Abstract
Aim
MicroRNAs (miRNAs) are noncoding RNAs that play a role in regulation of inflammation and cancer. It has been shown that miRNA-21 and 24 are downregulated in the exhaled breath condensate (EBC) of children with chronic inflammatory lung disease and asthma. A prospective study was performed to evaluate the miRNA-21 and 24 levels in the EBC of patients with esophageal atresia and tracheoesophageal fistula (EA-TEF).
Methods
Patients operated for EA-TEF were evaluated for age, sex, type of anomaly, surgical treatment, and respiratory problems. 500–1000 μl of EBC was obtained from all patients with Ecoscreen. miRNA-21 and 24 levels in EBC were analyzed with ELISA. The results of the study group were compared with a control group (CG) consisting of healthy children with no history of respiratory problems and allergy (n = 17). miRNA levels were compared with respiratory problems and gastroesophageal reflux (GER).
Results
Nineteen patients with EA-TEF with a mean age of 7.8 ± 3.2 years were enrolled in the study. The male–female ratio was 10:9. The mean age of the CG was 9.1 ± 3.6 years (P > 0.05). Distal fistula (78.9%) was the most common type of anomaly. 76.5% of cases required esophageal dilatations for strictures and 15.8% of them had fistula recurrence. Fifteen of the cases with EA were diagnosed as hyperreactive airway disease and require medical treatment. When miRNA levels were compared with CG (median = 0.68), EA cases had significantly decreased levels of miRNA-21 (median = 0.64, P < 0.05). There was no difference between groups for miRNA-24 levels (P > 0.05). The miRNA levels were also compared in patients with EA, according to positive pH testing for GER, use of proton pump inhibitor (PPI) treatment, and need for fundoplication. Patients with GER in pH test (median = 0.66) and fundoplication (median = 0.66) had increased levels of miRNA-21 than patients without reflux (median = 0.63) and surgical treatment (median = 0.64) (P < 0.05). The levels of miRNA-21 and 24 did not show any significant difference in patients with and without PPI treatment (P > 0.05).
Conclusion
The decreased levels of miRNA-21 in EBC suggest a hyperreactive airway problem in EA patients. Increased miRNA levels in EBC are associated with GER and its surgical treatment.
Oxidative stress markers are elevated in exhaled breath condensate of workers exposed to nanoparticles during iron oxide pigment production
