammation.. We wondered whether application of expiratory breath condensate could facilitate diagnosis of aspirin-intolerant asthma and reproduce eicosanoids mediators' abnormalities described in this disease.. We measured prostaglandins (PGs) E(2), F(2 alpha), 9 alpha 11 beta F(2) and iso-F(2) by gas-chromatography/mass-spectrometry and cysteinyl leukotrienes (cys-LTs) by radioimmunoassay in breath condensates of asthmatic patients undergoing oral aspirin challenge. Fourteen patients with aspirin-induced asthma and 20 aspirin-tolerating asthmatics, most of them on chronic inhaled corticotherapy, were studied and compared with 10 healthy subjects. Additionally, plasma 9 alpha 11 beta PGF(2), the metabolite of PGD(2) and urinary leukotriene (LT) E(4) were measured before and following the challenge.. At baseline, PG did not differ between the groups, except for lower 9 alpha 11 beta PGF(2) in aspirin-intolerant asthma. Their concentrations were not changed by the challenge. Breath condensate cys-LTs were similar in the groups studied at base, and after aspirin challenge increased only in aspirin-intolerant patients. Elevated baseline urinary LTE(4) and its further increase following aspirin challenge was highly diagnostic for aspirin-intolerant asthma. The discriminatory value of cys-LTs increase in breath condensates was lower (72.8%) than either basal (99%) or post-challenge increase (94%) of urinary LTE(4).. In asthmatic patients on chronic corticotherapy measurement of urinary LTE(4) excretion rather than cys-LTs in breath condensate is of greater value for diagnosis of aspirin hypersensitivity.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Area Under Curve; Aspirin; Asthma; Biomarkers; Breath Tests; Case-Control Studies; Dinoprost; Dinoprostone; Eicosanoids; Female; Gas Chromatography-Mass Spectrometry; Humans; Leukotriene E4; Lung; Male; Middle Aged; ROC Curve

In vitro antigen challenge has multiple effects on the excitability of guinea pig bronchial parasympathetic ganglion neurons, including depolarization, causing phasic neurons to fire with a repetitive action potential pattern and potentiating synaptic transmission. In the present study, guinea pigs were passively sensitized to the antigen ovalbumin. After sensitization, the bronchi were prepared for in vitro electrophysiological intracellular recording of parasympathetic ganglia neurons to investigate the contribution of cyclooxygenase activation and prostanoids on parasympathetic nerve activity. Cyclooxygenase inhibition with either indomethacin or piroxicam before in vitro antigen challenge blocked the change in accommodation. These cyclooxygenase inhibitors also blocked the release of prostaglandin D(2) (PGD(2)) from bronchial tissue during antigen challenge. We also determined that PGE(2) and PGD(2) decreased the duration of the action potential after hyperpolarization, whereas PGF(2alpha) potentiated synaptic transmission. Thus prostaglandins released during antigen challenge have multiple effects on the excitability of guinea pig bronchial parasympathetic ganglia neurons, which may consequently affect the output from these neurons and thereby alter parasympathetic tone in the lower airways.

Topics: Action Potentials; Animals; Asthma; Bronchi; Bronchoconstriction; Cyclooxygenase Inhibitors; Dinoprost; Dinoprostone; Excitatory Postsynaptic Potentials; Ganglia, Parasympathetic; Guinea Pigs; Indomethacin; Male; Ovalbumin; Piroxicam; Prostaglandin D2; Prostaglandin-Endoperoxide Synthases; Prostaglandins; Synaptic Transmission

Prostaglandin D(2) (PGD(2)) is the predominant cyclooxygenase product of mast cells, the number of which is increased in bronchial asthma. Release of PGD(2) might reflect mast cell activation and disordered function of the asthmatic lung.. We sought to determine blood and urinary levels of 9alpha,11beta-PGF(2), a major stable PGD(2) metabolite in 2 well-defined phenotypes of asthma, aspirin-induced asthma (AIA) and aspirin-tolerant asthma (ATA), and in healthy control subjects and to study the effects of aspirin on PGD(2) release.. Using gas chromatography/mass spectrometry, we determined plasma and urinary concentrations of 9alpha,11beta-PGF(2) at baseline in 131 stable asthmatic patients, 65 of whom had AIA and 66 of whom had ATA. Fifty healthy nonatopic subjects served as the control group. The measurements were also performed after an aspirin challenge in 26 of 65 patients with AIA and in 24 of 50 control subjects.. At baseline, patients with AIA had significantly higher plasma levels of 9alpha,11beta-PGF(2) than either patients with ATA or healthy subjects. A similar significant elevation of serum tryptase was observed in patients with AIA compared with patients with ATA and control subjects. Mean urinary 9alpha,11beta-PGF(2) values did not differ among the 3 groups. In patients with AIA, as opposed to healthy subjects, aspirin challenge invariably precipitated a clinical reaction, accompanied in most patients by a further rise in plasma levels of PGD(2) metabolite and tryptase.. In stable AIA, though not in ATA, there is a steady release of PGD(2) into the blood, accompanied by the release of tryptase. Aspirin enhances this reaction in most patients. Release of bronchoconstrictive PGD(2) might contribute to the severe clinical course of AIA.

Topics: Adult; Aged; Aspirin; Asthma; Dinoprost; Female; Humans; Leukotriene E4; Male; Middle Aged; Prostaglandin D2; Serine Endopeptidases; Tryptases

Cysteinyl leukotrienes (Cys-LTs) and isoprostanes are inflammatory metabolites derived from arachidonic acid whose levels are increased in the airways of asthmatic patients. Isoprostanes are relatively stable and specific for lipid peroxidation, which makes them potentially reliable biomarkers for oxidative stress. A study was undertaken to evaluate the effect of a course of oral steroids on Cys-LT and 8-isoprostane levels in exhaled breath condensate of children with an asthma exacerbation.. Exhaled breath condensate was collected and fractional exhaled nitric oxide (FE(NO)) and spirometric parameters were measured before and after a 5 day course of oral prednisone (1 mg/kg/day) in 15 asthmatic children with an asthma exacerbation. Cys-LT and 8-isoprostane concentrations were measured using an enzyme immunoassay. FE(NO) was measured using a chemiluminescence analyser. Exhaled breath condensate was also collected from 10 healthy children.. Before prednisone treatment both Cys-LT and 8-isoprostane concentrations were higher in asthmatic subjects (Cys-LTs, 12.7 pg/ml (IQR 5.4-15.6); 8-isoprostane, 12.0 pg/ml (9.4-29.5)) than in healthy children (Cys-LTs, 4.3 pg/ml (2.0-5.7), p=0.002; 8-isoprostane, 2.6 pg/ml (2.1-3.0), p<0.001). After prednisone treatment there was a significant decrease in both Cys-LT (5.2 pg/ml (3.9-8.8), p=0.005) and 8-isoprostane (8.4 pg/ml (5.4-11.6), p=0.04) concentrations, but 8-isoprostane levels remained higher than in controls (p<0.001). FE(NO) levels, which fell significantly after prednisone treatment (p<0.001), did not correlate significantly with either Cys-LT or 8-isoprostane concentrations.. After a 5 day course of oral prednisone there is a reduction in Cys-LT and 8-isoprostane levels in EBC of children with an asthma exacerbation, although 8-isoprostane levels remain higher than in controls. This finding suggests that corticosteroids may not be fully effective in reducing oxidative stress in children with an exacerbation of asthma.

Topics: Adolescent; Asthma; Biomarkers; Breath Tests; Child; Cysteine; Dinoprost; F2-Isoprostanes; Female; Forced Expiratory Volume; Glucocorticoids; Humans; Leukotrienes; Male; Nitric Oxide; Peak Expiratory Flow Rate; Prednisone

To quantify lung oxidative stress in asthmatic children by measuring concentrations of 8-isoprostane, a marker of oxidative stress, in exhaled breath condensate (EBC), which is a noninvasive method of sampling airway secretions. Secondary objectives were as follows: (1) to measure levels of exhaled prostaglandin (PG) E(2), since impaired PGE(2) production has been implicated in the pathogenesis of asthma in adults; and (2) to measure levels of fractional exhaled nitric oxide (FeNO), which is a marker of airway inflammation.. Single-center, cross-sectional study.. Twelve healthy children, 12 steroid-naïve asthmatic children, and 30 children in stable condition with mild-to-moderate persistent asthma who were being treated with inhaled corticosteroids (ICSs) [average dose, 300 micro g per day] were studied.. Subjects attended the outpatient clinic on one occasion for the collection of EBC and FeNO measurements.. 8-Isoprostane and PGE(2) concentrations in EBC were measured with specific radioimmunoassays. FeNO was measured online by a chemiluminescence analyzer. 8-Isoprostane was detectable in the EBC of healthy children (mean [+/- SEM], 34.2 +/- 4.5 pg/mL), and its concentrations were increased in both steroid-naïve asthmatic children (mean, 56.4 +/- 7.7 pg/mL; p < 0.01) and steroid-treated asthmatic children (mean, 47.2 +/- 2.3 pg/mL; p < 0.05). There was no difference in exhaled 8-isoprostane concentrations between the two groups of asthmatic children (p = 0.14). By contrast, exhaled PGE(2) concentrations were similar among the three study groups (p = 0.56). FeNO levels were higher in steroid-naïve children with asthma (49.2 +/- 9.6 parts per billion [ppb]; p < 0.05) and, to a lesser extent, in steroid-treated asthmatic children (37.8 +/- 6.6 ppb; p < 0.05) compared with healthy children (15.2 +/- 1.7 ppb).. Lung oxidative stress is increased in children who are in stable condition with asthma, as reflected by increased exhaled 8-isoprostane concentrations. This increase seems to be relatively resistant to treatment with ICSs. Decreased PGE(2) lung production is unlikely to play a pathophysiologic role in childhood asthma.

Topics: Adolescent; Anti-Inflammatory Agents; Asthma; Breath Tests; Child; Child, Preschool; Cross-Sectional Studies; Dinoprost; Dinoprostone; F2-Isoprostanes; Female; Forced Expiratory Volume; Humans; Luminescent Measurements; Male; Nitric Oxide; Oxidative Stress; Radioimmunoassay; Respiratory Function Tests; Steroids

Reactive oxygen species are involved in the activation of several mitogen-activated protein kinases (MAPKs), key-players in the production of several cytokines. Therefore the current study investigated whether N-acetylcysteine (NAC), an antioxidative agent, inhibits the interleukin (IL)-1beta-induced expression and production of eotaxin and monocyte chemotactic protein (MCP)-1 in human airway smooth muscle cells (HASMC). NAC (10 mM) decreased the expression of eotaxin and MCP-1, by 46 +/- 11% (n=7) and 87 +/- 4% (n=6), respectively; the eotaxin release was inhibited by 75 +/- 5% (n=7), whereas the MCP-1 release was decreased by 69 +/- 41% (n=10). NAC (1 mM) also decreased the IL-1beta-induced activation of p38 MAPK. Compared with unstimulated cells, a four-fold increase in 8-isoprostane production in IL-1beta-stimulated HASMC was observed, which could be inhibited by NAC in a concentration-dependent way, with a maximum inhibition of 39 +/- 12%, with 1 mM NAC. The present study demonstrated that N-acetylcysteine inhibits the interleukin-1beta-induced eotaxin and monocyte chemotactic protein 1 expression and production due to a decreased activation of p38 mitogen-activated protein kinase. This study has also shown that N-acetylcysteine decreases the interleukin-1beta-induced production of reactive oxygen species, as suggested by a reduction in the 8-isoprostane production.

Topics: Acetylcysteine; Asthma; Blotting, Northern; Cells, Cultured; Chemokine CCL11; Chemokine CCL2; Chemokines; Chemokines, CC; Dinoprost; Enzyme Activation; Enzyme-Linked Immunosorbent Assay; F2-Isoprostanes; Humans; Interleukin-1; JNK Mitogen-Activated Protein Kinases; MAP Kinase Kinase 4; MAP Kinase Signaling System; Mitogen-Activated Protein Kinase Kinases; Mitogen-Activated Protein Kinases; Muscle, Smooth; p38 Mitogen-Activated Protein Kinases; Signal Transduction; Statistics, Nonparametric; Stimulation, Chemical

The aim of this study was to investigate if mannitol inhalation, as a model of exercise-induced bronchoconstriction (EIB), causes mast cell activation and release of mediators of bronchoconstriction. Urinary excretion of previously identified mediators of EIB was investigated in association with mannitol-induced bronchoconstriction. Twelve asthmatic and nine nonasthmatic subjects inhaled mannitol and urine was collected 60 min before and for 90 min after challenge. The urinary concentrations of leukotriene (LT)E4, the prostaglandin (PG)D2 metabolite and the mast cell marker 9alpha,11beta-PGF2 were measured by enzyme immunoassay. N(tau)-methylhistamine was measured by radioimmunoassay. In asthmatic subjects, inhalation of a mean+/-SEM dose of 272+/-56 mg mannitol induced a reduction in forced expiratory volume in one second (FEV1) of 34.5+/-2.1%. This was associated with increases in urinary 9alpha,11beta-PGF2 (91.9+/-8.2 versus 66.9+/-6.6 ng x mmol creatinine(-1), peak versus baseline) and LTE4 (51.3+/-7.5 versus 32.9+/-4.7). In nonasthmatic subjects, the reduction in FEV1 was 1.0+/-0.5% after inhaling 635 mg of mannitol. Although smaller than in the asthmatics, significant increases of urinary 9alpha,11beta-PGF2 (68.4+/-6.9 versus 56.0+/-5.8 ng x mmol creatinine(-1)) and LTE4 (58.5+/-5.3 versus 43.0+/-3.3 ng x mmol creatinine(-1)) were observed in the nonasthmatic subjects. There was also a small increase in urinary excretion of N(tau)-methylhistamine in the nonasthmatics, but not in the asthmatics. The increased urinary levels of 9alpha,11beta-prostaglandin F2 support mast cell activation with release of mediators following inhalation of mannitol. Increased bronchial responsiveness to the released mediators could explain the exclusive bronchoconstriction in asthmatic subjects.

Topics: Adult; Asthma; Bronchial Provocation Tests; Bronchoconstriction; Case-Control Studies; Dinoprost; Female; Forced Expiratory Volume; Humans; Immunoenzyme Techniques; Leukotriene E4; Leukotrienes; Male; Mannitol; Mast Cells

The pathogenesis of aspirin-induced asthma (AIA) has not yet been clearly elucidated, although eicosanoid metabolites appear to play an important role. We hypothesized that levels of eicosanoids in exhaled air condensate are abnormal in patients with AIA and that they change in patients receiving steroid therapy. We measured cysteinyl-leukotrienes (cys-LTs), prostaglandin E(2) (PGE(2)), and leukotriene B(4) (LTB(4)), and also 8-isoprostane as a marker of oxidative stress, by enzyme immunoassay in exhaled breath condensate from patients with AIA (17 steroid naive; mean age, 41 +/- 23 years; FEV(1), 63%pred), 26 patients with aspirin-tolerant asthma (ATA) (11 steroid naive; mean age, 47 +/- 18 years; FEV(1), 69%pred), and 16 healthy subjects (mean age, 45 +/- 17 years; FEV(1), 93%pred). Cys-LTs were significantly higher in steroid-naive patients with AIA compared with steroid-naive patients with ATA and healthy subjects (152.3 +/- 30.4 and 36.6 +/- 7.1 versus 19.4 +/- 2.8 pg/ml; p < 0.05 and p < 0.05, respectively). Steroid-naive patients with AIA also had higher levels of 8-isoprostane than normal subjects (131.8 +/- 31.0 versus 21.9 +/- 4.5 pg/ml; p < 0.05). There were significantly lower levels of both cys-LTs and 8-isoprostanes in steroid-treated patients with AIA. There was no difference in either the PGE(2) or LTB(4) level between the patient groups. This is the first study to show that cys-LTs and 8-isoprostanes are elevated in expired breath condensate of steroid-naive patients with AIA, and that cys-LTs are decreased in steroid-treated patients. Exhaled PGE(2) levels are not reduced, so that it is unlikely that a deficiency of PGE(2) is an important mechanism, whereas exhaled LTB(4) levels are unchanged, indicating an abnormality beyond 5-lipoxygenase.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Asthma; Breath Tests; Cysteine; Dinoprost; Dinoprostone; F2-Isoprostanes; Female; Humans; Inflammation Mediators; Leukotriene B4; Leukotrienes; Male; Middle Aged; Oxidative Stress; Oxytocics; Respiratory System; Vasoconstrictor Agents

Asthma is a chronic inflammatory disease of the airways which may involve an oxidant injury to the lung. Assessment of oxidant stress is difficult in vivo, but measurement of F2-isoprostanes (F2-IsoPs), free radical-catalysed products of arachidonic acid, appears to offer a reliable approach for quantitative measurement of oxidative stress status in vivo. We have recently developed a mass spectrometric assay for 2,3-dinor-5,6-dihydro-15-F2t-IsoP (15-F2t-IsoP-M), the major urinary metabolite of the F2-IsoP, 15-F2t-IsoP (8-iso-PGF2a). Measurement of the urinary excretion of this metabolite offers a reliable index of oxidative stress status in vivo that has advantages over measuring unmetabolized F2-IsoPs in urine and plasma. To assess the occurrence of oxidative stress in patients with atopic asthma following allergen exposure in vivo by measuring the urinary excretion of 15-F2t-IsoP-M. Analysis of 15-F2t-IsoP-M by GC-NICI-MS in nine mild atopic asthmatics following inhaled allergen provocation and four asthmatic subjects after inhaled challenge with methacholine. Urinary excretion of 15-F2t-IsoP-M increased at 2 h after allergen challenge and remained significantly elevated in all urine collections during the subsequent 8-h period of the study compared to the baseline value (ANOVA, and Student-Newman-Keuls multiple comparisons test). No increase in the urinary excretion of 15-F2t-IsoP-M occurred after inhalation of methacholine. Allergen challenge causes an oxidant injury in human atopic asthmatics. 15-F2t-IsoP-M is a valuable marker of oxidant stress in vivo.

Topics: Allergens; Asthma; Dinoprost; F2-Isoprostanes; Humans; Hypersensitivity; Oxidative Stress

Although there is increasing evidence of the importance of cysteinyl leukotrienes (LT) as mediators of aspirin-induced bronchoconstriction in aspirin-sensitive asthma, the cellular origin of the LT is not yet clear.. Urinary concentrations of leukotriene E4 (LTE4), 11-dehydrothromboxane B2, 9alpha,11beta-prostaglandin F2, and Ntau-methylhistamine were measured during the 24 h following cumulative intravenous administration of increasing doses of lysine aspirin to asthmatic patients. In addition, the urinary concentrations of these metabolites were measured on 5 consecutive days in a patient who suffered an asthma attack after percutaneous administration of nonsteroidal anti-inflammatory drugs.. In aspirin-induced asthma patients (AIA, n=10), the basal concentration of urinary LTE4, but not the other metabolites, was significantly higher than that in aspirin-tolerant asthma patients (ATA, n=10). After intravenous aspirin provocation, the AIA group showed a 13.1-fold (geometric mean) increase in excretion of LTE4 during the first 3 h, and 9alpha,11beta-prostaglandin F2 also increased in the AIA group during the first 0-3 h and the 3-6 h collection period. Ntau-methylhistamine excretion was also increased, but to a lesser degree. Administration of aspirin caused significant suppression of 11-dehydrothromboxane B2 excretion in both the AIA and ATA groups. When the percentage of maximum increase of each metabolite from the baseline concentrations was compared between the AIA group and the ATA group, a significantly higher increase in excretion of LTE4, 9alpha,11beta-prostaglandin F2, and Ntau-methylhistamine was observed in the AIA group than the ATA group. An increased excretion of LTE4 and 9alpha,11beta-prostaglandin F2 has been detected in a patient who suffered an asthma attack after percutaneous administration of nonsteroidal anti-inflammatory drugs.. Considering that human lung mast cells are capable of producing LTC4, prostaglandin D2, and histamine, our present results support the concept that mast cells, at least, may participate in the development of aspirin-induced asthma.

Topics: Adult; Aged; Aspirin; Asthma; Bronchial Provocation Tests; Cyclooxygenase Inhibitors; Dinoprost; Female; Forced Expiratory Volume; Humans; Leukotriene E4; Male; Mast Cells; Methylhistamines; Middle Aged; Sensitivity and Specificity; Thromboxane A2; Thromboxane B2; Time Factors

Oxidlative stress is believed to play an important role in the pathophysiology of asthma. Recently discovered F2-isoprostanes, of which 8-iso-PGF2alpha is the most well-known isomer, have emerged as the most reliable marker of in vivo oxidative stress. The aim of this study was to examine 8-iso-PGF2alpha as a biomarker of oxidative stress in mild asthma in relation to endogenous and dietary antioxidant protection. Total (free and esterified) plasma 8-iso-PGF2alpha, plasma dietary antioxidants (vitamins E and C, Beta-carotene, Zn, and Se), and erythrocyte antioxidant enzyme activities (glutathione peroxidase and superoxide dismutase) were measured in 15 mild asthmatics and 15 age-and sex-matched controls. Total plasma 8-iso-PGF2alpha levels [median (quartile 1 - quartile 3)] were significantly increased in the asthmatics [213 pg/mL (122-455) vs. 139 pg/mL (109-174), P= 0.042]. The 8-iso PGF2alpha levels were found to be associated with clinical asthma severity (P = 0.044) and inhaled corticosteroid use (P = 0.027) in asthmatics. No differences were observed in the plasma dietary antioxidant vitamins. The asthmatics had significantly lower plasma levels of Zn (P = 0.027) and Se (P = 0.006). Plasma Se correlated negatively with 8-iso-PGF2alpha (r = -0.725, P= 0.002). No differences between the groups were observed for glutathione peroxidase or superoxide dismutase, however, superoxide dismutase activity was negatively associated with asthma severity (P = 0.042). In conclusion, oxidative stress is increased in mildly asthmatics, as reflected by increased plasma levels of 8-iso-PGF2alpha and a deficiency in plasma Zn and Se. The isoprostane 8-iso-PGF2alpha may provide a useful tool in intervention studies aimed at improving clinical status in asthma.

Topics: Adolescent; Adult; Antioxidants; Asthma; Biomarkers; Blood Cell Count; Child; Diet; Dinoprost; Erythrocytes; F2-Isoprostanes; Female; Glutathione Peroxidase; Humans; Lipid Peroxidation; Male; Metals; Oxidative Stress; Phenotype; Superoxide Dismutase; Vitamins

This study was designed to test the hypothesis that hyperventilation-induced bronchoconstriction (HIB) results from the combined effects of prostanoid and leukotriene metabolism. A bronchoscope was used in anesthetized dogs to record peripheral airway resistance and HIB before and after combined treatment with inhibitors of cyclooxygenase (indomethacin) and 5-lipoxygenase (MK-0591). Bronchoalveolar lavage fluid (BALF) cells and mediators from hyperventilated and control airways were also measured. Pretreatment with MK-0591 and indomethacin significantly attenuated, but did not abolish, HIB. However, addition of atropine nearly eliminated the residual response. Blockade of eicosanoid metabolism markedly reduced the concentrations of eicosanoids recovered in BALF after hyperventilation. Positive correlations between posthyperventilation BALF prostanoid and epithelial cell concentrations are suggestive of mucosal injury-induced mediator production and release. We conclude that HIB is prevented in the presence of eicosanoid and muscarinic-receptor blockade and that both classes of eicosanoids contribute similarly to the development of HIB.

Topics: Animals; Arachidonate 5-Lipoxygenase; Asthma; Bronchoalveolar Lavage Fluid; Bronchoconstriction; Cyclooxygenase Inhibitors; Dinoprost; Dogs; Eicosanoids; Epithelial Cells; Hyperventilation; Indomethacin; Leukotrienes; Male; Muscarinic Antagonists; Receptors, Muscarinic; Thromboxane A2

Indomethacin has been used to demonstrate that cyclooxygenase (COX) metabolites of arachidonic acid play a mechanistic role in ozone-induced spirometric decline in normals (Nm). Since the weight of evidence suggests that asthmatics (Asth) do not differ substantially from Nm subjects in the magnitude of their spirometric response to ozone, we sought to determine whether COX metabolites play a similar role in the asthmatic response to ozone. Thirteen (n = 13) Asth and nine (n = 9) Nm volunteers were pretreated with indomethacin or placebo (3 days, 75 mg/day), then exposed for 2 h to 400 ppb ozone or clean air while performing mild intermittent exercise (Vi(min) = 30 L/min.). Baseline changes in spirometry (FVC, FEV(1), FEF(25), FEF(50), FEF(60p), FEF(75)) and soluble markers of COX metabolism (prostaglandin [PG] F2-alpha) were measured from induced sputum samples. Results showed similar reductions in FVC (Asth = 12%, Nm = 10%) and FEV(1) (Asth = 13%, Nm = 11%) in Asth and Nm following ozone. Variables representing small-airways function demonstrated the greatest ozone-induced decline in Asth (FEF(75) = 25%). Indomethacin pretreatment significantly attenuated ozone-induced decreases in FVC and FEV(1) in Nm, but not in Asth. Marked attenuation of ozone-induced decrements in FEF(75) and FEF(60p) was observed in Asth but not in Nm. PGF2-alpha levels were similar in both groups prior to ozone exposure with indomethacin (Asth = 65 pg/ml, Nm = 59 pg/ml), but postexposure levels in Asth were significantly elevated (118 pg/ml) compared to Nm (54 pg/ml). We conclude that COX metabolites, such as PGF2-alpha, play an important but different role in asthmatics than normals with respect to ozone-induced pulmonary function decline. Specifically, COX metabolites contribute to restrictive-type changes in normals and obstructive-type changes in small airways in asthmatics.

Topics: Adolescent; Adult; Asthma; Dinoprost; Female; Humans; Indomethacin; Lung; Male; Ozone; Prostaglandin-Endoperoxide Synthases; Sputum

The airway of asthmatic patients is hyperresponsive to various stimuli in vivo. There are, however, only a few reports that compared the in vivo responsiveness of asthmatic patients and non-asthmatic subjects to those of lung parenchyma in vitro.. To compare the contractile response, release of various chemical mediators, and responsiveness to drugs in samples of lung parenchyma excised from asthma patients with those of non-asthmatic subjects.. Human lung parenchymal strips were subjected to passive sensitization with sera of 5+ RAST titer to mites. The strip was suspended in a magnus bath containing a buffer solution. Parenchymal contraction was induced by PGF2 alpha. After washing, the baseline concentrations of thromboxane B2 (TXB2), leukotriene (LT), and histamine were measured in each bath and then contraction was induced by the addition of a mite antigen. The concentrations of TXB2, LT, and histamine were measured after contraction. The inhibitory effects of TXA2 synthetase inhibitor (DP-1904) and TXA2 receptor antagonist (AA-2414) were also evaluated in both tissue samples.. There were no significant differences between lung parenchymal tissues of asthmatic and non-asthmatic patients with regard to PGF2 alpha-induced contraction, antigen-induced contraction, release of chemical mediators, and the response to drugs.. Unlike the response in vivo, there are no differences in the response to stimuli in vitro between lung parenchymal tissues of asthmatic and non-asthmatic patients.

Topics: Aged; Airway Resistance; Animals; Antigens; Ascaris; Asthma; Benzoquinones; Dinoprost; Dogs; Female; Heptanoic Acids; Histamine Release; Humans; Immune Sera; Immunization, Passive; Leukotrienes; Lung; Male; Middle Aged; Mites; Muscle Contraction; Muscle, Smooth; Radioallergosorbent Test; Smoking; Thromboxane B2; Thromboxane-A Synthase

Oxidative stress has an important role in the pathogenesis of asthma. 8-Isoprostane is a prostaglandin (PG)-F2-like compound belonging to the F2 isoprostane class that is produced in vivo by the free radical-catalyzed peroxidation of arachidonic acid. 8-Isoprostane is a biomarker of oxidative stress, and its concentration is increased in the bronchoalveolar lavage fluid of patients with interstitial lung diseases. We measured 8-isoprostane concentrations in exhaled breath condensate in healthy subjects and in patients with mild (steroid naive, n = 12), moderate (inhaled steroid treatment, n = 17), and severe asthma (oral steroid treatment, n = 15). We also measured exhaled carbon monoxide (CO) and nitric oxide (NO), which may also reflect oxidative stress in the airways. 8-Isoprostane was detectable in breath condensate of normal subjects (15.8 +/- 1.6 pg/ml), and was increased in the breath condensate of patients with mild (33.7 +/- 2.8, p < 0.001), moderate (38.3 +/- 3.7 pg/ml, p < 0. 001), and severe asthma (48.9 +/- 5.0 pg/ml, p < 0.001). There was a positive correlation (r = 0.68, p < 0.05) of 8-isoprostane with NO, but not with CO, in the exhaled air of patients with mild asthma, but not in that of patients with moderate or severe asthma. There was no correlation between 8-isoprostane and lung function tests in any group of patients. Our study shows that oxidative stress is increased in asthmatic subjects as reflected by 8-isoprostane concentrations in breath condensate.

Topics: Adult; Airway Resistance; Asthma; Breath Tests; Bronchi; Carbon Monoxide; Dinoprost; F2-Isoprostanes; Female; Forced Expiratory Volume; Humans; Lipid Peroxidation; Male; Middle Aged; Nitric Oxide; Oxidative Stress; Reactive Oxygen Species

Topics: Asthma; Dinoprost; Humans; Leukotrienes; Mast Cells; Prostaglandins; Thromboxanes

9Alpha,11beta-prostaglandin (PG) F2 is an initial metabolite of PGD2 which has a potent bronchoconstrictive activity.. We measured the urinary levels of 9alpha,11beta-PGF2 in asthmatic children to investigate its role in not only acute asthmatic attack in a time course study but also in exercise-induced asthma (EIA).. In the acute asthma study, 30 asthmatic children were examined. Urine samples were collected on the first, third, and sixth days. Urinary levels of 9alpha,11beta-PGF2 were measured with gas chromatography mass spectrometry using the electron impact method. In the exercise challenge study, 14 children with EIA and 14 children without EIA were studied. Urine samples were collected before exercise challenge, and at 1 h, and 5 h after exercise challenge. Urinary levels of 9alpha,11beta-PGF2 were measured.. Elevated urinary levels of 9alpha,11beta-PGF2, which were observed on the first day when treatment was started in the hospital, were gradually decreased on the third day (P < 0.05), and on the sixth day (P < 0.01). A significant correlation between urinary levels of 9alpha,11beta-PGF2 and symptom scores (P < 0.005) was observed on the first day. In EIA, there was a significant increase in urinary levels of 9alpha,11beta-PGF2 at 1 h (P < 0.01) and at 5 h (P < 0.01) after exercise challenge, but not in the children without EIA.. 9Alpha,11beta-PGF2 may be involved in the pathogenesis of acute and exercise-induced asthma in children.

Topics: Acute Disease; Adolescent; Asthma; Asthma, Exercise-Induced; Child; Child, Preschool; Dinoprost; Female; Gas Chromatography-Mass Spectrometry; Humans; Male; Time Factors

Cyclooxygenase products modulate the expression of nitric oxide synthase (NOS) in certain cell types. We determined the effect of prostaglandins (PG) E2 and F2alpha on exhaled nitric oxide (NO) concentrations measured by chemiluminescence. Inhaled PGE2 and PGF2alpha significantly reduced exhaled NO. After the highest dose of PGE2 (100 micrograms), NO concentrations fell from 6.9 +/- 0.5 ppb to 4.0 +/- 0.8 ppb (p < 0.001), and from 22.9 +/- 2.0 ppb to 12.3 +/- 1. 2 ppb (p < 0.001), whereas after PGF2alpha, it fell from 6.5 +/- 0.6 ppb to 3.0 +/- 0.5 ppb (p < 0.001), and from 26.0 +/- 3.4 ppb to 11. 5 +/- 1.4 ppb (p < 0.001) in normal (n = 7) and asthmatic (n = 8) subjects, respectively. Although the prostaglandins did not change FEV1 in normal subjects, PGE2 caused an increase in asthmatics (from 3.6 +/- 0.3 L to 3.8 +/- 0.4 L, p < 0.05) and PGF2alpha caused a transient reduction in FEV1 from 4.0 +/- 0.2 L to 3.5 +/- 0.2 L (p < 0.05). To further determine the relationship between bronchoconstriction and exhaled NO levels, we examined the effect of inhaled methacholine which did not change exhaled NO concentrations in normal and asthmatic subjects despite a greater than 20% fall in FEV1 in asthmatics. Therefore, PGE2 and PGF2alpha reduce exhaled NO, an effect not related to airway caliber changes but which may result from an inhibition of nitric oxide synthase (NOS), particularly inducible NOS (iNOS).

Topics: Administration, Inhalation; Adult; Asthma; Bronchi; Bronchial Provocation Tests; Bronchoconstriction; Bronchoconstrictor Agents; Bronchodilator Agents; Dinoprost; Dinoprostone; Enzyme Inhibitors; Female; Forced Expiratory Volume; Humans; Luminescent Measurements; Male; Methacholine Chloride; Nitric Oxide; Nitric Oxide Synthase

Topics: Asthma; Biomarkers; Dinoprost; Humans; Inflammation Mediators; Leukotriene E4; Methylhistamines

It is generally accepted that the early asthmatic response to inhaled allergen is a result of IgE-mediated mast cell activation. In contrast, the underlying mechanism of the late asthmatic response is much less clear.. In order to investigate the pattern of mediator release during the early and late asthmatic responses to allergen, measurements of the urinary excretion of the mast cell markers 9alpha,11beta-PGF2 and Ntau-methylhistamine were made. In addition, urinary levels of eosinophil protein X (EPX) and leukotriene E4 (LTE4) were measured.. Twelve mild atopic asthmatics participated in the study. On the study day, pulmonary function was recorded at baseline and for 12 h after inhalation of allergen. Urine was collected prior to challenge and thereafter at 1 h intervals. Measurements of 9alpha, 11beta-PGF2 and LTE4 were made with enzyme-immunoassay, and levels of Ntau-methylhistamine and EPX were analysed with radioimmunoassay.. All subjects developed both an early and late phase airway response. Within 1 h of the early peak airway response, there was a significant increase in the urinary concentrations (AUC/h) of 9alpha, 11beta-PGF2 (49.3 +/- 9.2 to 142.5 +/- 49.2; P < 0.001) Ntau-methylhistamine (10.4 +/- 1.4 to 19.5 +/- 1.4; P < 0.001) and LTE4 (43.7 +/- 5.9 to 105.9 +/- 21.3; P < 0.001). Levels of all three mediators were also significantly increased above baseline during the LAR to 79.4 +/- 9.5 (P < 0.01), 19.8 +/- 1.9 (P < 0.001) and 85.6 +/- 10.4 (P < 0.001), respectively. Levels of EPX remained unchanged during the early and late responses (39.2 +/- 10.2 to 37.5 +/- 18.5, 33.9 +/- 6.8).. These results indicate that mast cell activation is a feature not only of the early but also the late asthmatic response. Finally, increased LTE4 supports the contribution of the leukotrienes to airway obstruction during both phases of the asthmatic response to allergen.

Topics: Adolescent; Adult; Allergens; Asthma; Biomarkers; Blood Proteins; Bronchial Provocation Tests; Dinoprost; Eosinophil-Derived Neurotoxin; Female; Forced Expiratory Volume; Humans; Inflammation Mediators; Leukotriene E4; Lung; Male; Methylhistamines; Ribonucleases; Time Factors

Topics: Antibodies; Antibody Specificity; Aspirin; Asthma; Biomarkers; Chromatography, High Pressure Liquid; Dinoprost; Forced Expiratory Volume; Humans; Hypersensitivity; Immunoenzyme Techniques; Mast Cells; Sensitivity and Specificity

The goal of the current study was to examine the formation of phospholipids, 1-radyl-2-lysosn-glycero-phospholipids (lyso-PL) and 2-acetylated phospholipids (such as PAF) as well as mechanisms responsible for generating these phospholipids in bronchoalveolar lavage fluid (BAI.F) from allergic subjects challenged with antigen. Bronchoalveolar lavage was performed in normal and allergic subjects before, 5-30 min, 6 h, and 20 h after segmental antigen challenge via a wedged bronchoscope. Levels of 1-hexadecyl-2-lyso-phospholipids and 1-hexadecyl-2-acetyl-phospholipids were initially determined by negative ion chemical ionization gas chromatography/mass spectrometry (NICI-GC/MS). Antigen dramatically elevated quantities of 1-hexadecyl-2-lyso-phospholipids in allergic subjects 20 h after challenge when compared to non-allergic controls. In contrast, there was not a significant increase in levels of 1-hexadecyl-2-acetyl-phospholipids after antigen challenge. Closer examination of 1-radyl-2-lyso-sn-glycero-3-phosphocholine (GPC) revealed that 1-palmitoyl-2-lyso-GPC, 1-myristoyl-2-lyso-GPC and 1-hexadecyl-2-lyso-GPC were three major molecular species produced after antigen challenge. 1-palmitoyl-2-lyso-GPC increased sevenfold to levels of 222 +/- 75 ng/ml of BALF 20 h after antigen challenge. The elevated levels of lyso-PL correlated with levels of albumin used to assess plasma exudation induced by allergen challenge. In contrast, the time course of prostaglandin D2 (PGD2) or 9 alpha, 11 beta PGF2 (11 beta PGF2) formation did not correlate with lyso-PL generation. To examine the mechanism leading to lyso-phospholipid formation in antigen-challenged allergic subjects, secretory phospholipase A2 (PI.A2) and acetyl hydrolase activities were measured. There was a significant increase in PLA2 activity found in BALF of allergic subjects challenged with antigen when compared to saline controls. This activity was neutralized by an antibody directed against low molecular mass, (14 kD) human synovial PLA2 and dithiothreitol. Acetyl hydrolase activity also markedly increased in BALF obtained after antigen challenge. This study indicates that high levels of lyso-PLs are present in airways of allergic subjects challenged with antigen and provides evidence for two distinct mechanisms that could induce lyso-PL formation. Future studies will be necessary to determine the ramifications of these high levels of lyso-phospholipids on airway function.

Topics: Adult; Asthma; Bronchoalveolar Lavage; Bronchoalveolar Lavage Fluid; Dinoprost; Female; Gas Chromatography-Mass Spectrometry; Humans; Hypersensitivity; Lysophospholipids; Male; Methacholine Chloride; Prostaglandin D2; Reference Values; Rhinitis; Time Factors

The study revealed the relation of bronchial asthma (bacterial variant) clinical pattern to plasma levels of PGF2 alpha, 6-keto-PGF1 alpha and TxB2. In remission of the disease the above indices are lower. Severe asthma remission is characterized by higher levels of 6-keto-PGF1 alpha and TxB2 than moderate asthma one, demonstrates a tendency to growing PGF2 alpha levels. A rise in PGF2 alpha and TxB2 in manifest asthma points to their participation in bronchospasm formation suggesting an active role of these bronchoconstrictors in asthma pathogenesis. Higher levels of 6-keto-PGF1 alpha are of a compensary nature in the pathogenesis of PGF2 alpha and TxB2 bronchoconstrictory action, and of damaging nature contributing to the formation of bronchial mucosa edema and bronchial gland hypersecretion.

Topics: 6-Ketoprostaglandin F1 alpha; Adolescent; Adult; Asthma; Dinoprost; Female; Humans; Male; Middle Aged; Remission Induction; Severity of Illness Index; Thromboxane A2

Bronchoalveolar lavage (BAL) was performed in healthy subjects (n = 12) and patients with bronchial asthma (n = 11). Between the two groups there was no significant difference in the total number of cells and the percentage of alveolar macrophages (AM), lymphocytes (L), neutrophils (N) and eosinophils (E) in BAL fluids. When AM were cultured in vitro and stimulated with dermatophagoides farinae (DPF) antigen, the amount of PGE released by AM was significantly increased in the asthmatics. When the asthmatics, AM were sensitized with specific IgE positive serum and stimulated with DPF, they released more PGE and PGF2 alpha than those when specific IgE negative serum was used (P < 0.01). The PGE/PGF2 alpha ratio was significantly decreased. There was positive correlation between the decreased value of PGE/PGF2 alpha and patients, MCH-PC20. The increase in the amount of PGE and PGF2 alpha released and the decrease of PGE/PGF2 alpha ratio might play an important role in the pathogenesis of allergic asthma.

Topics: Animals; Antigens; Asthma; Bronchoalveolar Lavage Fluid; Cells, Cultured; Dinoprost; Humans; Immunization; Macrophages, Alveolar; Mites; Prostaglandins E

The activity of phospholipase A2 and its metabolic production-prostaglandins were examined in lung tissue of allergic asthmatic guinea pigs. The results shows that the activity of phospholipase A2 after three days of asthma attack was raised 54.19% than that of control group (P < 0.01), and decreased 69.27% when protected with chloroquine before asthma, and decreased 65.98% when only given chloroquine as a control; the ratio of those prostaglandins was resumed to control group when previously given chloroquine in asthma and normal guinea pigs. These results suggest that the activity of phospholipase A2 and changes of prostaglandins in lung tissue were related to allergic asthma of guinea pigs, the increase of TXB2 or PGF2 alpha and decrease of PGE2 or 6-Keto-PGF2 alpha in lung tissue after three days of asthma attack may have a correlation with allergic asthma in guinea pigs.

Topics: 6-Ketoprostaglandin F1 alpha; Albumins; Animals; Asthma; Chloroquine; Dinoprost; Dinoprostone; Guinea Pigs; Lung; Male; Phospholipases A; Phospholipases A2; Prostaglandins

The in vitro release of endogenous and exogenous PgF2 alpha from plasma and serum proteins by aspirin and other analgesic drugs has been studied by RIA and equilibrium-dialysis techniques, respectively. Before aspirin addition, the mean plasma level of PgF2 alpha measured by RIA was significantly lower in aspirin-sensitive asthma (ASA) patients (11.3 +/- 6.5 pg/ml; n = 8) than in aspirin-tolerant asthma (ATA) patients (25.0 +/- 11.4 pg/ml; n = 21). After aspirin addition (50 micrograms/ml) the mean PgF2 alpha level detected in plasma by RIA was higher in ASA patients (97.6 +/- 5.5 pg/ml) than in ATA patients (66.9 +/- 4.5). The binding of [3H]PgF2 alpha to serum protein was significantly inhibited by NSAIDs but not by paracetamol (0.2-1.0 mM). These results implicate PgF2 alpha and the protein-binding property of analgesic drugs in the pathogenesis of aspirin-sensitive asthma.

Topics: Acetaminophen; Administration, Inhalation; Adult; Aged; Aspirin; Asthma; Dinoprost; Drug Tolerance; Female; Flufenamic Acid; Humans; Indomethacin; Male; Mefenamic Acid; Middle Aged; Phenylbutazone; Prostaglandin-Endoperoxide Synthases

In patients with aspirin-sensitive asthma, no significant changes in plasma beta-thromboglobulin or bicyclic prostaglandin (PG) E2 were observed during aspirin challenge. The addition of aspirin to platelet suspensions from patients with aspirin-sensitive asthma produced no detectable chemiluminescence. Small concentrations of aspirin generated PGF2 alpha but not PGE2 or PGD2 from plasma in vitro. PGF2 alpha levels were significantly higher in plasma from aspirin-sensitive patients and distinguished aspirin-sensitive from aspirin-tolerant patients with asthma. The results of this study suggest that the displacement of protein-bound PGF2 alpha may be of importance in the pathogenesis of aspirin-induced asthma.

Topics: Adult; Aged; Aspirin; Asthma; beta-Thromboglobulin; Blood Platelets; Dinoprost; Dinoprostone; Drug Tolerance; Female; Humans; Luminescent Measurements; Male; Middle Aged; Prostaglandin D2; Prostaglandin-Endoperoxide Synthases

We report here an efficient method for simultaneous and quantitative determinations of plasma prostaglandins (PGs) from asthmatic patients using 9-anthryldiazomethane-reversed-phase high performance liquid chromatography (HPLC). Detection and simultaneous quantitation of 20 pg PGE1, PGE2, PGF2 alpha and 100 pg 6-keto PGF1 alpha, thromboxane B2 (TXB2) was possible by the present method. Preliminary studies showed that plasma TXB2 levels from stable asthmatic patients were elevated compared with normal healthy subjects, suggesting pathophysiologic implications regarding PGs and TXB2 in asthma may be elicited by the present HPLC method.

Topics: Anthracenes; Asthma; Chromatography, High Pressure Liquid; Dinoprost; Dinoprostone; Fluorometry; Humans; Microchemistry; Prostaglandins; Radioimmunoassay; Thromboxane B2; Time Factors

1. Guinea-pigs were sensitized with 3 injections of ovalbumin (OA) (1 or 10 micrograms per animal) using Al(OH)3 and pertussis vaccine as adjuvants at two week intervals. 2. Sensitized guinea-pigs were challenged with an aerosol of OA (0.1%) over a one hour period and both airway reactivity and cellular content of bronchoalveolar lavage (BAL) fluid were assessed at intervals for up to 7 days. 3. Guinea-pigs sensitized with 1 microgram of ovalbumin responded to an aerosol of OA with increased pulmonary airway eosinophilia, which was evident 1 day after challenge and was present for up to 7 days. Airway hyperreactivity was not detectable in these animals. 4. Guinea-pigs sensitized with 10 micrograms of ovalbumin responded to an aerosol of OA with increased pulmonary airway neutrophilia and eosinophilia and with increased airway reactivity which was maximal between 8 and 24 h after exposure to OA. 5. Depletion of circulating platelets or neutrophils, by use of selective antisera, did not alter either the magnitude of eosinophilia or the intensity of airway reactivity in sensitized guinea-pigs (10 micrograms) exposed to an aerosol of OA. 6. Pretreatment of sensitized guinea-pigs (10 micrograms) for 6 days with AH 21-132, aminophylline, dexamethasone or ketotifen inhibited pulmonary airway eosinophilia, but did not diminish airway hyperreactivity. Neither eosinophil accumulation nor development of airway hyperreactivity was influenced by treatment with mepyramine or salbutamol over a 6 day period before OA inhalation. 7. Although eosinophilia may occur in association with increased airway reactivity in this animal model, there is no evidence of a causal relationship.

Topics: Animals; Asthma; Blood Platelets; Bronchoalveolar Lavage Fluid; Dinoprost; Eosinophils; Guinea Pigs; Histamine; In Vitro Techniques; Lung; Male; Neutrophils; Ovalbumin; Passive Cutaneous Anaphylaxis; Pertussis Vaccine; Rabbits; Respiratory Hypersensitivity

Recently identified Ascaris suum sensitive cynomolgus monkeys were further characterized to determine if a chronologic relationship existed between mediator release and onset of bronchoconstriction. In these anesthetized Ascaris-sensitive monkeys, aerosol antigen challenge of each animal produced rapid and severe bronchoconstriction, as determined by decreases in dynamic lung compliance (-80.2 +/- 4.1%) and airway conductance (-64.5 +/- 13.8%). Maximum changes were achieved within 5 min following exposure and remained substantially altered throughout the 30 min observation period. However, changes in pulmonary function related to duration of onset and maximum change seemed to have some correlation with each animals' sensitivity to the antigen. Comparison of pre- and post-challenge blood gas profiles, showed a progressive formation of respiratory acidosis through decreases in arterial blood pH, partial pressure of O2 (pO2), O2 saturation (sO2) and an increase in partial pressure of CO2 (pCO2). When arterial blood plasma was assayed by RIA for mediators of anaphylaxis, large increases in 5-hydroxyeicostetraenoi acid (5-HETE), leukotriene B4 (LTB4) and histamine were observed. No amount of prostaglandin F2-alpha (PGF2 alpha) or thromboxane A2 were detected. Two of the three monkeys also produced detectable amounts of leukotriene C4 (LTC4). Therefore, in Ascaris-sensitive monkeys, histamine is the predominate mediator released and is probably responsible for at least the early part (5-10 min) of the observed bronchoconstriction. However, mediators from the lipoxygenase pathway may also be playing a role in the antigen-induced bronchoconstriction, especially beyond the 10 min period following anaphylaxis.

Topics: Animals; Antigens, Helminth; Ascaris; Asthma; Dinoprost; Histamine; Histamine Release; Hydroxyeicosatetraenoic Acids; Leukotrienes; Macaca fascicularis; Male; Radioimmunoassay; Respiratory Function Tests; Thromboxane B2; Time Factors

The effects of 9-methyl-3-(1H-tetrazol-5-yl)-4H-pyrido[1,2-a]pyrimidin-4-one potassium salt (TBX), a new antiallergic drug, on histamine release from lung fragments, experimental asthma and isolated tracheal muscle were investigated in guinea pigs. TBX (10(-7) to 10(-4) g/ml) dose-dependently inhibited antigen-induced histamine release from lung fragments of guinea pigs passively sensitized with homologous IgE serum. Antigen inhalation-induced experimental asthma in passively sensitized animals was inhibited in a dose-dependent fashion by i.v. (1 to 5 mg/kg) and p.o. (10 to 100 mg/kg) administrations of TBX. In vivo bronchoconstriction by platelet-activating factor (PAF, i.v.) was also inhibited by TBX (0.3 to 10 mg/kg, i.v.). However, high concentrations of TBX (more than 3 x 10(-4) g/ml) were needed to inhibit PAF-induced platelet aggregation in vitro. With regard to the effect on isolated tracheal muscle, TBX itself at concentrations higher than 10(-5) g/ml induced dose-dependent reduction in the resting tonus, which was not affected by pretreatment with propranolol. Neither the leukotriene D4-induced contraction nor the prostaglandin F2 alpha-induced one was specifically antagonized by TBX. The results obtained indicate that TBX is an antiasthmatic agent effective in inhibiting both IgE- and PAF-induced bronchoconstriction, possibly by interfering with mediator release.

Topics: Animals; Asthma; Bronchi; Dinoprost; Guinea Pigs; Histamine Antagonists; Histamine Release; In Vitro Techniques; Lung; Male; Muscle Contraction; Muscle Relaxation; Muscle, Smooth; Platelet Activating Factor; Platelet Aggregation; Pyridines; Pyrimidinones; SRS-A; Trachea

In this study we investigated the effect of the selective and potent thromboxane A2 (TxA2) receptor antagonist GR32191 on smooth muscle contraction induced by the TxA2 analogue U46619, prostaglandin (PG) D2, PGF2 alpha, and methacholine (MCh) in guinea pig airways in vitro and the airways response provoked by inhaled PGD2 and MCh in asthmatic subjects in vivo. GR32191 antagonized competitively the contractile responses of all three prostanoids to a similar degree but had no effect on MCh-induced contractions. In asthmatic subjects GR32191, in a single oral dose of 80 mg, did not affect base-line airway caliber or MCh-induced broncho-constriction but caused significant inhibition of PGD2-induced bronchoconstriction, displacing the concentration-response curves to the right by greater than 10-fold. The effect of the same oral dose of GR32191 on allergen-induced immediate bronchoconstriction was subsequently investigated in allergic asthmatic subjects. In individual subjects, GR32191 inhibited to varying degrees the overall bronchoconstrictor response, with the maximum effect occurring between 10 and 30 min after allergen challenge. These studies suggest that prostanoids contribute to the immediate bronchoconstriction induced by inhaled allergen in allergic asthmatics, and that this effect is mediated by stimulation of a thromboxane receptor.

Topics: 15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid; Adolescent; Adult; Animals; Asthma; Biphenyl Compounds; Bronchi; Dinoprost; Guinea Pigs; Heptanoic Acids; Histamine; Humans; Male; Methacholine Compounds; Prostaglandin D2; Prostaglandin Endoperoxides, Synthetic; Receptors, Prostaglandin; Receptors, Thromboxane; Thromboxane A2

The blood levels of stress mediators--catecholamines (adrenaline and noradrenaline), parameters characterizing the intensity of lipid peroxidation (hydroperoxides, blood antioxidant activity (from the levels of SH groups), and the content of prostaglandins F2 alpha and E (PGF2 alpha and PGE) were measured in patients with bronchial asthma and chronic asthmatic bronchitis before and after exercise. The studies have revealed that bronchial hyperreactivity to exercise is in accord with the high blood levels of catecholamines, hydroperoxides, PGF2 alpha and low content of thiol group reflecting the depression of the total antioxidant system in asthmatics. Increase of catecholamine, hydroperoxide, and PGF2 alpha levels and decrease of the total thiol group content after muscular exercise in the patients with bronchial asthma is in accord with the bronchial reactivity. Changes in the bronchoconstrictor PGF2 alpha are the most marked and measurements of its blood levels and computation of the PGF2 alpha/PGE coefficient may help assess the bronchial hyperreactivity without resorting to provocative tests.

Topics: Adult; Asthma; Bronchi; Bronchial Provocation Tests; Dinoprost; Exercise; Female; Humans; Male; Middle Aged; Prostaglandins E

Airway reactivity to histamine was determined in a group of non-asthmatic and asthmatic patients prior to thoracotomy. The latter group was more reactive to histamine provocation than the former (PC40: 28.40 +/- 6.27 mg/ml and 1.15 +/- 0.19 mg/ml, respectively). Subsequent to the surgical intervention, isolated human bronchial muscle preparations were obtained from both groups (15 non-asthmatic and 5 asthmatic subjects). Histamine concentration-effect curves were generated both in the absence and in the presence of indomethacin (1.7 microM; 30 min). Neither the basal tone nor the histamine response and sensitivity of the preparations were altered by the antiinflammatory drug. In bronchial preparations from one asthmatic subject, indomethacin significantly reduced the prostaglandin production during histamine contraction. Prostaglandin E2 and F2 alpha contracted isolated human bronchial muscle preparations from these asthmatic individuals. These data suggest that endogenous prostaglandins may not regulate the contractile response to histamine in vitro.

Topics: Acetylcholine; Asthma; Bronchi; Dinoprost; Dinoprostone; Histamine; Humans; In Vitro Techniques; Indomethacin; Muscle Contraction; Muscle, Smooth; Reference Values

Topics: Adult; Aged; Aspirin; Asthma; Bronchial Provocation Tests; Dinoprost; Female; Histamine; Humans; Male; Methacholine Chloride; Methacholine Compounds; Middle Aged; SRS-A

We have demonstrated that PGF2 alpha potentiates airway contraction in vitro and suggested that this response may be mediated by TxA2. We have localized the site of action of PGF2 alpha to a point distal to the parasympathetic ganglion and shown that it is a specific effect since PGD2 produces no similar potentiation. The mechanism of the potentiation may be by a direct alteration in smooth muscle sensitivity induced by TxA2 (Fig. 4). In our previous studies we have been able to induce hyperresponsiveness in vivo (Berend et al., 1986) but no increased responsiveness in vitro (Armour et al., 1987b). In vivo airway hyperresponsiveness may depend on the presence of a mediator like TxA2 which has a short half-life, is produced by continual stimulation of inflammatory cells and which is "washed out" in vitro once the source of stimulation is removed. The fact that we can demonstrate an increase in sensitivity in vitro using PGF2 alpha or a TxA2 analogue, combined with the fact that both mediators are released from a variety of inflammatory cells suggests that one or both of these agents may mediate part of the increased responsiveness observed in asthma.

Topics: Animals; Asthma; Bronchi; Bronchial Spasm; Carbachol; Dinoprost; Histamine; Muscle, Smooth; Prostaglandins F; Rabbits; Thromboxane A2; Trachea

Recent studies of laboratory-provoked asthma have suggested that asthma is an inflammatory disease of lower airways. The purpose of this study was to measure the systemic elaboration of 2 bronchoconstrictive inflammatory mediators during naturally acquired acute asthma utilizing a prospective, serial-sampling protocol. Plasma levels of 13,14-dihydro-15-keto-PGF2 alpha and histamine were measured by radioimmunoassay and radioenzymatic assay, respectively, in 23 children with acute asthma. Mean PG metabolite and histamine values (pg/ml) before (167 +/- 72, 1,029 +/- 378) and 10 to 90 min after (377 +/- 145, 1,000 +/- 489) initial therapy were significantly higher than those of the same children after resolution of asthma (2.9 +/- 0.2, 260 +/- 42) and those of normal children (4.3 +/- 0.9, 240 +/- 14). Peak PG metabolite levels were significantly higher in children who presented with PEFR values (% predicted) less than 40% (1,234 +/- 432) compared with those who presented with greater than 40% (404 +/- 296), and in children with post-therapy improvement in PEFR of less than 20% (1,281 +/- 470) compared with those with greater than 20% (365 +/- 226). Histamine levels were significantly higher in children with post-therapy improvement in PEFR of less than 20% (2,560 +/- 1,600) compared with those with greater than 20% (475 +/- 100), and in hospitalized (3,915 +/- 1,910) compared with nonhospitalized (408 +/- 130) children. Significant differences were not observed on the basis of corticosteroid dependence, allergic disposition, or type of initial therapy. These data suggest a role for histamine and PGF2 alpha in the pathogenesis of airway inflammation in acute asthma.

Topics: Acute Disease; Adolescent; Asthma; Child; Child, Preschool; Dinoprost; Histamine; Hospitalization; Humans; Peak Expiratory Flow Rate; Prospective Studies

The aim of this study was to investigate circadian variation in concentrations of arachidonic acid (AA) metabolites in relation to the circadian pattern in bronchial patency. Blood samples were obtained at 4-hr intervals from 2000 of 1 day until 1400 of the next from 12 diurnally active asthmatic and six diurnally active non-asthmatic patients. Bloods were analyzed for the prostanoids thromboxane A2 (measured as stable metabolite 6-keto-PGF1a), PGE2 and PGF2a. Airways patency was assessed by self-measurement of peak expiratory flow (PEF). In asthmatics, circadian variation was detected in PEF as well as PGE2 and TXB2. The circadian trough of the PEF rhythm closely coincided with the circadian peak of the PGE2 and TXB2 rhythms. In the controls, the PEF was not circadian rhythmic. Of the AA metabolites only 6-keto-PGF1a exhibited 24-hr bioperiodicity in the controls. The controls exhibited a significantly higher circadian mean of PEF (P less than 0.001), while the asthmatics had a lower 24-hr average PGE2 but greater mean TXB2/PGE2 ratio. The obstructive effect caused by the overall 24-hr deficiency of PGE2 in asthmatics is possibly amplified by the increased of TXB2 during the early morning hours. This dissociation of the temporal patterns in TXB2 and PGE2 levels over the 24 hr is discussed as a characteristic finding for asthmatics.

Topics: Adult; Arachidonic Acids; Asthma; Circadian Rhythm; Dinoprost; Dinoprostone; Female; Humans; Male; Middle Aged; Peak Expiratory Flow Rate; Prostaglandins F; Reference Values; Thromboxane B2

Topics: Adult; Airway Resistance; Asthma; Dinoprost; Forced Expiratory Volume; Histamine; Humans; Male; Maximal Expiratory Flow Rate; Prostaglandin D2; Prostaglandins D; Prostaglandins F

In this study, we have investigated the contribution of cholinergic-mediated bronchoconstriction in the airway response provoked by inhaled prostaglandin (PG)D2, its metabolite 9 alpha, 11 beta-PGF2, and PGF2 alpha, which are generated during mast cell activation in vivo and are potent bronchoconstrictor agonists in humans. The effect of prior inhalation of 1 mg ipratropium bromide (IB) on the bronchoconstrictor response to inhaled methacholine (MCh), PGD2, 9 alpha, 11 beta-PGF2, and PGF2 alpha was determined in 7 allergic asthmatic subjects by measuring changes in SGaw, FEV1, and Vmax30. Methacholine, PGD2, and 9 alpha, 11 beta-PGF2 caused concentration-related bronchoconstriction with PGD2 and 9 alpha, 11 beta-PGF2 being between 45 and 112 times more potent than MCh (p less than 0.05), depending on the method used to measure airway caliber. Preinhalation of IB displaced the concentration response curves to MCh between 69- and 196-fold to the right, and this was significantly greater than that observed with PGD2 (12- to 23-fold, p less than 0.02) and 9 alpha, 11 beta-PGF2 (12- to 22-fold, p less than 0.02). Ipratropium bromide inhibited the bronchoconstriction achieved with the highest concentration of agonist by 73 to 91% with MCh, 46 to 79% with PGD2, and 32 to 38% with 9 alpha, 11 beta-PGF2. Ipratropium bromide did not affect the bronchoconstriction pattern to inhaled PGF2 alpha, irrespective of the nature of the response. We conclude that although PGD2 and 9 alpha, 11 beta-PGF2 are potent contractile agonists of human smooth muscle in vitro, bronchoconstriction observed with these mediators in vivo results from a combination of both direct and cholinergic-mediated mechanisms.

Topics: Adult; Airway Resistance; Asthma; Bronchi; Dinoprost; Forced Expiratory Flow Rates; Forced Expiratory Volume; Humans; Ipratropium; Male; Methacholine Chloride; Methacholine Compounds; Parasympathetic Nervous System; Prostaglandin D2; Prostaglandins; Prostaglandins D; Prostaglandins F

Prostaglandin (PG) D2, the predominant prostanoid released from activated mast cells in humans is initially metabolized by reduction of the C-11 keto function to yield 9 alpha,11 beta-PGF2. In this study the airways effects of 9 alpha,11 beta-PGF2 were compared with those of its epimer 9 alpha,11 alpha-PGF2 (PGF2 alpha) and PGD2. 9 alpha,11 beta-PGF2 was a potent contractile agonist of isolated guinea pig trachea and 4-mm human airways in vitro; the potencies of the PGs relative to PGD2 (= 1.00) being 0.65 (NS) and 4.08 (P less than 0.001) for 9 alpha,11 beta-PGF2, and 0.52 (P less than 0.01) and 2.40 (P less than 0.001) for PGF2 alpha, respectively. When inhaled by asthmatic subjects, 9 alpha,11 beta-PGF2 was a potent bronchoconstrictor agent, being approximately equipotent with PGD2 and 28-32 times more potent than histamine (P less than 0.01). These studies suggest that 9 alpha,11 beta-PGF2 is at least equipotent with PGD2 as a bronchoconstrictor agonist, and in being a major metabolite of PGD2, could contribute to the bronchoconstrictor effect of this mast cell-derived mediator in asthma.

Topics: Adult; Airway Resistance; Animals; Asthma; Bronchi; Dinoprost; Forced Expiratory Volume; Guinea Pigs; Histamine; Humans; Lung Volume Measurements; Male; Muscle Contraction; Prostaglandin D2; Prostaglandins D; Prostaglandins F; Trachea

Human plasma has been reported to inhibit the conversion of arachidonic acid into prostaglandin (PG) E2 and PGF2 alpha. In the present study the plasma inhibitory activity was determined in three groups (16 each) of plasma obtained from normal healthy volunteers, treated asthmatics and untreated asthmatic patients. The result showed that plasma from all three groups were equally effective in inhibiting the biosynthesis of PGE2. Plasma of normal volunteers and treated asthmatics also inhibited PGF2 alpha biosynthesis. In contrast the plasma obtained from untreated asthmatics was considerably less active in inhibiting the biosynthesis of PGF2 alpha than plasma from the other two groups.

Topics: Asthma; Blood Proteins; Dinoprost; Dinoprostone; Humans; Prostaglandin Antagonists; Prostaglandins E; Prostaglandins F

Angiotensin converting enzyme activity, prostaglandin F2 alpha and immunoglobulin E level have been studied in 35 asthmatic and 20 control children. The patients were divided in three groups: sever, mid-severe and moderate according to the severity of asthma. Angiotensin converting enzyme activity was the lowest in the severe and mid-severe groups. Prostaglandin F2 alpha was high in all three asthmatic groups. Immunoglobulin E level was highest in the severe group, but in the mid-severe and moderate groups it was high too. There was a significant negative correlation between prostaglandin F2 alpha level and angiotensin converting enzyme activity. Neither we found a correlation between the levels of prostaglandin F2 alpha and immunoglobulin E, nor between the immunoglobulin E level and angiotensin converting enzyme activity. These data suggest that angiotensin converting enzyme and prostaglandin F2 alpha may play a primary or secondary role in control of vascular tone of asthma bronchiale.

Topics: Adolescent; Asthma; Child; Dinoprost; Female; Humans; Immunoglobulin E; Male; Peptidyl-Dipeptidase A; Prostaglandins F

Topics: Adult; Aspirin; Asthma; Dinoprost; Drug Hypersensitivity; Female; Humans; Hypergammaglobulinemia; Immunoglobulin E; Male; Middle Aged; Prostaglandins E; Prostaglandins F

Topics: Adult; Asthma; Dinoprost; Female; Forced Expiratory Flow Rates; Histamine; Humans; Male; Maximal Expiratory Flow-Volume Curves; Middle Aged; Prostaglandins F; SRS-A

There appears to be a close interrelationship among airway responsiveness to mediators and to natural stimuli, the presence and severity of asthma, and endogenous mediator release in the airways. Histamine and methacholine have been most commonly used to measure airway responsiveness. Airway responsiveness to the two drugs is increased in patients with current symptoms of asthma, and the degree of increase relates closely to the degree of variable airflow obstruction and the therapy to control symptoms. The degree of airway responsiveness to histamine also correlates closely with the degree of responsiveness to methacholine and less closely with responsiveness to PGF2 alpha and to natural stimuli such as exercise and allergens. The less close correlations with responsiveness to exercise and allergens is probably because of variations in the ease and type of endogenous mediator release in the airways by these stimuli. Endogenous mediator release from a number of stimuli including allergens and ozone causes inflammation in the airways, asthma, and airway hyperresponsiveness. These various interrelationships indicate that the treatment of asthma should be directed to reduce airway responsiveness, prevent mediator release, and prevent or reverse inflammation.

Topics: Airway Resistance; Asthma; Bronchial Provocation Tests; Dinoprost; Histamine; Humans; Inflammation; Lung; Methacholine Chloride; Methacholine Compounds; Prostaglandins; Prostaglandins F; SRS-A

Eighteen patients with a history of urticaria or asthma, or both, induced by aspirin were studied before and after provocation of symptoms with aspirin. The plasma prostaglandin F2 alpha concentration, which was characteristically raised before challenge, fell significantly at the time of adverse reactions. Repeated administration of aspirin up to a dose of 650 mg daily induced tolerance in most of the patients, and several developed bronchodilator responses to aspirin. Although median total IgE concentrations may be raised in patients with aspirin sensitivity, it appears likely that pharmacological rather than immunological mechanisms are chiefly responsible for the phenomena of aspirin sensitivity and desensitisation.

Topics: Adolescent; Adult; Aspirin; Asthma; Bronchial Provocation Tests; Dinoprost; Dinoprostone; Female; Humans; Immunoglobulin E; Male; Middle Aged; Peak Expiratory Flow Rate; Prostaglandins E; Prostaglandins F; Skin Tests; Time Factors; Urticaria

In the present study the relationship between plasma prostaglandins (PGs) level and the immuno-inflammatory reactions, known to accompany bronchial asthma and/or schistosomiasis infection, was investigated. It was found that plasma PGF2 alpha increased significantly above the control values in 30 asthmatics, 30 schistosomal and 30 asthmatic schistosomal patients. Plasma PGE increased also together with that of PGF2 alpha which is considered to be useful for the protection of the patient against the injurious effects of the infection, due to the known opposing actions of PGE to those of PGF2 alpha.

Topics: Adolescent; Adult; Aged; Asthma; Dinoprost; Humans; Middle Aged; Prostaglandins; Prostaglandins E; Prostaglandins F; Schistosomiasis

Although prostaglandin D2 is the most abundant prostanoid generated by human lung mast cells and causes bronchoconstriction in animals, its effects have not been studied in human beings. We have compared the effects of inhaled prostaglandin D2 and prostaglandin F2 alpha on specific airway conductance in seven normal subjects and seven patients with mild allergic asthma. In dose-response studies in normal subjects, prostaglandin D2 caused a significant (20 +/- 6 per cent) fall in specific airway conductance after the two highest concentrations (250 and 500 micrograms per milliliter), whereas prostaglandin F2 alpha had no effect. In the asthmatic subjects, both prostaglandin D2 and prostaglandin F2 alpha caused a dose-related fall in specific airway conductance, starting at the lowest concentration of 4 micrograms per milliliter. Prostaglandin D2 was 3.5 times more potent than prostaglandin F2 alpha. In a single-dose study of both drugs (250 micrograms per milliliter), a minor fall in specific airway conductance occurred with prostaglandin D2 in the normal subjects, and a larger fall occurred with both drugs in the asthmatic subjects. Maximum effects were seen at three minutes: there was a 75 +/- 5 per cent fall with prostaglandin D2 and a 33 +/- 8 per cent fall with prostaglandin F2 alpha. These results suggest that prostaglandin D2 may be involved in the pathogenesis of bronchoconstriction in allergic asthma.

Topics: Adult; Airway Resistance; Asthma; Bronchi; Dinoprost; Dinoprostone; Dose-Response Relationship, Drug; Heart Rate; Histamine; Humans; Male; Prostaglandins E; Prostaglandins F

Prostaglandin F2 alpha (PGF2 alpha) is generated by human lung tissue in response to a number of stimuli and is widely viewed as a bronchoconstrictor mediator. We have shown that aerosolized PGF2 alpha in concentrations between 1 and 100 micrograms/ml caused dose-related bronchoconstriction, but that continued stimulation at higher concentrations resulted in a partial return of pulmonary function toward control, suggesting that airways were refractory to further stimulation. To explore the mechanism and specificity of airway refractoriness induced by PGF2 alpha, we examined bronchomotor responses evoked by repeated PGF2 alpha stimulation, repeated histamine stimulation, and PGF2 alpha stimulation followed by histamine. Studies were carried out on 3 separate days in 7 subjects with allergic asthma. For each subject the aerosol concentration of each agonist remained constant throughout the study. Responses were measured as the percent change in FEV1 versus time, and comparisons were made between the first and second agonist challenge of each study day. We found that prior stimulation with PGF2 alpha resulted in diminished airway responsiveness, not only to PGF2 alpha but to histamine as well. In contrast, similar refractoriness could not be induced by repeated histamine stimulation, indicating that the PGF2 alpha-induced decrease in responsiveness was not a nonspecific effect of bronchoconstriction per se. Further, the finding that PGF2 alpha caused a decrease in the response to histamine suggests that diminished airway responsiveness was not due to down-regulation of specific PGF2 alpha receptors. Our findings suggest that in addition to its bronchoconstrictor properties, PGF2 alpha may play a role in the modulation of acute airway responses.

Topics: Adolescent; Adult; Aerosols; Asthma; Bronchi; Bronchial Provocation Tests; Bronchial Spasm; Dinoprost; Dose-Response Relationship, Drug; Forced Expiratory Volume; Histamine; Humans; Male; Prostaglandins F

The effects of leukotriene C4 (LTC4), prostaglandin F2 alpha (PGF2 alpha), histamine, and bradykinin upon intratracheal pressure and nerve activity from rapidly-adapting receptors (RARs) before and after the nonsteroidal anti-inflammatory drugs salicylic acid (SA) and aspirin (ASA, acetylsalicylic acid) have been studied in guinea pigs. All mediators increased tracheal pressure and nerve activity in a time-dependent manner. The peak in nerve activity always preceded the peak in tracheal pressure. Neither SA or ASA blocked the effects of histamine or PGF2 alpha upon tracheal pressure or nerve activity. ASA and even SA blocked the effects of bradykinin on both parameters. While SA had no effect on LTC4, ASA blocked the effects of LTC4 upon both tracheal pressure and nerve activity. These results suggest that both LTC4 and bradykinin may act through mediators derived from arachidonic acid not only in increasing tracheal pressures but also to increase RAR nerve activity.

Topics: Animals; Aspirin; Asthma; Bradykinin; Dinoprost; Guinea Pigs; Histamine; Mechanoreceptors; Muscle, Smooth; Pressure; Prostaglandins F; Pulmonary Stretch Receptors; Salicylates; Salicylic Acid; SRS-A; Trachea

Topics: Adolescent; Adrenergic alpha-Antagonists; Adult; Aged; Asthma; Dinoprost; Female; Humans; Male; Metaproterenol; Middle Aged; Prostaglandins F; Quinazolines

Tests of bronchial reactivity in man may help in understanding the nature of bronchial hyperreactivity which is characteristic of asthmatic subjects. Comparison of published studies is, at present, limited because diverse methods have been used to study and to report the results of bronchial provocation tests. The factors which affect the response include the type of provoking agent used, the method of delivery, the lung function test used, the method of expressing the result and "subject" factors. The effect of each of these factors is reviewed. Histamine and methacholine are the most useful substances for distinguishing normal from asthmatic subjects, the technique of provocation appears to have only a small effect on the results and, the FEV1 appear to be the best test for distinguishing asthmatic from normal subjects. It is recommended that, whenever possible, the whole dose response curve is reported with the percent change in FEV1 plotted against the dose delivered on a log scale.

Topics: Allergens; Asthma; Bronchi; Bronchial Provocation Tests; Dinoprost; Gases; Histamine; Humans; Methacholine Chloride; Methacholine Compounds; Physical Stimulation; Prostaglandins F; Respiration; Respiratory Function Tests; Respiratory Hypersensitivity

Topics: Acetylcholine; Allergens; Asthma; Dinoprost; Histamine; Humans; Neuraminic Acids; Prostaglandins F

Prostaglandins appear to have cytoprotective effects in the upper bowel and are released in increased amounts in patients with abnormal peristalsis and diarrhea. Drugs which interfere with prostaglandin (PG) synthesis often prevent the symptoms of food intolerance and have been reported as improving food-related symptoms in the irritable bowel syndrome.

Topics: Adult; Asthma; Dinoprost; Dinoprostone; Eczema; Female; Food Hypersensitivity; Humans; Intestinal Mucosa; Prostaglandins; Prostaglandins E; Prostaglandins F; Urticaria

Topics: Adult; Asthma; Bronchial Provocation Tests; Bronchial Spasm; Dinoprost; Female; Humans; Male; Prostaglandins E; Prostaglandins F; Radioimmunoassay

Topics: Adult; Aged; Asthma; Dinoprost; Female; Humans; Male; Middle Aged; Pleural Effusion; Pleurisy; Prostaglandins; Prostaglandins E; Prostaglandins F; Pulmonary Heart Disease

Aspirin and many other analgesics may be hazardous for some patients with asthma. These patients, numbering approximately 10% to 15% of all asthmatics, have a clinical course that has been well characterized. The diagnosis is usually made from the history, but sometimes it requires analgesic challenge tests. The pathogenesis remains controversial. It appears that the analgesics responsible for the syndrome inhibit prostaglandin synthesis, and this action in turn causes the release of potent bronchoconstrictors such as SRS-A, histamine, or kinins. Usually, recognition of the syndrome and careful avoidance of prostaglandin synthesis inhibitors in affected patients are the two steps needed for effective management. Persistent symptoms, however, may require aminophylline, corticosteroids, and disodium cromoglycate as well. Recent developments may allow these patients to use substituted aspirin analogues or even aspirin itself under certain conditions. Further investigation of the prostaglandins may promote a better understanding of asthma.

Topics: Alprostadil; Analgesics; Aspirin; Asthma; Dinoprost; Dinoprostone; Drug Hypersensitivity; Humans; Prostaglandins; Prostaglandins E; Prostaglandins F; SRS-A

Topics: Adolescent; Adult; Asthma; Dinoprost; Dinoprostone; Humans; Macrophage Activation; Macrophages; Middle Aged; Prostaglandins E; Prostaglandins F; Thromboxane B2

Plasma concentrations of prostaglandins E2 (PGE2) and F2a (PGF 2a) are studied in venous and arterial blood in 14 healthy subjects and 32 asthmatic patients. In the asthmatic patients we found: (1) a good correlation between PGE2 concentration in venous blood and the seriousness of the airway obstruction; (2) a good correlation between PGE2 and PGF2a in the arterial blood, but not in the venous blood; (3) a decrease in the arterial concentrations of PGE2 and PGF2a after fenoterol-induced bronchodilatation, but the variations of PGE2 and PGF2a still correlate. None of these results were obtained in normal subjects. It seems that the asthmatic allergic patient has a disorder of the metabolism of prostaglandins in the lungs; however, the results obtained do not allow us to say if it is a causal condition or a metabolic consequence of the bronchospasm. Concerning the venous blood, there could be an increase in the peripheral production of PGE2 which might result from the hypoxemia following airway obstruction.

Topics: Adolescent; Adult; Airway Obstruction; Arteries; Asthma; Dinoprost; Dinoprostone; Fenoterol; Humans; Lung; Middle Aged; Prostaglandins E; Prostaglandins F; Veins

Topics: Asthma; Dinoprost; Humans; Lung; Physical Exertion; Prostaglandins F; Radioimmunoassay; Respiration; Thromboxane B2; Thromboxanes